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How should we address moral distress and burnout in ICU workers?

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CHÉOS Scientist Dr. Peter Dodek was recently invited to speak at the Summit on Burnout in Intensive Care Unit (ICU) Professionals about the role of moral distress in burnout. He outlined ongoing research at CHÉOS that is searching for solutions to this important problem.

“Moral distress is the stress that results from a discrepancy between the care that health care professionals think should be provided and the care that is actually delivered,” said Dr. Dodek, a Professor in the Division of Critical Care at the UBC Faculty of Medicine.

Discrepancies can be caused by financial constraints, standards of care, or lack of communication about end-of-life care.

“In the ICU, as well as other settings, moral distress can have serious effects on staff, interdisciplinary teamwork, and the safety and quality of care for patients,” said Dr. Dodek.

Dr. Dodek, along with CHÉOS’ Dr. Hubert Wong, recently published an evaluation of internal medicine residents at UBC and found that a quarter of respondents considered quitting the program due to moral distress and one in five showed signs of high burnout.

“Burnout can be thought of as a state of emotional exhaustion, typically caused by a number of factors, one of which is moral distress,” he said.

Dr. Dodek’s previous research has shown that nurses are more likely than physicians to experience moral distress and that increasing years of experience in ICU nurses is associated with moral distress and a tendency to quit.

“One theory is that physicians experience less moral distress because they have greater control over the care delivered,” said Dr. Dodek.

Scientists at CHÉOS are currently looking for solutions for moral distress.

“What we’re doing currently is to have ICU health care professionals characterize their experiences with moral distress,” noted Dr. Dodek “This allows and encourages participants to find and test their own solutions in real-time.”

Dr. Dodek will discuss this ongoing CIHR-funded research during the next Work in Progress Seminar on January 17.

The Summit on Burnout in ICU Professionals was held in Chicago on Dec 1, 2017 and was sponsored by the Society for Critical Care Medicine, the American Thoracic Society, the American College of Chest Physicians, and the American Association of Critical Care Nurses.