Moral distress occurs when one recognizes one’s moral responsibility in a situation; evaluates the various courses of action; and identifies, in accordance with one’s beliefs, the morally correct decision—but is then prevented from following through.
The literature is replete with the mounting evidence of the incidence and sources of moral distress.It’s a growing problem that not only contributes to burnout, fractured inter-professional relationships, and shortages of healthcare workers, but also undermines the safety and quality of care. Despite the widespread scholarship and dialogue about moral distress, few interventions have been effective in mitigating its negative impact. What has been missing is a way forward that acknowledges the reality of moral distress and points to effective ways to build moral resilience.
Moral resilience
As nurses, our primary focus is on the people we serve. When ethical challenges arise in clinical care, we need to be morally resilient to respond in ways that minimize our distress and preserve our integrity. Moral resilience is the capacity of a person to sustain, restore or deepen their integrity in response to moral complexity, confusion, distress, or setbacks. It’s founded on our self-knowledge of and commitment to our values and intentions.
Moral resilience requires us to conscientiously examine our views. Fundamentally, moral resilience arises from a self-regulated, balanced mind and heart, an open, curious, nonreactive mindset, clear values, and principled action. If we are morally resilient, we are resolute in our moral actions despite fear and realistic about our own limitations; we seek meaning in situations that threaten our moral sensitivity and reasoning. Likewise, we are able to discern the appropriate levels of moral responsibility in morally complex, ambiguous, or conflict-laden situations.
Strategies to Cultivate Moral Resilience
As nurses, we can adopt strategies that help us cultivate our individual moral resilience, and advocate for systems strategies that create a culture of ethical practice. We can take steps to address moral distress in ethically difficult situations. Based on previous work, here are some ideas that can enrich and leverage heart, mind, and spirit. These individual strategies, in tandem with systems-focused interventions to foster a culture of ethical practice, are essential to preserve or restore nurse’s integrity.
Foster self-awareness
Explore your thoughts and feelings that accompany moral distress, and be willing to acknowledge that they may be biased, incorrect, or congruent with your values. Become curious about the conscious or unconscious assumptions (positive and negative) that may be guiding your actions. Repeatedly inquire to determine if they are true or relevant in the current situation or if they may involve projections from prior experiences. By being self-honest and transparent, we can expand our ability to respond to morally distressing situations with clarity, confidence, and diminished personal cost.
Develop self-regulation capacities
Cultivate your ability to make and uphold your moral commitments despite fear or uncertainty. Self-regulation includes the capacity to mindfully notice and respond to signals from the body, emotions, and thought patterns to restore balance when upsets or ethical challenges occur. When our nervous system becomes imbalanced or reactive, we can become judgmental, narrow-minded, or experience self-doubt. When fear arises, courage is needed to name, notice, and potentially release the source of our fears. Building a self-regulation “muscle” is a foundation for principled choice and ethically grounded action. When we focus on our core values, we can practice mindfulness and active engagement in ways that allow us to embody stability and clarity in challenging circumstances and to reflect our values in our choices, behavior, and character. Methods such as mindfulness based stress reduction (MBSR), meditation, and movement practices such as yoga and tai chi are effective and accessible.
Develop ethical competence
Live the values you hold and align your inner character with your outward behaviors. Cultivating your ability to perceive ethical issues in complex cases can help you explore ethical values and principles and exert robust moral agency. Ethical competence encompasses skills in moral reasoning, habits and patterns of behavior that reflect our character, ongoing reflection, and principled, responsible action. When we attain new levels of ethical competence as nurses, we can achieve a new openness to the values, motivations, hopes, and fears of others.
Speak up with clarity and confidence
Find your voice of wisdom and clarity. Go beyond the protests of “why are we doing this” to state your concerns in inter-professional encounters using a clear, compelling, and ethically robust vocabulary. Courage, the ability to befriend your fears when confronted with a situation that requires you to act to preserve integrity, is often needed. Self-regulatory skills and self-awareness can be essential to differentiate your suffering from the patient’s and to clearly articulate the nature of the ethical conflict or concern.
