Dementia nurses suffer moral distress: study

Three-quarters of nurses in southern Alberta who treat residential dementia patients frequently experience distress from being unable to give patients what they need, a new study says.

The findings from the University of Lethbridge also report that onethird of those nurses also engage in unhealthy behaviour because of those circumstances.

“If things don’t get better, we’re going to have a revolving door of care providers that aren’t going to stay,” said Shannon Spenceley, lead researcher on the study and nursing professor at the university.

“Nobody would want to stay when they’re feeling the way that participants in our study were saying they feel.”

The research focused on the phenomenon of moral distress — the feeling nurses and caregivers get when they know what the right thing for their patient is, but are unable to do it because of a lack of time and resources.

Because of it, half of the study’s respondents said they were frustrated weekly and losing sleep monthly. Around 40 per cent said they felt physically exhausted, emotionally drained and powerless once a week or more. Six of the 10 situations they reported as the most distressing were also the most frequent ones they faced.

Spenceley says a staff shortage is one of the main causes.

“We heard stories from nurses where they were in a situation where two patients needed them, and they needed them right now, but ... because of the staffing levels, they had to choose which resident to help first,” she said.

“Nobody goes into caregiving because they want to make those kind of decisions.”

Colin Zieber, executive director of seniors health in Alberta Health Services’ south zone, says the results will guide his organization in the future. “We know we have much more that we can provide, but we can accept the report and certainly it gives us more focus.”

In the beginning of the study, Spenceley and her colleagues interviewed caretakers and nurses about their experiences. Using that information, they designed a survey to measure how common those feelings and situations were.

The study included 30 of 35 facilities in southern Alberta with 400 participants.

Jane Sustrik, first vice-president of United Nurses of Alberta, says almost any nurse could tell stories about the problem. She says the number of moral distress situations reported to the union is on the rise.

“It’s fairly common now, given the massive changes and reduction of funding to health care that we’ve seen over the years,” Sustrik said.

Liberal MLA David Swann, who is also a medical doctor, says providing enough staff is vital to the well-being of the entire healthcare system.

“There’s no substitute for setting a staff ratio that allows professionals to spend more time with people and not be treating them like objects, like tasks to be done,” Swann said.

The study, which has yet to be submitted to a peer-reviewed publication, also asked care providers what would improve their situation. The vast majority said being able to talk to managers and co-workers about their difficulties would be a large help. About 88 per cent said they needed more staff, and 41 per cent wanted more dementiaspecific training and support.