IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v19y2022i14p8349-d858371.html
   My bibliography  Save this article

Moral Distress Events and Emotional Trajectories in Nursing Narratives during the COVID-19 Pandemic

Author

Listed:
  • Daniela Lemmo

    (Department of Humanities, University of Naples Federico II, 80100 Naples, Italy)

  • Roberta Vitale

    (Department of Humanities, University of Naples Federico II, 80100 Naples, Italy)

  • Carmela Girardi

    (Department of Humanities, University of Naples Federico II, 80100 Naples, Italy)

  • Roberta Salsano

    (Department of Humanities, University of Naples Federico II, 80100 Naples, Italy)

  • Ersilia Auriemma

    (Department of Humanities, University of Naples Federico II, 80100 Naples, Italy)

Abstract

The COVID-19 pandemic produced several ethical challenges for nurses, impacting their mental health and moral distress. In the moral distress model the categories of events related to moral distress are: constraint, dilemma, uncertainty, conflict, and tension, each one related to different emotions. This study explored moral events’ memories and emotions in narratives of a sample of 43 Italian nurses who worked during the COVID-19 pandemic. We constructed an ad-hoc narrative interview asking nurses to narrate the memory, and the associated emotion, of an event in which they felt they could not do the right thing for the patient. We conducted a theory-driven analysis, using the categories proposed by the literature, identifying the main emotion for each category. Results show that 36 memories of events are representative of moral distress; among these, 7 are representative of none of the categories considered, and we categorized them as moral compromise. The main emotional trajectories are powerlessness, worthlessness, anger, sadness, guilt, and helplessness. From a clinical psychological point of view, our findings highlight the narration of the memories of moral events as a tool to use in the ethical sense-making of critical experiences, in order to promote well-being and moral resilience among nurses in emergency situations.

Suggested Citation

  • Daniela Lemmo & Roberta Vitale & Carmela Girardi & Roberta Salsano & Ersilia Auriemma, 2022. "Moral Distress Events and Emotional Trajectories in Nursing Narratives during the COVID-19 Pandemic," IJERPH, MDPI, vol. 19(14), pages 1-12, July.
  • Handle: RePEc:gam:jijerp:v:19:y:2022:i:14:p:8349-:d:858371
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/19/14/8349/pdf
    Download Restriction: no

