Bernhofer, to note if the experience is

Bernhofer, I, Esther
and Sorrell, M, Jeanne. (2015). Nurses
managing Patient’s pain May     Experience
Moral Distress. Clinical Nursing Research. Cleveland Nursing institute.
Vol. 24(4)., 401-4


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            The nurses do a great job in helping the patients with
their pain. In this research it is evident that they do not all succeed in pain
management and this failure affects them. Frustrations of the nurses for not
being able to help their patients leads to moral distress for them. It is then
required that the necessary management do something on teaching the health
department on management of pain for the patients. This is necessary since
nurses’ education alone on the matter will only increase on the stressors if
other physicians have no knowledge on the matter. Communication between nurses
and physicians should also be clear and effective to help in the management of
the patient’s pain.


            The limitations experienced in the study are that
although the number of participants in the study was large, the study was only
done in one hospital therefore it is hard to note if the experience is similar
to other nurses in other hospitals. The other problem is that the research
design used was secondary analysis and researchers could not specifically ask
about moral distress and its components. The findings of this study helped to
form a foundation on the education of pain management education on the nursing

            As much as educating nurses on the importance, strategies
and theories of managing pain to their patients is important, not educating
other health colleagues in their line of work is of no use and this will only
lead to more stressors on the other colleagues (Bernhofer & Sorrell,2015).
It has been reported also that many physicians just like nurses have no
knowledge on pain management and this leads to them being frustrated when their
patients pain is not managed.

            Moral distress is a phenomenon that is related to nurses
who are not able to effectively support patients who are in acute or chronic
pains. frustration has been discussed by many of the participants of the study
as a main cause of moral distress as they are unable to provide the required
treatment to the patients regardless of their source of pain. On the other
hand, there are nurses who are capable of helping their patients but are
powerless and they do nothing about it. These nurses were reported to experience
extreme moral distress. The capable nurses are seen to have little knowledge on
the education of pain management but they are powerless in implementing this
knowledge: They are seen to have higher levels of moral distress.


            Among the barriers to managing the patient’s pain, one of
the issue s addressed by the nurses was on the communication with the
doctors/physicians. Many nurses argued that the doctors once called they had
nothing more to offer to the patients. This made the nurses frustrated thus
leading to moral distress on their part. Lack of pain management education was
also discussed as a barrier. The nurses said that the doctors do not have the
education on pain management thus they cannot teach them on the matter. Some
other nurses who did not report on frustrations, indicated that the patients
did not seem to care about pain management and they usually ignore the question
on pain asking the nurses less aware of what they are experiencing.

            One of the questions of the study was the nurse being
unable to manage pain. In the audios recorded during the interviews of the
participants, it was noted that they used the word, ‘frustrated’ when they were
not able to help/ manage pain. They used the term frustration to signify their
lack of power or control on the situation they were presented with. This
revelation proved that frustration was one of the main causes of moral distress
to the nurses. The recordings that were used contained sounds of signs, pauses
and voice intonations that expressed their distress. The notes gotten from the
interviewers on the body language of the interviewees suggested a sense of
moral distress on a patient who was narrating their desperation in trying to
relief the pain of a patient.


            The study was conducted by the original members of the
primary study. They ensured that all the 48 nurse participant interviews audios
were recorded, saved the interviews and the written notes gotten from the
participants were well stored. The research group focused on the themes of
frustrations, distress and the barriers that they experienced that made
management of pain of the patients challenging. For this study, having used
digital resources to record audios of the participants, the researchers
listened to the audios and wrote notes on their ideas and their insights on
what they heard. These notes helped to document the information got and helped
in identifying the upcoming trends impressions of the study. This helped them
to sort and label the data they got after every audio.

The study was design that
used for the study was a secondary qualitative analysis of an original study
theory. This type of design is used when new questions of a research are got
from the information acquired. The nurses used for the study were from a
tertiary care hospital in the Midwest. The nurses were forty-eight, who were
registered and operated on the surgery units and the emergency departments in
the hospital. The nurses were between the ages of 23-59years. The nurses were
chosen in terms of their managers who were asked to recommend nurses who had
previously discussed their experiences while working with patients with chronic
and acute pain (Bernhofer & Sorrell,2015). Most of the participants were of
the female gender and worked on the surgery department. Interviews were used
for ever nurse. Initials consent of every nurse was first obtained which
included a statement that approved that the recorded interviews would be stored
and reviewed if need for any analysis related to their experiences arose.