Nurse’s identity construction in the face of the moral distress process in an intensive care unit*

Abstract

Objective: to understand nurses’ identity construction in the face of the moral distress process, from the perspective of intensive care nurses. Methods: qualitative, descriptive, interpretive and analytical study, developed in 2016 in
an intensive care center of a university hospital. Twelve nurses from the day shift participated in the research. Data collection took place through interviews guided by a semi-structured script and the data were submitted to thematic
content analysis. Results: from the nurses' perspective, the relationship between the identity configuration and moral distress occurred through experiences of situations in the daily work at the ICU that prevent them from exercising the
practice as they believe it is the correct way, such as: the model of care of work organization; the development of technical-assistance activities to the detriment of care management; work more mechanically than intellectually;
not belonging to the health team; and organizational aspects such as intense work schedules, the relationship with coordination and difficulties in implementing improvements in the work process. Final considerations: it was concluded that the nurse's work is permeated by experiences of moral problems that influence the construction of identity and their ethical commitment to provide the care that they deem appropriate for critical patients. This is because identity is built from the perception of oneself and one's work and is influenced
by interpersonal relationships, the organization of work and their daily experiences.