In Hong Kong’s public hospitals, distressed nurses left feeling like Allied troops at Dunkirk
The local hospital environment has recently been described as “a battlefield”. (“Hong Kong’s ‘war on flu’ rages on”, February 19). This reminds me of the film Dunkirk, and of the Allied soldiers waiting for evacuation – frustrated and powerless.
Amid the outcry about the waiting time for medical consultation stretching to more than eight hours and the cramped ward environment, I think the victims here are not only the patients and their family members, but hospital staff as well.
Moral distress is the term that best describes the feelings of health care providers when they know the right thing to do but cannot pursue that course of action. The negative emotions emerging from moral distress would persist as a lingering feeling of unease and may manifest themselves as impatience, anger, frustration, guilt and shame. Health care providers who experience moral distress may distance themselves from clients or turn a blind eye to their needs, due to a sense of powerlessness.
Hence, unrelieved moral distress jeopardises the physical and psychological well-being of health care providers as well as the quality of patient care.
We conducted a study earlier to examine moral distress among Hong Kong nurses, which showed that this is a prevalent issue among our nursing task force; also, those who were considering leaving their current position reported a significantly higher degree of moral distress.
Institutional constraint has been identified as the major factor contributing to moral distress in health care providers across disciplines and health care settings. Moral distress often arises in a situation of inadequate staffing, incompetent co-workers, poor teamwork and inappropriate use of health care resources that comprise their professional autonomy and integrity.
Therefore, monetary incentives, career progression and even recruiting part-time staff may not be effective measures to motivate those who are in despair.
Clearly, moral distress among health care providers is an issue highly pertinent to the cost, quality and sustainability of health care services. Perhaps the policymakers and hospital administrators have to learn a lesson from the Dunkirk evacuation and think outside the box for the current quandary.
Helen Yue-lai Chan, associate professor, The Nethersole School of Nursing, Faculty of Medicine, Chinese University of Hong Kong