Advanced Practice Nursing Decisions That Cause Moral Distress

AdvancedPractice Nursing Decisions That Cause Moral Distress

AdvancedPractice Nursing Decisions That Cause Moral Distress

Moraldistress happens when someone knows the ethically right action totake but feels week in making a move. On a daily basis, nurses faceethical dilemmas regardless of where they practice. An ethicaldilemma is a choice where one is required to choose between twooptions, and both of the options will result in a negative outcomebased on the guidelines of a person and society. Nurses face problemsthat do not have a satisfactory resolution in their practice.However, they experience moral distress after encountering an ethicaldilemma in a situation that is hard to do the right thing. Ethicaldilemmas faced by nurses are many and different depending on theworkplace. This paper will exclusively explore on an ethical-legaldilemma of inserting a feeding tube to 92 years old patient withAlzheimer’s illness that would cause the advanced practice nursemoral distress.

Nursescan encounter many ethical problems in their workplace. The decisionsthey make determines the effects of ethical issues to patients. Forinstance, a nurse may encounter an ethical-legal dilemma of insertinga feeding tube into a 92-year-old patient with Alzheimer’s illness.This kind of ethical-legal dilemma can cause moral distress since anurse can have difficulties in decision making each day. Thepatient’s day-to-day dignity and autonomy must be balanced againstthe needs for safety. A nurse should also balance his or her needswith those of the patient. In this case, there is no a single rightanswer and in many instances, successful strategies change as thedisease progresses (Davis, 2010).

Anurse working on a 92-year-old patient with Alzheimer’s illness canhave difficulties in balancing the needs of multiple patients. A92-year-old patient requires a special care when inserting a feedingtube since most people at this age do not have energy in their body.However, balancing of the needs becomes very hard for the nursesbecause most of their time is spent attending the patient. The otherpatients remain unattended, and this causes moral distress to thenurse. Besides, a nurse must consider problems related to thepotential for elder abuse, confidentiality, and the benefits andrisks of procedures and medication. However, this ethical-legaldilemma can cause moral distress to nurses since they will not beable to make decisions and express their will (Hunt, 2003).

Theability to maintain hydration and nutrition for a 92-year-old patientwith Alzheimer’s illness is paramount. A patient with Alzheimer’sillness needs sufficient nutrition to provide the required energy forthe body. The patient also needs to keep the body hydrated forseveral reasons such as maintaining temperature and removal of wasteproducts. Sometimes it can be difficult to recognize that a feedingtube cannot maintain a long-term nutrition and hydration. As aresult, this decision is often distressing for the nurse sincecompeting benefits and risks of tube feeding can be very overwhelming(Lachman, 2009).

Inconclusion, this type of ethical-legal dilemma can cause moraldistress to nurses since a 92-year-old patient with Alzheimer’sillness needs a special care and a nurse should also be attending toother patients. Additionally, it can be difficult to maintainnutrition and hydration for the patient when using a feeding tube.However, nurses need to avoid moral distress by making the rightdecision in their practice


Davis, A. J. (2010). Ethical Dilemmas and Nursing Practice. California: Pearson.

Hunt, D. G. (2003). Ethical Issues in Nursing. New York: Routledge.

Lachman, V. D. (2009). Ethical Challenges in Health Care: Developing Your Moral Compass. New York: Springer Publishing Company.