Ethical distress as perceived by nurses in Kenya

Abstract

Introduction: Ethics have been regarded as a vital part of nursing as a profession since the beginning of modern nursing, starting with the era of Florence Nightingale. Ethical distress occurs when ethical problems arise among nurses in different situations such as when they have to make decisions on life-sustaining treatment. Different factors such as hospital policies can give rise to ethical problems. These problems clearly lead to ethical distress among nurses who have to make different decisions with regard to patients’ care; ethical action can be described as listening to patients, putting their needs first and upholding confidentiality. The aim of this study was to describe ethical distress as perceived by nurses in Kenya. Methods: The study was done at Kenyatta National Hospital, Machakos and Kisii County Referral Hospitals A qualitative phenomenological design was used. Convenience sampling was used to select the hospitals and informants from a population of registered nurses who had experienced situations in the clinical area believed to be causing ethical distress. Data was collected using in-depth interviews and Focus Group Discussions. Data was then subjected to thematic content analysis. Results: The informants perceived ethical distress as moral uncertainty, ethical dilemmas and moral distress all of which explained their understanding of ethical distress. Conclusion: Nurses in Kenya have experienced ethical distress regardless of their age, position, number of trainings attended or years of work experience. The two overarching causes of ethical distress among Kenyan nurses are the scarcity of resources and overwhelming workload.