Nursing Education: Students' Narratives of Moral Distress in Clinical Practice.

ABSTRACT

BACKGROUND: Research indicates that newly graduated nurses are often unprepared for meeting challenging situations in clinical practice. This phenomenon is referred to as a "reality shock". This gap in preparedness may lead to moral distress. The aim of this article is to provide knowledge of moral distress in clinical nursing practice. METHODS: Bachelor and further education nursing students were invited to write a story about challenging situations from their own clinical practice, resulting in 36 stories. Analysis was based on hermeneutical reading inspired by a narrative method; therefore, six stories were selected to represent the findings. RESULTS: A finding across the stories is that the students knew the right thing to do but ended up doing nothing. Four themes were related to moral distress (a) undermining of professional judgement, (b) disagreement concerning treatment and care, (c) undignified care by supervisors, and (d) colliding values and priorities of care. CONCLUSION: Nursing education should emphasize to a greater extent ethical competency and training for the challenging situations students will encounter in clinical practice.