Marie-Josée Potvin, PhD (c) Programmes de bioéthique Faculté de médecine Université de Montréal

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Détresse morale Sentiment d’atteinte à l’intégrité morale conçu comme le fait d’agir en accord avec ses valeurs profondes et ses engagements (Laabs, 2007) Lavoie-Tremblay et al., (2008) Infirmières (Québec)309 Niveau élevé détresse43% Changer emploi (inf)62% Quitter profession13% Canadian Federation of Nurses Unions (2011) Absentéisme,infCa 2010$711 million Nb inf /sem19,000 You are in a hospital, Nurse Hill. If you collapse from exhaustion, the emergency room is just down the hall Désengagement émotionnel; Dimin.empathie; Aggressivité, Perte de confiance (Austin, 2003)

Répondre aux standards professionnels (Bebeau 2008; Burkhardt,2008) Assurer un leadership éthique efficient et Participer à la transformation des organisations (Bell, 2008; Ellis, Abbott, 2012)

VULNÉRABIITÉ Tableau tiré de: “An image may be worth a thousand words, but not in professional ethics”: using Blasi’s identity modes to build professional ethics identity tendencies (PEIT). Kennedy Institute of Ethics Journal (soumis). Professionnal Ethics Identity Tendencies (PEIT)

En pratique?

& Responsabilité des organisations

Viser des objectifs plus ambitieux (Agrément Canada) Décloisonner l’éthique clinique (systémique) Faciliter/obliger la formation des gestionnaires Créer conditions pour discussion Éviter l’approche fits all Dépasser l’approche «window dressing» Faire preuve d’humilité

Austin, Wendy, Vangie Bergum, and Lisa Goldberg. (2003). Unable to answer the call of our patients: mental health nurse’s experience of moral distress. Nursing Inquiry 10 (3): Bell, J., J. M. Breslin, Jennifer Bell, and Jonathan M. Breslin. (2008). Healthcare provider moral distress as a leadership challenge. JONA's Healthcare Law, Ethics, & Regulation 10 (4):94- 7; quiz Burkhardt, Margaret, and Alvita K. Nathaniel. (2008). Ethics and issues in contemporary nursing. Clifton Park, New York: Thomson Delmar Learning. Bebeau, Muriel J. (2008). Promoting ethical development and professionalism : insight from educational research in the professions. Univesity of St. Thomas Law Journal 5 (2): Berry, Lois, and Paul Curry. (2012). Nursing Workload and Patient Care. Understanding the Values of Nurses, the Effects of Excessive Workload, How Nurse-Patient Ratios and Dynamic Staffing Models can Help. edited by T. C. F. o. N. Unions. Ottawa.

Canadian Federation of Nurses Unions. (2012). Long-Term Health Care Workforce Planning Built on Partnership, Expertise and Safe Staffing: A Practical Imperative (Submission to the House of Commons Standing Committee on Human Resources, Skills and Social Development). Ottawa, ON, Canada. Ellis, Peter, and Jane Abbott. (2012). The renal manager: the ethics of leadership. Journal of Renal Nursing 4 (4): Lavoie-Tremblay, M., O’Brien-Pallas, L., C., G., Desforges, N. & Marchionni, C. (2008). Addressing the turnover issue among new nurses from a generational viewpoint. Journal of Nursing Management, 16(6):