Moral Distress

“Unfortunately, information about moral distress and its consequences is often inadequate in healthcare provider education.”

This topic of moral distress was never spoken of in our physical therapy program, but I am unsure if this has changed with time.  Moral distress occurs when someone knows the morally right thing to do for that person, but the individual feels like they are unable to do the right thing for one of many reasons.

These are topics that are not addressed well enough in PT school.  If a person doesn’t have strong moral resolve, then the person may work to appease the reason that he/she feels constrained instead of fulfilling his/her own moral code.

 

“Moral distress as ‘psychological response to morally challenging situations such as those of moral constraint or moral conflict or both’…experience moral distress and burnout in situations such as patients receiving non-beneficial treatment, patient suffering, care not consistent with patients’ preferences, lack of administrative support, perceived powerlessness, and competing obligations.”

For those that are new grads reading this…WELCOME TO THE WORLD OF HEALTH CARE!

Burnout is a topic that has apparently been taboo to talk about in previous years or there hasn’t been a platform in which healthcare practitioners felt comfortable releasing their thoughts.  I can’t remember in my career, albeit only 11 years, in which burnout has been such a large topic as it has been in recent months.

Moral conflict can happen from providing care that is not beneficial.  WHY IN THE WORLD WOULD ANYONE EVER GIVE THIS TYPE OF CARE?!

Enter Shane McMahon

Unfortunately, there have been many therapists that I have spoken to across the country that are performing treatments that they do not personally believe to help the patient, but are trying to stay out of trouble with higher-ups in the company that they are employed.

 

If you are a patient reading this, close your eyes for this and skip to the next paragraph…Companies are trying to get their hands in your pockets.  (YOU WEREN’T SUPPOSED TO READ THAT!)

“Poor work environments…associated with a higher frequency of nurse-reported healthcare-associated infections. Persistent moral distress can progress to burnout, which is also associated with increased incidence of hospital-acquired infections.”

So…who do you want treating you? Do you want to be treated in an environment that increases your likelihood of developing an infection?

If not…pay attention to your surroundings.  Are your healthcare professionals happy, energized, empowered and fulfilled?  If so, you are probably in a good spot.

“Nurse leaders provided insights on risk factors that increase the possibility of moral distress. System-level factors such as work environment, lack of strong ethics resources, and heavy workloads prevailed.”

If you are practicing in healthcare, does this sound familiar.  A lack of ethical resources and heavy workloads describes most institutions in which I have worked and hear from others in the field of PT.  At no time should money trump patient care, but it happens all too frequently.

I get it…I am trying to run a business.  I have heard the phrases that we need to keep the lights on.  We need to make sure that we are making a small profit.  I get it, but at no point in time should we allow greed to take precedence over patient care.

Seek it out

Understand it

Pay attention to workplace climate

Promote receptive environment and engagement

Open opportunity for dialogue

Reflect, Evaluate, Revise

Transform Environment

Link to article

Thanks for taking the time to read this synopsis.  It would mean a lot to me if you would share this for others to see the state of healthcare in today’s environment.

Unknown's avatar

Author: Dr. Vince Gutierrez, PT, cert. MDT

After having dedicated 8 years to growing my knowledge regarding the profession of physical therapy, it seems only fitting that I join the social media world in order to spread a little of the knowledge that I have gained over the years. This by no means is meant to act in place of a one-one medical consultation, but only to supplement your baseline knowledge in which to choose a practitioner for your problem. Having completed a Master of Physical Therapy degree, the MDT (Mechanical Diagnosis and Therapy) certification and currently finishing a post-graduate doctorate degree, I have spent the previous 12 years in some sort of post-baccalalaureate study. Hopefully the reader finds the information insightful and uses the information in order to make more informed healthcare decisions. MISSION STATEMENT: My personal mission statement is as follows: As a professional, I will provide a thorough assessment of your clinical presentation and symptoms in order to determine both the provocative and relieving positions and movements. The assessment process and ensuing treatment will be based on current and relevant evidence. Furthermore, I will educate the patients regarding their symptoms and their likelihood of improving with either skilled therapy, an independent exercise program, spontaneous recovery or if the patient should be referred to a separate specialist to possibly provide a more rapid resolution of symptoms. Respecting the patient’s limited resources is important and I will provide an accurate overview of the prognosis within 7 visits, again based on current research. My goal is to empower the patient in order to take charge of both the symptomatic resolution and return to full function with as little dependence on the therapist as possible. Personally, I strive to be an example for family and friends. My goal is to demonstrate that success is not a byproduct of situations, but a series of choices and actions. I will mentor those, in any way possible, that are having difficulty with the choices and actions for success. I will continue to honor my family’s “blue-collar” roots by working to excel at my chosen career and life situations. I choose to be a leader of example, and not words, all the while reducing negativity in my life. I began working towards the professional aspect of the mission statement while still in physical therapy school. By choosing an internship that emphasized patient care and empowering the patient, instead of the internship that was either closest to home or where I knew that I would have the easiest road to graduation, I took the first step towards learning how to utilize the evidence to teach patients how to reduce their symptoms. I continued this process by completing Mechanical Diagnosis and Therapy courses A-D and passing the credentialing exam. I will continue to pursue my clinical education through CEU’s on MDT and my goal is to obtain the status of Diplomat of MDT. Returning back to school for the t-DPT was a major decision for me, as resources (i.e. time and money) are limited. My choice was between saving money for the Dip MDT course (about 15,000 dollars) and continuing on with the Fellowship of American Academy of Orthopedic Manual Physical Therapists (FAAOMPT) (about 5,000 dollars), as these courses are paired through the MDT curriculum or returning to school to work towards a Doctorate of Physical Therapy degree. I initially planned on saving for the Dip MDT and FAAOMPT, but life changes forced me to re-evaluate my situation. The decision then changed to return for the tDPT, as my employer paid for a portion of the DPT program. My goal for applying to and finishing the Dip MDT and FAAOMPT is 10 years. This is how long I anticipate that it will take to finish paying student loans and save for both programs, based on the current rate of payment. I don’t know if I will ever accomplish what I set forth in the mission statement, but I do know that it will be a forever struggle to maintain this standard that I set for myself.

Leave a comment