LETTERS
LETTERS
TO THE
EDITOR
Submit all Letters to the Editor online at http://ees.elsevier.com/jen/
Moral Distress Among Nurses
Parent Awareness of Child Protection Is Important
Dear Editor: The article “Moral Distress in Emergency Nurses” 1 sheds light on moral distress that occurs in the nursing practice. I have been a registered nurse for 5 years, and from my experiences in the emergency department, you have to make tough and quick decisions with consideration of the family’s and patient’s wishes. Emergency nurses experience moral distress because they are the first nurses to see patients when they arrive to the hospital. 2 In nursing, moral distress occurs because of a variety of situations, including providing life-sustaining treatments that prolong the dying process and following the directives of family members to continue life-sustaining treatments that are not in the best interest of the patient. Emergency nurses have to cope with the families and decisions by physicians regarding life support. The effects of moral distress can be very detrimental. 3 Moral distress can lead to feelings of anger, depression, helplessness, frustration, and sadness. Nurses may become distressed and disappointed and have physiological and psychological exhaustion because of feelings of distress. The previously mentioned article is very interesting, and more studies should be done to explore moral distress in nursing. Increased knowledge on moral distress can lead to improved coping mechanisms, job satisfaction, and nurse retention. —Ashley Jones, RN, BSN, Staff Nurse, Medical Surgical Neurological Unit, Methodist Health Systems, Dallas, TX; E-mail: [email protected]
Dear Editor: We enjoyed the article, “Pediatric Injury Prevention: Are We There Yet?,” 1 which was about prevention of unintentional injury-related death in children. The author illustrated the highest risk factors of injury-related pediatric death of different ages in American children, and discussed the emergency nurse’s contribution to preventing unintentional pediatric injuries. According to this article, the leading cause of death in infants aged younger than 1 year, 1-4 years, and 5-19 years were suffocation, drowning, and motor vehicle crashes, respectively. Other risk factors included children living in poverty, children with young parents, children living in single mother households, and certain minority populations. In China, the mortality rate of young peoples’ injuries in 2010 was at the same level as that in the United States in 1979 (13.07%). 2 And the first 5 ranking causes of under-5 mortality are early birth or low birth weight, pneumonia, birth asphyxia, congenital heart disease, and accidental asphyxia, which altogether account for 60.7% of the total deaths. 2 Among unintentional injuries, traffic accidents were the most frequent cause of death in young people aged 10-24 years. 3 The article also mentioned that poisoning, attributed to prescription drug use and alcohol poisoning, is another major cause of death among adolescents aged 15-19 years. However, death from poisoning takes up a much lower proportion of total children’s death in China. According to a national report in 2011, due to multiple factors (eg, financial, transport or medical conditions, and health-seeking behavior), 36.3% of the deceased children in China died at home in 2010, and 11.6% didn’t get medical treatment before death. 2 According to another recent investigation, 55.1% children experienced unintentional injury, whereas only 28% of the parents would regularly check the circumstance flatness for dangerous facilities that might undermine the safety for children's activity. 4 We believe that parents’ guardianship is the most important and effective means to protect children from injury-related death, which was also a good lesson learned from this article. Thus, it’s highly recommended that parents in China be alert with causes of death such as drowning and suffocation, as well as learn first-aid methods. Also, specific instructions regarding transportation safety can be provided to families.
http://dx.doi.org/10.1016/j.jen.2013.03.022
REFERENCES 1. Fernandez-Parsons R, Rodriguez L, Goyal D, Chilemba E. Moral distress in emergency nurses. J Emerg Nurs. 2013;39(6):547-52. 2. Maluwa V, Andre J, Ndebele P, Chilemba E. Moral distress in nursing practice in Malawi. Nurs Ethics. 2012;19(2):196-207. 3. Wiegand D, Funk M. Consequences of clinical situations that cause critical care nurses to experience moral distress. Nurs Ethics. 2012;19(4):479-87.
J Emerg Nurs 2014;40:4-5. 0099-1767/$36.00 Copyright © 2014 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.