Identify situations where you are able to act with integrity and when you must excuse yourself on grounds of conscience. Begin to notice when you are acting in ways that are aligned with your character and conscience. These patterns can be useful when confusion or uncertainty arise to help re-orient us toward integrity preserving action and inform how we communicate our concerns. Within our practice settings, we have access to relationships, systems, and structures that we can—and should—leverage for guidance and support.
Find meaning in the midst of despair
When confronted with seemingly senseless situations, meaning can be an antidote to despair. If the source of your moral distress is unmovable, stabilize your emotions to neutralize reactivity. Articulate your regrets and unmet expectations by journaling, debriefings, or reflections. Release, to the extent possible, the moral residue and re-calibrate to a “new normal” that restores your mind and heart to wholeness and makes space for the moral disappointment, sense of moral failure, or moral harm that was produced.
Create a potent antidote to powerlessness and despair by reconnecting with your core values and intentions. For all of us, reaffirming the values and purpose that originally drew us to the nursing profession can sustain us in the midst of ethical conundrums. Similarly, the practice of connecting to what we are grateful for—in ourselves, our patients, our colleagues, and our profession—is a powerful antidote to despair.
Engage with others
You are not alone. People with moral resilience leverage connections to themselves and others to support their integrity and well-being. Strong social connections can act as a safety net when you struggle to address ethical complexities and the isolation that often accompany moral distress. Become part of a moral community by talking one-on-one with colleagues or trusted advisors, connecting with family and friends, or reaching out to leaders within your institutions or professional organizations. Within our practice environment, we should look to and seek support from team activities such as facilitated inter-professional discussions or ethics consultation.
Participate in transformational learning
Seize the opportunity to learn from moral crises and the situations that produce moral distress. Confront your limitations, re-examine your positions and realign them with your moral core. We can change our behavior and practice by participating in professional activities including routine case reviews, root cause analysis of morally distressing cases, and ongoing quality improvement.
Contribute to a culture of ethical practice
The American Nurses Association Code of Ethics tells us that we are responsible for creating and sustaining a culture of ethical practice. As nurses, we can actively contribute to and leverage interprofessional efforts to design structures that bolster resilience. We can, for instance, find useful and tested tools in the work of the Center for Ethics in the Veteran’s Administration and by other ethics initiatives. And we can benefit from ongoing research into the nature of resilience for starting points in developing a culture of ethical practice, such as the work of Zolli, who suggests the alignment of “beliefs, values and habits of mind; trust and cooperation; cognitive diversity; strong communities, translational leadership and adaptive governance.”
Commitment to moral resilience
Moral resilience is an evolving concept in response to moral distress. Like physical exercise, moral resilience requires dedication, discipline, and compassion toward our limitations and inevitable setbacks. Creating a regular time and commitment to cultivate the elements of moral resilience and engaging resources to resist distractions and flagging will, are essential for robust moral resilience. As an ongoing practice, nurses will have regular opportunities to return to three core questions.
- Who am I being in this moment?
- How do I want to be known?
- Am I choosing to act or not act in a way that I can live with?
These questions ground our intentions, character, choices, and behaviors to reduce the exhaustion that arises when we are out of alignment with our values and obligations. Regularly committing to specific actions to support your moral resilience upholds the 5th Provision of the ANA Code of Ethics: “The nurse owes the same duties to self as to others, including the responsibility to…preserve wholeness of character and integrity.” Being morally resilient is not optional; enact your moral resilience plan toda
The author would like to acknowledge Judy Douglas and Peter Young for editorial assistance and to note that this article is based on Rushton C. Moral resilience: a capacity for navigating moral distress in critical care. AACN Advanced Critical Care. 2015;27(1):111-9.
