Dr Fiona Miles

Paediatric Intensivist, Starship Child Health, Auckland, NZ

Fiona is a paediatric intensivist at Starship Children’s Hospital, Auckland. She is the unit supervisor of training, member of the ICM and Paediatric Vocational Training Committees, Deputy Chair of the CICM second part paediatric examination committee and faculty for the Wellington ICM course.  Her interests are ethics and communication and she is a member of the ADHB Hospital ethics committee. She has completed a Diploma in Professional Ethics, Postgraduate Diploma in Arts (ethics) and is now undertaking a PhD. She enjoys balancing clinical work with a busy family life. 

Moral Distress in the PICU

Moral distress refers to the sense of frustration and failure arising from an individual’s struggles to fulfill their moral obligations to patients, families, and the public, particularly around the issues of inappropriate use of resources, end of life care and communication.

With increasing treatment options and family expectations, there is potential for patient care which is at odds with what the individual thinks is right.  It is marked by a sense of helplessness and can be cumulative. It has been associated with burnout and poor staff retention.

Common themes and causes for moral distress in the PICU will be discussed with reference to recent studies.