Critical care nurses’ moral distress in end-of-life decision making
Bibliographic record
Abstract
Moral distress is a phenomenon in which a healthcare professional perceives an ethically preferable or morally right course of action to take, but internal or external constraints make it nearly impossible to pursue that course. Although healthcare professionals’ moral distress has been studied for over twenty years, we have not reached a point of full understanding and appreciation of this complex phenomenon. Attempts to define moral distress and refine our understanding of it have been frustrated by tendencies to interchange or mislabel very distinct—yet related—concepts. A comprehensive knowledge base of root causes and the interrelationships between individual and team or system factors is timely and critical. We qualitatively interviewed 29 healthcare professionals of various backgrounds in two intensive care units at a tertiary, academic medical center with the goal of understanding interrelationships between team and individual factors of moral distress. Herein, we report our findings with regard to nurses’ moral distress and suggest a list of practical strategies to mitigate this moral distress. Normal 0 7.8 磅 0 2 false false false EN-US ZH-CN X-NONE
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.046 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.004 | 0.008 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.001 | 0.004 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".