Cynda Hylton Rushton is the Anne and George L. Bunting Professor of Clinical Ethics and a professor of nursing and pediatrics at Johns Hopkins University, School of Nursing & Berman Institute of Bioethics, Baltimore, Maryland.
Selected references
American Nurses Association. Code of ethics for nurses with interpretive statements.
Foglia M, Pearlman R, Bottrell M, et al. Ethical challenges within Veterans Administration healthcare facilities: perspectives of managers, clinicians, patients, and ethics committee chairpersons. Am J Bioethics. 2009;9(4):28-36.
Helft PR, Bledsoe PD, Hancock M, et al. Facilitated ethics conversations: a novel program for managing moral distress in bedside nursing staff. JONA’S Healthc Law Ethics Regul. 2009;11(1):27-33.
Nelson HL. Damaged Identities, Narrative Repair. Ithaca, NY: Cornell University Press; 2001.
Oh Y, Gastmans C. Moral distress experienced by nurses: a quantitative literature review. Nurs Ethics. 2015;22(1):15-31.
Rushton C. Moral resilience: a capacity for navigating moral distress in critical care. AACN Adv Crit Care. 2015;27(1):111-9.
Rushton CH, Caldwell M, Kurtz M. Moral distress: empowering nurses to restore integrity. Am J Nurs. In press.
Rushton CH, Kaszniak AW, Halifax JS. A framework for understanding moral distress among palliative care clinicians. J Palliat Med. 2013;16(9):1074-9.
University of Kentucky, College of Medicine. The Moral Distress Project.
Varcoe C, Pauly B, Webter G. Moral distress: tensions as springboards for action. HEC Forum. 2012;24(1):51-62.
Zolli A, Healy A. Resilience: Why Things Bounce Back. New York: Free Press; 2012:15.
408 Comments.
This inofrmation if very helpful for nurses at all stages of their professional development. Mary
Thank you so much for your comment!
great
Very interesting article!
Very good article, with good information
Good reading
Very good article
This is an great article
Overall great infomation
Great information and review
Thank you for your comment!
Very useful Information
very interesting so happy i read this!
great article, nurses take great care of others and not themselves. Nice resources for us to focus on self care.
I’m glad I read this article.
This was a great article to read, its important for nurses to understand why becoming a nurse is such an important job. Building moral resilience is not just an individual thing its a group effort with your nursing care team.
Great reminder that we must take care of ourselves in order to take care of others.
I really enjoyed hearing about various self-care strategies. Then in the article I could related to feeling powerlessness in the workplace. Especially with the nursing shortage.
Awesome!
Thank You!
Great article, thank you!
Thank you for your lovely comment!
As a newer nurse, I have heard stories from other nurses about their personal experiences and ways that they have helped battle fatigue. It is important to maintain a team mindset and to help each other. Personally, one of the nurses I used to work would have little group “therapy/decompression” sessions during an afternoon break. She would lead us in breathing exercises and mindfulness exercises to help us to recenter and refocus. She now has her own yoga/mindfulness studio and I visit there at least one time a month to help with my own mental health and to help relieve stress from work.
great article
Very Informative!
This is a great reminder to take care of ourselves while helping others.
Great article we need to talk about more.
Great information on self regulation
Moral resilience needs to be discussed more everyday.
Great article about our wonderful profession
Thank you for your lovely comment!
I will be more mindful of my needs as well as my patients, so that I can be at my best in order to provide the best care possible for my patients.
Great information. This article just reiterates what I already know to be true. I just have to put these strategies into action more often than I do. Thanks again for posting.
Great article to help review how to be more resilent
I am grateful for this educational program. I feel I have become the poster child for Moral distress. Thank you for the summation of who I am as a nurse and ways to move forward and continue to be the best nurse I can be.
Great information, fostering strong connections in the workplace can only help to ensure a great work environment and also help with positive patient outcomes. When co-workers look out for each other they help patients stay safe and better ensure that errors not be made in the workplace.
