Dr. Andrew Jameton, the University of Nebraska professor who literally wrote the book on professional nursing with his Nursing Practice: The Ethical Issues in 1984, was one of the first to recognize the problem of moral distress among professional nurses.
Although Jameton’s book was published 35 years ago, the issue of moral distress – “The experience of knowing the right thing to do while being in a situation in which it is nearly impossible to do it” – could not be more relevant than it is today in the nursing profession in Ontario.
As CEO of the Registered Practical Nurses Association of Ontario, and a nurse myself, I can tell you with absolute certainty – and alarm – that nurses in Ontario today are facing an unprecedented level of stress over the challenge of providing the level of care patients need and that we have spent years training to deliver.
Of course, nurses don’t exist in isolation from our patients. When we’re distressed, patients feel it.
In fact, our organization recently conducted a survey of our member nurses working in long-term care environments throughout the province – and the majority surveyed reported experiencing high moral distress because of such issues as:
- Having to rush the daily care of residents due to lack of time
- Seeing resident and specialized nursing care suffer due to lack of funding to hire more nurses
- Poor communication between staff members leading to challenges in patient care
The problem is that for many years provincial policies continuously came up short in addressing the mounting strains on the entire Ontario health-care system. More precisely, at the front lines, nurses are bearing the burden of inadequate health-care funding and ineffective human resources strategies.
Quite frankly, the direct mental and physical impact of this situation on front-line nurses is bad and it’s getting worse every day.
It wasn’t so long ago that young people entering the nursing profession did so with a view to being a nurse for life. Now, the unfortunate reality is that we’re seeing growing numbers of nurses feeling overwhelmed and choosing to leave the profession at an unprecedented rate.
The new Conservative government at Queen’s Park has been clear in its intent to refocus the provincial health-care system on patient-centred care. A key step in achieving that goal will be to address head on the unreasonable and untenable workloads that are at the root of the moral distress felt by nurses throughout Ontario.
The fact is, to date, we haven’t seen a viable long-term health-care plan put in place to deal with our growing, aging population. The result has been a worsening of the nursing shortage in Ontario to the point of crisis.
To solve the problem, we need bold leadership from elected officials, health-care leaders, and policy makers.
However, we know government can’t solve this alone. We need to work together for the best interest of patients.
We think it’s important to adopt a balanced approach that invites everyone in the health-care system to the table – including both Registered Practical Nurses and Registered Nurses – to develop a patient-centred perspective on what is needed to deliver efficient and effective health care to citizens throughout Ontario.
Crucially, the solution must include an innovative approach to health-care staffing that recognizes the capabilities and respects the limitations of care providers at every stage in the system.
By the very nature of what we do, nurses bear witness to the patient journey through our health-care system. We are by our patients’ sides as they experience and deal with often profound and difficult changes in their health and lives, and we stand there not as passive observers, but as active, engaged advocates for their health and quality of life.
We must be allowed to do what we’ve been trained to do, what we love to do, and what Ontarians need us to do.
Published in The Ontario Citizen