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Nursing Students' Experience of Moral Distress in Clinical Settings: A Phenomenological Study Publisher Pubmed



Dehkordi LM1 ; Kianian T2 ; Nasrabadi AN3
Authors
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Authors Affiliations
  1. 1. Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Nursing and Midwifery Care Research center, Iran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical sciences, Tehran, Iran

Source: Nursing Open Published:2024


Abstract

Aim: To explore nursing students' moral distress (MD) experiences in clinical settings. Design: An interpretative phenomenological analysis (IPA) design was employed. Methods: Purposive sampling was used. In-depth semi-structured face-to-face interviews were conducted from December 2020 to June 2021 with nursing students who were taking the internship course in clinical settings. Data analysis was conducted following Dickman et al.'s (1989) method. Results: Ten nursing students participated in this study. Three main themes were identified, including (1) negative learning environments, (2) internal disgust and (3) threats to professional identity. Conclusion: Findings showed that value conflict, lack of knowledge of ethical standards and its application, and unprofessional approaches result in negative environmental learning perceptions from the nursing students. Therefore, due to being unable to change the situation, they start to feel guilt and shame and, as a result, decide to escape the problem instead of managing it. These feelings lead to internal disgust. This issue indicates the importance of improving the knowledge and perception of these situations. Thus, nursing students must be prepared for the real world, where their ideals are constantly challenged. MDs were experienced as threats to dignity, inequality, distrust, and change of mentality towards nursing, characterised as threats to professional identity. It is suggested to inquire about the process of nursing students' resiliency in morally disturbing situations to deduce the suitable approach for clinical education. © 2024 The Authors. Nursing Open published by John Wiley & Sons Ltd.