Self care leads to better patent care.
to me it’s been important to be part of the committee on our unit that focuses on problems we are having and instituting “small tests of change” to deal with those. The solutions come from the staff actually doing the work, so we feel listened to and able to participate in the outcomes.
The speaker talked about having a life outside of work. So important. She learned to dance. Others learn gourmet cooking. I do animal rescue and volunteer at the local shelter. Those things give us a different focus and MAYBE also keep us from saying “yes” every single time we are asked to stay over, come in early. or pick up an extra shift. Important to realize that the work of the unit goes on even if it’s your day off or you’re staying home because you are ill. I feel more ready to hit the challenges when I come back after a few days off.
It is important to create an environment that is safe and open for disagreements at the workplace. Otherwise, it is not an environment that is focused on growth but an environment focused on control.
Great article containing a lot of great information
This is a great article for all nurses to read.
Thanks !!
I found this information to be very useful to me personally
Uncovers a lot of the discrepancy between the emotional and moral toll that the nurse must take on versus the different parties who have made the decisions. Resilience is the only way to survive such a position and seems to be rather harsh to continue this way in the healthcare system. I believe there is need for change in the structure of our healthcare systems and how things are done.
after reading this i got some points and how to care somenone very well its very useful to me
after reading i got some very useful ponits and how to care a person ,its very useful to me
good
great article.
Very enriching topic.Everything said here is very true. We need these everyday at work since there are always stressful, complex & frustrating situations.
Fantastic topic that I feel that we overlook at times. Just a few minutes every day in a huddle can make a difference.
Fantastic topic that I feel that we overlook at times.
I loved the topic. I’ve learned a lot on this topic. Thank you
Very helpful and informative topic. Thank you
We are lucky that we have a platform of building and sharing our best practices of taking care of each other and training us the culture of Resilient Leadership despite our differences. Thank you for this wonderful amazing instrumental information.
great article!
Good Article
Excellent information
Enjoyed reading it
Insightful and informative
Well written
As a longtime nurse who stop practicing due to moral distress, this article will help in getting back my “why” and help motivate me to return to practice.
Great thinking and good information overall.
Great article & provides something to think about
Good Article. I do believe we need to support each other. Now more than after post Covid 19.
thank you for the cllarity of the content. Much needed
We do need to remember why we became nurses. Make sure we support, respect, and take care of ourselves and coworkers
Much need article. Great resource during these unprecedented times.
Great article-very applicable.
Very Good article, being self aware is important as a nurse.
Good article, information that should be passed to co-workers.
Good message to pass along within our nursing circle and to new and upcoming nurses.
Thank you!
Great!
Very detailed article, to foster self-awareness is so important.
Very informative article.
Very informative article.
excellent topic
Thank you
Great articles for nurses
Excellent information.
timely course
Good course
Excellent article needed at this time of nursing with so much stress in the workplace.
Just saw this CE and thought I would share it with my co-workers
Thank you for information
This was a very useful article
A good reminder to take care of ourselves so we may continue to care for others>
After work, several RN’s would just talk about their stressful nights, especially the real sad ones & it was not only a source of decompression, but also a bonding experience within ourselves. Some nights after work in the parking lot we’d be crying & on a rare occasion we would be laughing. I think that 1/2 hour decompressing after work & the ability to show compassion for a nurse who had a particularly sad or stressful shift is so important in preventing burn out. We never felt alone & we took it upon ourselves to do that because we found benefits & comfort in doing so. I think that there should be a paid 1/2 post shift for nurses to decompress. That sense of support in knowing you are not alone is priceless & goes along way in the equation of preventing or at least diminishing burn out.
Nice article, easy to follow; and great points brought up.
Great
Thank you for this article
the workplace should provide an in house place, meeting, group, and a variety of therapy
like art therapy (writing, journaling, drawing, painting, hand made crafts OR just a mandatory meditation session daily., and better a gym and sauna…to quiet the mind, good nutrition stations. We need convenience when stressed. It’s not unrealistic or too much to ask for. What would happen without us? We need to know we are taken care of and help is right around the hallway per say.
