There is an increasingly strong movement in support of having a public inquiry into the allegations that Alberta Health Services uses intimidation to make it difficult for health-care professionals to advocate on behalf of their patients and programs.
Of all the things I have read in the papers, this quote from the Edmonton Journal on March 12 sums it up best: “At the moment there is no institutional mechanism to protect physicians and other health-care workers who wish to speak in the public interest about front line matters they witness and which bring them moral distress.”
Much has been said about doctors but I would like to speak as a retired nurse on how this effects nurses and other front line staff.
Shortly after Alberta Heath Services was formed, they released a Code of Conduct that applied to all employees and was also sent to volunteers to follow. It contained information on how concerns were to be expressed up the chain of command.
It also had instructions regarding interaction with the press; you referred them to the Public Relations Department, who answered all questions. If you were approached, you needed to get the name of the paper, the reporter, the subject and what you said and report it.
Front-line people knew this was an attempt to limit information at a time when we were going through the chaos and uncertainty involved in creating the Alberta Health Superboard. We called it the “gag order” and it was so unpopular it was rewritten. Softer words, same content.
It is still called the gag order and nurses are often not in a position they feel they can speak out.
Unions and associations are now putting out information on burnout and moral distress.
Professionals are supposed to practise within their competencies. However, they have no control over their workload.
Burnout happens when the workload is continually too much, when staff works overtime out of loyalty to their patients and fellow staff members and then are told they are the problem because they get paid overtime to do it. (If there was enough staff, you wouldn’t have to pay so much overtime.)
Moral distress comes when you do your best every day but you are so busy you cannot meet your own expectations of the kind of nurse you want to be and you know tomorrow will be the same. Moral distress comes when problems are moved from the areas where the public are watching (emergency) to areas where they are not — and it is called “progress.”
Moral distress is when you are trying to find help that is required for a patient who is falling through every crack the system has to offer and there is nowhere you can find for them to be.
Working in psychiatry, that was the one that I had the most difficulty with. Moral distress is when you want to speak out and cannot.
Do we need a public inquiry? Yes, but don’t limit it to doctors. It is deeper than that.
Brenda D. Corney, Retired RN