倫理道德困擾與護理領導

Moral Distress and Leadership in Nursing

護理人員在接受專業教育的過程中雖不斷被灌輸遵守倫理原則的重要，但在執業過程中卻無法有效遵循，因而不斷地造成困惑、挫折與壓力。這種因無力扭轉情境所產生的情緒挫折統稱為「倫理道德困擾(moral distress)」。倫理道德困擾將直接導致護理人才的疲潰與流失，是護理領導者或管理者必須留意的議題。本文由臨床案例出發，探索倫理道德困擾的意涵與影響因素，再從護理領導與管理的角度提出可能的處理方法，希望藉助這些策略能讓護理人員重新檢視自己的價值、安撫受挫的情緒、提升自我效能與價值感，以及能保有道德勇氣與倫理行動以面對各種不同的臨床情境。

While nursing staff learn the rules of ethical behavior in nursing education programs, they commonly experience confusion, frustration and stress in practice settings due to barriers to moral action faced in the work environment. ”Moral distress” is a term used to describe the situation in which a decisionmaker cannot carry out an ethical or moral action due to the presence of an obstacle. In this article, we described the meaning of and factors influencing moral distress in nursing work settings in relation to nursing leader management strategies. Goals of the article were to help nursing leaders appreciate their personal beliefs as well as to develop strategies to alleviate emotional distress and promote selfefficacy among nursing staff members. One favorable benefit is expected to be greater retention of nursing staff.