The general experience and moral distress of nurses in the sociocultural context of the intensive care unit and the COVID-19 pandemic: A focused ethnography
Bibliographic record
Abstract
Background and purpose: Moral distress is defined by Morley et al. (2019, p. 3) as “a direct causal link between the experience of a moral event and psychological distress.” It can lead to psychological, physical, and organizational consequences. The COVID-19 pandemic exacerbated and created factors that may have contributed to moral distress in intensive care (ICU) nurses. The framework for this study is the typology of moral distress written by Morley, Sese et al. (2020). The purpose of this study is to understand the general experience and moral distress of nurses better, in the sociocultural context of the ICU and the COVID-19 pandemic. Method and procedures: A qualitative focused ethnography design was used. The data collection was carried out by observations with field notes, an observation grid, informal exchanges with general informants, semi-structured interviews with key informants, as well as a reflective journal. Data analysis was conducted with the constant comparison method. Results: Eight key informants between the ages of 26 and 50 participated in the interviews. Three main themes emerged: 1) the temporality of the pandemic, 2) factors influencing the general experience, and 3) moral distress. Discussion: The type of moral distress most experienced by participants was that of moral constraint, when informants felt that their patients were suffering or that there was therapeutic futility. The second most common type of distress was that of moral tension, as nurses felt they could not talk about their experiences with anyone. Conclusion: Moral distress is a common phenomenon amongst RNs, already known in the sociocultural context of the ICU. The circumstances of the pandemic only exacerbated and added to this moral distress. Recommendations were made to mitigate moral distress in times of crisis. Keywords: moral distress, registered nurses, intensive care unit, culture, focused ethnography
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.006 | 0.008 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.007 | 0.008 |
| Scholarly communication | 0.003 | 0.005 |
| Open science | 0.001 | 0.006 |
| Research integrity | 0.002 | 0.002 |
| 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".