Evaluating peer support as an intervention to reduce the adverse sequelae associated with ethical dilemmas

Abstract

Background: Regular exposure to ethical dilemmas can impact a nurse’s well-being and by extension, the healthcare system. Peer support programs are interventions that have been implemented to mitigate these effects. CARED rounds are a local peer support program that has not been evaluated since implementation in 2020 and thus, the efficacy in addressing ethical dilemmas is unknown. Purpose: I aimed to evaluate CARED rounds’ efficacy in addressing the adverse consequences of ethical dilemmas and determine the potential benefits, challenges and opportunities for improvement. Methods: I completed a literature review, consultation with stakeholders, and an evaluation of CARED rounds, including a questionnaire and interviews. The Moral Distress Scale-Revised (MDS-R) captured moral distress levels. Results: Peer support programs, including CARED rounds, have promoted resilience and camaraderie among participants by validating their feelings, decreasing feelings of isolation, and improving job satisfaction. Moderate moral distress levels were observed in both participant and non-participant groups, suggesting that while CARED rounds offer some support, broader sources of distress could remain. Key barriers to attendance included scheduling conflicts, staff workloads, and insufficient understanding of CARED rounds’ benefits among non-participants. Conclusion: Most registered nurses, regardless of participation status report moderate moral distress levels suggesting that CARED rounds offer some support but may not fully address broader sources of moral distress. Addressing logistical challenges and enhancing communication about the program’s benefits could improve participation and ensure greater alignment with its intended design.