Moral Competence and Perceived Moral Distress among Health Care Professionals in an Urban Health Care Setting; Facility Based Study

Caring for patients and their families in their vulnerable moments is a great challenge to health care providers. Moral distress occurs when health care professionals cannot carry out what they believe to be ethically appropriate for patient care. Imbalance between authority and responsibility, frustrating patterns in health care team and inability to make ethical decision making for patient care are more commonly associated ethical dimensions for practice resulting to moral distress. Unresolved ethical problems have been linked to increased experience of moral distress and reduced job satisfaction. Aim The present study aimed to identify the perceptions of moral distress and associated levels of job satisfaction among Registered Nurses (RN) and physicians in an urban area hospital. Methods Registered Nurses (n=65) and physicians (n=25) between the age group of 22-58 years, with minimum of two years of work experience, working in the government urban area hospital, who were willing to participate were included in the study. After securing informed consent, data was collected on demographic information and on moral distress and job satisfaction. Structured Questionnaire was used to collect data on, Demographic information, moral distress and Job satisfaction. Four Point Lickert scale was used to measure the frequency and intensity of morally distressing situations, which was scored between 0 4 (never to always). The intensity was measured from 0 4 (no effect to great extent in disturbance). Results The mean scores were found to be 90.86 in Nurses and it was 60.85 in Physicians.68 % of the Nurses and 52 % of the Physicians were not satisfied with the quality of patient care provided. Among them 69 % of RN expressed powerlessness in decision making, while 8 % of the physicians agreed for the powerlessness experience in patient care decision making.58 % of the nurses were dissatisfied with the type of decision-making in patient care, where as 58 % of the Physicians were fully satisfied with patient care decisions implemented. Conclusion Moral distress was found to be experienced by both nurses and physicians. But physicians show comparatively lower levels of moral distress to nurses in the same units and setting. The study provides evidence that the job satisfaction and moral distress are negatively associated and the perceptions of quality of health care rendered and there is dire need to adopt resilient measures in health care settings.