No place to turn: Nursing students' experiences of moral distress in mental health settings

• Published in: International journal of mental health nursing Vol. 23; no. 3; pp. 257 - 264
• Main Authors: Wojtowicz, Bernadine, Hagen, Brad, Van Daalen-Smith, Cheryl
• Format: Journal Article
• Language: English
• Published: Australia Blackwell Publishing Ltd 01.06.2014; Wiley Subscription Services, Inc
• Subjects: Adult; Clinical nursing; ethics; Female; Humans; Inpatient care; Medical ethics; Mental disorders; Mental Disorders - nursing; Mental health; Moral aspects; moral distress; Morality; Morals; Nurse's Role; Nurses; Nursing; Physicians; Power structure; Psychiatric nurses; Psychiatric nursing; Psychiatric Nursing - education; Psychiatric Nursing - ethics; Psychiatric units; Psychiatric-mental health nursing; Psychological distress; Qualitative research; Rotation; Stress, Psychological - epidemiology; Stress, Psychological - etiology; student; Students; Students, Nursing - psychology; Talking; Young Adult; moral distress; nursing; ethics; student; mental health
• ISSN: 1445-8330; 1447-0349
• DOI: 10.1111/inm.12043

While researchers have documented the significant issue of moral distress among nurses, few have explored moral distress among mental health nurses. In addition, no research to date has explored nursing students' experiences of moral distress during mental health clinical rotations, despite nursing students typically reporting negative attitudes towards mental health nursing. This manuscript reports on a qualitative study involving seven Canadian baccalaureate nursing students, who reported on their experiences of moral distress during a 13‐week clinical rotation on inpatient psychiatric units. Overall, nursing students reported significant moral distress related to the perceived lack of nurses talking meaningfully to patients on the unit, a hierarchical power structure for physicians, a lack of information given to patients about their psychiatric medications, and an inability of their nursing instructors to advocate for ethical change on the units. Several students made a specific connection between their moral distress and not wanting to pursue a career in mental health nursing.