FATEME BEHESHT AEEN - MSc in Critical care nursing, Shiraz University of Medical Sciences

Introduction and Aims: Cancer is a global health challenge due to high prevalence and poor outcomes in developing countries. Nurses who are often the frontline caregivers for oncology patients, have to deal on a daily basis with difficult symptoms of terminal illnesses, distressed patients and families, suffering and death, so they are predisposed to moral distress rather than other health care providers.Materials and Methods: This review article was conducted through a library search using key words "moral distress, oncology, nurses" in databases like pub med, science direct, Google scholar and Scopus.Results: Moral distress is defined as a ‘‘painful feeling or mental imbalance caused by inabilities of a person to perform the duties due to internal or external restrictions.Prolonged and continuous contact with critically ill and near-death patients, increased responsibilities, lack of adequate recreational facilities, decreased clinical knowledge, difficult decision-making in a critical situation and futile care are some factors leading to moral distress in oncology wards.Moral distress has negative consequences on nurses’ health status. Public health problems, distancing and avoidance strategies toward patients, losing veteran nurses from the workforce, and decreasing the quality of patient care are among these consequences. Nightmares, insomnia, heart palpitations and mental problems like anxiety and frustration, intolerance and depression are also reported, which could impair nurses personal and professional life.Talking and sharing with colleagues, knowing own limitations, healthy human relations, having supporting peers, physical activities, sports, and hobbies are some coping methods to encounter moral distress. Also, nurses should be supported by various activities such as postgraduate seminars, conferences, courses, group meetings, counseling.Conclusion: In view of the feelings of suffering these workers experience in daily work, the managers, together with nurses need to seek solutions to promote health, improving the quality of life in the work environment and, consequently, in professional life.

oncology, moral distress, nurses