4
JOURNAL OF EMERGENCY NURSING
VOLUME 40 • ISSUE 1
January 2014
LETTERS
TO THE
EDITOR
Submit all Letters to the Editor online at http://ees.elsevier.com/jen/
Moral Distress Among Nurses
Parent Awareness of Child Protection Is Important
Dear Editor: The article “Moral Distress in Emergency Nurses” 1 sheds light on moral distress that occurs in the nursing practice. I have been a registered nurse for 5 years, and from my experiences in the emergency department, you have to make tough and quick decisions with consideration of the family’s and patient’s wishes. Emergency nurses experience moral distress because they are the first nurses to see patients when they arrive to the hospital. 2 In nursing, moral distress occurs because of a variety of situations, including providing life-sustaining treatments that prolong the dying process and following the directives of family members to continue life-sustaining treatments that are not in the best interest of the patient. Emergency nurses have to cope with the families and decisions by physicians regarding life support. The effects of moral distress can be very detrimental. 3 Moral distress can lead to feelings of anger, depression, helplessness, frustration, and sadness. Nurses may become distressed and disappointed and have physiological and psychological exhaustion because of feelings of distress. The previously mentioned article is very interesting, and more studies should be done to explore moral distress in nursing. Increased knowledge on moral distress can lead to improved coping mechanisms, job satisfaction, and nurse retention. —Ashley Jones, RN, BSN, Staff Nurse, Medical Surgical Neurological Unit, Methodist Health Systems, Dallas, TX; E-mail: [email protected]
Dear Editor: We enjoyed the article, “Pediatric Injury Prevention: Are We There Yet?,” 1 which was about prevention of unintentional injury-related death in children. The author illustrated the highest risk factors of injury-related pediatric death of different ages in American children, and discussed the emergency nurse’s contribution to preventing unintentional pediatric injuries. According to this article, the leading cause of death in infants aged younger than 1 year, 1-4 years, and 5-19 years were suffocation, drowning, and motor vehicle crashes, respectively. Other risk factors included children living in poverty, children with young parents, children living in single mother households, and certain minority populations. In China, the mortality rate of young peoples’ injuries in 2010 was at the same level as that in the United States in 1979 (13.07%). 2 And the first 5 ranking causes of under-5 mortality are early birth or low birth weight, pneumonia, birth asphyxia, congenital heart disease, and accidental asphyxia, which altogether account for 60.7% of the total deaths. 2 Among unintentional injuries, traffic accidents were the most frequent cause of death in young people aged 10-24 years. 3 The article also mentioned that poisoning, attributed to prescription drug use and alcohol poisoning, is another major cause of death among adolescents aged 15-19 years. However, death from poisoning takes up a much lower proportion of total children’s death in China. According to a national report in 2011, due to multiple factors (eg, financial, transport or medical conditions, and health-seeking behavior), 36.3% of the deceased children in China died at home in 2010, and 11.6% didn’t get medical treatment before death. 2 According to another recent investigation, 55.1% children experienced unintentional injury, whereas only 28% of the parents would regularly check the circumstance flatness for dangerous facilities that might undermine the safety for children's activity. 4 We believe that parents’ guardianship is the most important and effective means to protect children from injury-related death, which was also a good lesson learned from this article. Thus, it’s highly recommended that parents in China be alert with causes of death such as drowning and suffocation, as well as learn first-aid methods. Also, specific instructions regarding transportation safety can be provided to families.
http://dx.doi.org/10.1016/j.jen.2013.03.022
REFERENCES 1. Fernandez-Parsons R, Rodriguez L, Goyal D, Chilemba E. Moral distress in emergency nurses. J Emerg Nurs. 2013;39(6):547-52. 2. Maluwa V, Andre J, Ndebele P, Chilemba E. Moral distress in nursing practice in Malawi. Nurs Ethics. 2012;19(2):196-207. 3. Wiegand D, Funk M. Consequences of clinical situations that cause critical care nurses to experience moral distress. Nurs Ethics. 2012;19(4):479-87.
J Emerg Nurs 2014;40:4-5. 0099-1767/$36.00 Copyright © 2014 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.
4
JOURNAL OF EMERGENCY NURSING
VOLUME 40 • ISSUE 1
January 2014