    File URL: https://www.mdpi.com/1660-4601/19/14/8349/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Vanessa Bertuzzi & Michelle Semonella & Denise Bruno & Chiara Manna & Julian Edbrook-Childs & Emanuele M. Giusti & Gianluca Castelnuovo & Giada Pietrabissa, 2021. "Psychological Support Interventions for Healthcare Providers and Informal Caregivers during the COVID-19 Pandemic: A Systematic Review of the Literature," IJERPH, MDPI, vol. 18(13), pages 1-13, June.
    2. Natasha Smallwood & Amy Pascoe & Leila Karimi & Karen Willis, 2021. "Moral Distress and Perceived Community Views Are Associated with Mental Health Symptoms in Frontline Health Workers during the COVID-19 Pandemic," IJERPH, MDPI, vol. 18(16), pages 1-15, August.
    3. Pamela Z. Cacchione, 2020. "Moral Distress in the Midst of the COVID-19 Pandemic," Clinical Nursing Research, , vol. 29(4), pages 215-216, May.
    4. Priya-Lena Riedel & Alexander Kreh & Vanessa Kulcar & Angela Lieber & Barbara Juen, 2022. "A Scoping Review of Moral Stressors, Moral Distress and Moral Injury in Healthcare Workers during COVID-19," IJERPH, MDPI, vol. 19(3), pages 1-20, February.
    5. Giulia Lamiani & Davide Biscardi & Elaine C. Meyer & Alberto Giannini & Elena Vegni, 2021. "Moral Distress Trajectories of Physicians 1 Year after the COVID-19 Outbreak: A Grounded Theory Study," IJERPH, MDPI, vol. 18(24), pages 1-10, December.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Daniela Lemmo & Maria Luisa Martino & Anna Rosa Donizzetti & Maria Francesca Freda & Daniela Caso, 2022. "The Relationship between Healthcare Providers and Preventive Practices: Narratives on Access to Cancer Screening," IJERPH, MDPI, vol. 19(17), pages 1-18, September.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Mihaela Alexandra Gherman & Laura Arhiri & Andrei Corneliu Holman & Camelia Soponaru, 2022. "The Moral Impact of the COVID-19 Pandemic on Nurses’ Burnout, Work Satisfaction and Adaptive Work Performance: The Role of Autobiographical Memories of Potentially Morally Injurious Events and Basic P," IJERPH, MDPI, vol. 19(13), pages 1-22, June.
    2. Dominik Hinzmann & Katharina Schütte-Nütgen & Arndt Büssing & Olaf Boenisch & Hans-Jörg Busch & Christoph Dodt & Patrick Friederich & Matthias Kochanek & Guido Michels & Eckhard Frick, 2022. "Critical Care Providers’ Moral Distress: Frequency, Burden, and Potential Resources," IJERPH, MDPI, vol. 20(1), pages 1-14, December.
    3. Esther Alonso-Prieto & Holly Longstaff & Agnes Black & Alice K. Virani, 2022. "COVID-19 Outbreak: Understanding Moral-Distress Experiences Faced by Healthcare Workers in British Columbia, Canada," IJERPH, MDPI, vol. 19(15), pages 1-14, August.
    4. Barnabás Oláh & Bence Márk Rádi & Karolina Kósa, 2022. "Barriers to Seeking Mental Help and Interventions to Remove Them in Medical School during the COVID-19 Pandemic: Perspectives of Students," IJERPH, MDPI, vol. 19(13), pages 1-18, June.
    5. Mehwish Majeed & Muhammad Irshad & Jos Bartels, 2021. "The Interactive Effect of COVID-19 Risk and Hospital Measures on Turnover Intentions of Healthcare Workers: A Time-Lagged Study," IJERPH, MDPI, vol. 18(20), pages 1-15, October.
    6. Rodriquez, Jason, 2023. "Reconfiguring the social organization of work in the intensive care unit: Changed relationships and new roles during COVID-19," Social Science & Medicine, Elsevier, vol. 317(C).
    7. William E. Rosa & Kailey E. Roberts & Amelia E. Schlak & Allison J. Applebaum & William S. Breitbart & Emily H. Kantoff & Hayley Pessin & Wendy G. Lichtenthal, 2022. "The Critical Need for a Meaning-Centered Team-Level Intervention to Address Healthcare Provider Distress Now," IJERPH, MDPI, vol. 19(13), pages 1-9, June.
    8. Evija Nagle & Sanita Šuriņa & Ingūna Griškēviča, 2023. "Healthcare Workers’ Moral Distress during the COVID-19 Pandemic: A Scoping Review," Social Sciences, MDPI, vol. 12(7), pages 1-17, June.
