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The Relationship Between Providing Neonatal Palliative Care and Nurses' Moral Distress: An Integrative Review

Cavinder, Christina DNP, RN, CPNP-PC

Section Editor(s): Catlin, Anita

doi: 10.1097/ANC.0000000000000100
Ethical Issues in Newborn Care

Moral distress has been identified in multiple clinical settings especially in critical care areas. The neonatal intensive care unit (NICU) has frequent situations in which moral distress may occur including providing palliative care. The purpose of this integrative review was to determine the relationship between the provision of palliative care in a NICU and nurses' moral distress. The evidence reviewed supports that moral distress does occur with the provision of neonatal palliative care. An interdisciplinary care team, an established protocol, and educational interventions may decrease moral distress in nurses providing end-of-life care to infants in the NICU.

College of Nursing, Valparaiso University, Indiana.

Correspondence: Christina Cavinder, DNP, RN, CPNP-PC, Valparaiso University, LeBien Hall, 836 La Porte Ave, Valparaiso, IN 46383 (

The work occurred at Valparaiso University in Valparaiso, Indiana.

The author declares no funding or conflicts of interest.

© 2014 by The National Association of Neonatal Nurses