Week 12: Moral Distress

Question 1

Define Quality Practice Environment

Answer 1

A quality practice environment supports the delivery of safe, compassionate, competent and ethical care while maximizing the health of clients and nurses, as per CNA’s Code of Ethics for Registered Nurses.

Question 2

What are the characteristics of a quality practice environment?

Answer 2

-Communication & collaboration *teams communicate w/ each other
-Responsibility & accountability *have responsibilities BUT don’t do things you’re not trained for
- Safe & realistic workload
-Leadership
-Technology & tools
-Professional development
-Workplace culture

Question 3

Define Discrimination

Answer 3

differential treatment of an individual or group on the basis of a Protected Characteristic rather than on personal merit.

Question 4

Define Harassment

Answer 4

a course of offensive and unwelcome conduct or comment made of the basis of a Protected Characteristic.

Question 5

What is Workplace Violence?

Answer 5

Any act that results in injury or threat of injury, real or perceived, by an individual, including but not limited to:
- acts of aggression
- Physical, verbal or written threats
- vandalism of personal property

Question 6

What is Horizontal Violence?

Answer 6

-Form of psychological aggression & intimidation
-Within healthcare → characterized as hostile, aggressive/harmful behaviour by a nurse/group of nurses directed towards a coworker/group of nurses
-May be overt or covert (secretive)
-Usually includes a series of undermining events over, compared to a single occurrence
-Long term impacts on workplace & mental health

Question 7

Which law governs workplace health and safety?

Answer 7

Workplace health and safety act

Question 8

What are the rights of the employee?

Answer 8

1. Know about hazards
2. Bring forward health and safety concerns
3. To refuse unsafe work – important to know when that line is
4. Freedom from discriminatory actions

Question 9

What are the responsibilities of the employee?

Answer 9

1. Follow all health and safety rules
2. Cooperate with health and safety committees

Question 10

What are the responsibilities of the employers?

Answer 10

1. Provide safety equipment
2. Adequate training on equipment

Question 11

What is the Public interest Disclosure Act (PIDA)?

Answer 11

”Disclosure of unethical or unsafe practice that creates substantial danger to the life, health or safety of persons, or to the environment”

Question 12

What are the main points of the PIDA?

Answer 12

-Code of requires nurses to address the issue w/ the person if possible
o We’re required to report/disclose concerns to the appropriate authority
o Disclosures = NOT anonymous
-Carries significant personal risks despite protections in law

Question 13

What are things to consider with PIDA?

Answer 13

-Seriousness of wrongdoing
-Responses to previous efforts to address issue
o Most concerns can be addressed by reporting to the direct supervisor/manager; however, when attempts to resolve situations don’t make changes, the whistleblower legislation gives staff the protection to escalate the concerns w/o a fear of punishment.

Question 14

What is Moral Distress?

Answer 14

Due to barriers, a nurse cannot act according to what they believe is morally right. This can lead to negative feelings.

Question 15

What are the steps to address Moral Distress?

Answer 15

1. Determine what you are experiencing
2. Gauge the severity of your distress
3. Identify the causes and constraints
4. Take action to help you move forward

Question 16

Define Burnout

Answer 16

the emotional & physical exhaustion that comes w/ the stressful responsibilities needed for nursing

Question 17

Define Compassion Fatigue

Answer 17

occurs when prolonged emotional strain leads to detachment & difficulties in providing empathetic care
-Comes from working with victims of trauma, although this isn’t necessarily the case for nurse burnout
-Can also appear more quickly than nurse burnout & can even cause anger or existential despair