    9. Sherman, Melina & Klinenberg, Eric, 2024. "Beyond burnout: Moral suffering among healthcare workers in the first COVID-19 surge," Social Science & Medicine, Elsevier, vol. 340(C).
    10. Vanessa Bertuzzi & Michelle Semonella & Gianluca Castelnuovo & Gerhard Andersson & Giada Pietrabissa, 2022. "Synthesizing Stakeholders Perspectives on Online Psychological Interventions to Improve the Mental Health of the Italian Population during the COVID-19 Pandemic: An Online Survey Study," IJERPH, MDPI, vol. 19(12), pages 1-13, June.
    11. Alejandro Dominguez-Rodriguez & Reyna Jazmín Martínez-Arriaga & Paulina Erika Herdoiza-Arroyo & Eduardo Bautista-Valerio & Anabel de la Rosa-Gómez & Rosa Olimpia Castellanos Vargas & Laura Lacomba-Tre, 2022. "E-Health Psychological Intervention for COVID-19 Healthcare Workers: Protocol for its Implementation and Evaluation," IJERPH, MDPI, vol. 19(19), pages 1-20, October.
    12. Oliver S. Holmes & Steven Ellen & Natasha Smallwood & Karen Willis & Clare Delaney & Leon J. Worth & Shelley Dolan & Lisa Dunlop & Geraldine McDonald & Leila Karimi & Megan Rees & Maria Ftanou, 2023. "The Psychological and Wellbeing Impacts of Quarantine on Frontline Workers during COVID-19 and Beyond," IJERPH, MDPI, vol. 20(10), pages 1-11, May.
    13. Mihaela Alexandra Gherman & Laura Arhiri & Andrei Corneliu Holman & Camelia Soponaru, 2022. "Injurious Memories from the COVID-19 Frontline: The Impact of Episodic Memories of Self- and Other-Potentially Morally Injurious Events on Romanian Nurses’ Burnout, Turnover Intentions and Basic Need ," IJERPH, MDPI, vol. 19(15), pages 1-25, August.
    14. Karen Willis & Paulina Ezer & Sophie Lewis & Marie Bismark & Natasha Smallwood, 2021. "“Covid Just Amplified the Cracks of the System”: Working as a Frontline Health Worker during the COVID-19 Pandemic," IJERPH, MDPI, vol. 18(19), pages 1-15, September.
    15. Priya-Lena Riedel & Alexander Kreh & Vanessa Kulcar & Angela Lieber & Barbara Juen, 2022. "A Scoping Review of Moral Stressors, Moral Distress and Moral Injury in Healthcare Workers during COVID-19," IJERPH, MDPI, vol. 19(3), pages 1-20, February.
    16. Mihaela Alexandra Gherman & Laura Arhiri & Andrei Corneliu Holman & Camelia Soponaru, 2022. "Protective Factors against Morally Injurious Memories from the COVID-19 Pandemic on Nurses’ Occupational Wellbeing: A Cross-Sectional Experimental Study," IJERPH, MDPI, vol. 19(18), pages 1-42, September.
    17. Giulia Lamiani & Davide Biscardi & Elaine C. Meyer & Alberto Giannini & Elena Vegni, 2021. "Moral Distress Trajectories of Physicians 1 Year after the COVID-19 Outbreak: A Grounded Theory Study," IJERPH, MDPI, vol. 18(24), pages 1-10, December.
    18. Kim Ritchie & Andrea M. D’Alessandro-Lowe & Andrea Brown & Heather Millman & Mina Pichtikova & Yuanxin Xue & Maxwell Altman & Isaac Beech & Mauda Karram & Fardous Hosseiny & Sara Rodrigues & Charlene , 2023. "The Hidden Crisis: Understanding Potentially Morally Injurious Events Experienced by Healthcare Providers during COVID-19 in Canada," IJERPH, MDPI, vol. 20(6), pages 1-12, March.
    19. Marina Maffoni & Elena Fiabane & Ilaria Setti & Sara Martelli & Caterina Pistarini & Valentina Sommovigo, 2022. "Moral Distress among Frontline Physicians and Nurses in the Early Phase of COVID-19 Pandemic in Italy," IJERPH, MDPI, vol. 19(15), pages 1-23, August.
    20. Davis Cooper-Bribiesca & Dulce María Rascón-Martínez & José Adan Miguel-Puga & María Karen Juárez-Carreón & Luis Alejandro Sánchez-Hurtado & Tania Colin-Martinez & Juan Carlos Anda-Garay & Eliseo Espi, 2023. "Physicians’ Distress Related to Moral Issues and Mental Health In-Between Two Late Waves of COVID-19 Contagions," IJERPH, MDPI, vol. 20(5), pages 1-19, February.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:19:y:2022:i:14:p:8349-:d:858371. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.