Nav: Home

Moral distress in health care -- Special report outlines strategies to increase moral resilience

February 14, 2017

February 14, 2017 - Nurses in all roles and specialties face complex ethical situations that challenge their values, giving rise to moral distress. New approaches to overcoming the challenges of moral distress by increasing moral resilience are presented in a supplement to the February issue of the American Journal of Nursing. The journal is published by Wolters Kluwer.

Based on the proceedings of a recent expert symposium, the special report outlines strategies to mitigate the harmful effects of moral distress in the health care workforce and to create healthy work environments--with the goal of providing safe, high-quality care for patients and families. The supplement, titled "State of the Science: Transforming Moral Distress into Moral Resilience in Nursing," is now available on AJN's website. Cynda Hylton Rushton, PhD, RN, FAAN, and Kathy Schoonover-Shoffner, PhD, RN, are the guest editors of the special report.

Addressing Moral Distress by Building Moral Resilience

Moral distress occurs when nurses and others "recognize their responsibility to respond to care situations but are unable to translate their moral choices into action." For example, an oncology nurse may know that a cancer patient wishes to refuse treatment, but doesn't do so because his physician and family want him to "fight on"; or nurses on a geriatric unit may know they are not providing needed care to patients because of poor staffing.

With the increasing complexity of health care, mortal distress in nursing has risen to unprecedented levels. These conflicts threaten nurses' core values and moral integrity, contributing to burnout and staff shortages and endangering safety and quality of care.

At an invited symposium held in Baltimore last August, 46 nursing researchers, clinicians, ethicists and organization representatives met to discuss moral distress and to develop strategies to address it. Following a consensus process, the participants approved recommendations on essential steps for addressing moral distress and supporting the cultivation of moral resilience in individuals; and for building systems that support ethical practice. In both areas, priorities for education, practice, and policy are identified.

The full supplement, including a concise executive summary, is freely available to read and download on AJN's website: http://journals.lww.com/ajnonline/Pages/Moral-Distress-Supplement.aspx. The report can also be found in a digital magazine format at http://mydigimag.rrd.com/publication?i=379260.

The project was a four-year collaborative effort of The Johns Hopkins School of Nursing and Berman Institute of Ethics, the American Journal of Nursing, and the Journal of Christian Nursing, along with the American Association of Critical Care Nurses and the American Nurses Association. Funding support came from Johnson & Johnson, the Heilbrunn Family Foundation, and Nurses Christian Fellowship/USA.

"We hope clinicians, administrators, educators, and researchers will use this report to initiate conversations, plan strategies and curricula, and conduct research toward creating effective ways to respond to situations that provoke moral distress," according to an introductory editorial by Maureen Shawn Kennedy, MA, RN, FAAN, Editor-in-Chief of American Journal of Nursing.

The Editors voice the hope that the information presented will lead to new approaches to lessening the occurrence and harmful effects of moral distress. They write, "With determined action, we can help nurses and other providers mitigate the effects of moral distress, enhance the ethical environment in which they practice, and improve the quality of health care."
-end-
About the American Journal of Nursing

American Journal of Nursing is the most honored broad-based nursing journal in the world. Peer reviewed and evidence-based, it is considered the profession's premier journal. AJN's mission is to promote excellence in nursing and health care through the dissemination of evidence-based, peer-reviewed clinical information and original research, discussion of relevant and controversial professional issues, adherence to the standards of journalistic integrity and excellence, and promotion of nursing perspectives to the health care community and the public.

About Wolters Kluwer

Wolters Kluwer is a global leader in professional information services. Professionals in the areas of legal, business, tax, accounting, finance, audit, risk, compliance and healthcare rely on Wolters Kluwer's market leading information-enabled tools and software solutions to manage their business efficiently, deliver results to their clients, and succeed in an ever more dynamic world.

Wolters Kluwer reported 2015 annual revenues of €4.2 billion. The group serves customers in over 180 countries, and employs over 19,000 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands. Wolters Kluwer shares are listed on Euronext Amsterdam (WKL) and are included in the AEX and Euronext 100 indices. Wolters Kluwer has a sponsored Level 1 American Depositary Receipt program. The ADRs are traded on the over-the-counter market in the U.S. (WTKWY).

Wolters Kluwer Health is a leading global provider of information and point of care solutions for the healthcare industry. For more information about our products and organization, visit http://www.wolterskluwer.com, follow @WKHealth or @Wolters_Kluwer on Twitter, like us on Facebook, follow us on LinkedIn, or follow WoltersKluwerComms on YouTube.

Wolters Kluwer Health

Related Health Care Articles:

Care management program reduced health care costs in Partners Pioneer ACO
Pesearchers at Partners HealthCare published a study showing that Partners Pioneer ACO not only reduces spending growth, but does this by reducing avoidable hospitalizations for patients with elevated but modifiable risks.
Health care leaders predict patients will lose under President Trump's health care plans
According to a newly released NEJM Catalyst Insights Report, health care executives and industry insiders expect patients -- more than any other stakeholder -- to be the big losers of any comprehensive health care plan from the Trump administration.
The Lancet: The weaponisation of health care: Using people's need for health care as a weapon of war over six years of Syrian conflict
Marking six years since the start of the Syrian conflict (15 March), a study in The Lancet provides new estimates for the number of medical personnel killed: 814 from March 2011 to February 2017.
In the January Health Affairs: Brazil's primary health care expansion
The January issue of Health Affairs includes a study that explores a much-discussed issue in global health: the role of governance in improving health, which is widely recognized as necessary but is difficult to tie to actual outcomes.
Advocacy and community health care models complement research and clinical care
Global lung cancer researchers and patient advocates today emphasized that new models of delivering care and communicating about cancer care play an important role in the fight against lung cancer.
More Health Care News and Health Care Current Events

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Anthropomorphic
Do animals grieve? Do they have language or consciousness? For a long time, scientists resisted the urge to look for human qualities in animals. This hour, TED speakers explore how that is changing. Guests include biological anthropologist Barbara King, dolphin researcher Denise Herzing, primatologist Frans de Waal, and ecologist Carl Safina.
Now Playing: Science for the People

#534 Bacteria are Coming for Your OJ
What makes breakfast, breakfast? Well, according to every movie and TV show we've ever seen, a big glass of orange juice is basically required. But our morning grapefruit might be in danger. Why? Citrus greening, a bacteria carried by a bug, has infected 90% of the citrus groves in Florida. It's coming for your OJ. We'll talk with University of Maryland plant virologist Anne Simon about ways to stop the citrus killer, and with science writer and journalist Maryn McKenna about why throwing antibiotics at the problem is probably not the solution. Related links: A Review of the Citrus Greening...