What keeps you up during the day?

Abstract: At many hospitals, the experiences of the night shift – particularly nurses -- are vastly different than the daytime staff, which can lead to significant ethical challenges. Night nurses typically have three years or less of experience, and are joined by fewer on-site clinical and support staff, meaning they have less opportunity to engage in interdisciplinary dialogue about patients’ medical status, psychosocial issues, and plans of care. 'Novice’ overnight nurses might feel challenged by the weight of their responsibilities and unprepared to navigate ethical challenges. These stressors are particularly acute in the pediatric oncology unit setting, where caring for young patients presents unique ethical challenges given the intensity of treatment protocols, the varied age and developmental levels of patients, complexities of family dynamics, and difficulties navigating pediatric assent and parental consent. Less-experienced pediatric oncology nurses are still learning the intricacies of their roles and responsibilities, and those who work night shifts often feel unsupported as they try to navigate ethical issues, often leading to burnout and moral distress.
This paper/flash presentation will present an intervention designed to evaluate the ethical challenges that pediatric oncology nurses experience on the nightshift, and to then provide supports and educational opportunities to address them. An assessment will measure nurses’ knowledge and interest of ethics and their perceived ethical challenges, followed by a series of lectures tailored to these identified knowledge gaps, interests, and challenges. The project will initially involve only the pediatric unit of the institution but may be replicated in other units.

Keywords: Pediatrics, Novice nurses, moral distress