Some of us need this and some of us are just fine without it. All work and no play is no fun. Most of us go home to more work and therefore more need for resilience. A lot of people have no resources or knowledge on this matter. Many, have NO ONE to talk to or trust. There are ways to identify those with resilience problems and provide in house solutions because most of us don’t have time or willingness to go through trouble of visiting a doctors office or therapist .Providing in house physical and spiritual activities for employees is only common sense to me. The administrators have no idea what it’s like to be a staff nurse, therefore, they probably don’t realize the importance of workplace pleasure, fun, teamwork, laugh at our insecurities and speak up when we feel a need to, at appropriate times An in house support group may work. I am speaking from my
own experience when I was a young nurse working 12 -16 hr shifts, kids at home, single mom, no family support, all work and no play. I just wanted to go home and crash much less drive to a gym or therapist office. I guess we need to become creative and trust trial and error to make the nurse more comfortable and at ease knowing support is around the corner, not on the other side of town. That’s my opinion
Thank you, good information
Relevant and terrific
Excellent
Great reminder of its not just physical presence’ but emotional, moral and support for collegues
Great reading with great tactics. I will utilize some of these in my work place.
I like the self-awareness piece love this article. Building moral resilience may be team effort, but it definitely starts with internal changes.
great article.
Great article
Nice work to give nurses more tools to help work situations become less stressful!
great article
Good article
Great content!
Great article. Informative.
Enjoyed this article. Very informative during these trying times
Resilency is important
a very good article
Excellent article that helps us to remain in line with our morals and values especially in this difficult nursing situation that we have been forced into.
Great article.
I am so thankful for this information. This is very helpful.
Great article! Thank you
Great article, Every nurse would benefit from this article.
Great article!! Every nurse should read about these topics!
thank you for this important information!
Functional AND fun teams make the job worth it
good information to use
if you are in a job that always causes stress and you see that no changes are being made to change the situation, then its time to move on to another job.
Very good article
This content needs to be updated with examples from the pandemic however provides an excellent foundation
Good reminders of working to make sure nurses and staff have the support they need to solve and give care for patients. Creating a trusting work environment that give nurses the tools they need to make sound decisions for being the best they can be and advocate for their patients makes for well nurses and patients.
Very informative and well presented material.
Thanks!
Happy healthy Nurse Happy Healthy patient!
Appreciating the importance of everyone’s role in making a difference in the climate is crucial to help change a negative vortex. Being able to appreciate the holistic being of our co-workers is important.
Informative information
Great read. Bottom line is that if we are not healthy ourselves as nurses we can’t provide the care that our patients deserve and are entitled to. i am person who finds comfort and relief in just going to the bathroom and saying a little prayer. If you know of someone on your unit who prays as well perhaps getting together with them will help get you through the day and daily issues on a unit. there are those who do not like to pray in public and that’s okay.
Very informative, helpful information
Great article with wonderful information and advice on how to increase resiliency in order to prevent burnout and decrease stress!
thank you.
Very informative
great read – very informative
wow – so many good comments!
Excellent article! Our job is to take care of others, but we must remember to take care of ourselves first! Thank you!!
Great article!
Great
enjoyed
Thank you
Thanks!
As nurses I think we all struggle at learning to prioritize our self care. It is truly a goal for myself. Great article.
Great read, informative and affirrming. Sometimes in the hustle and bustle of caring for others we forget even the most fundamental of things like self-care.
very informative
great
Having been in moral despair and come back around, this is just what I need to read before returning to nursing practice to help vaccinate.
AWESONE article, very appropriate during this time of the pandemic. As nurses, we pour our hearts and souls into taking care of our patients, ensuring everyone else is cared for and their needs are met. We forget to take care of ourself and to practice self care.
Very good article
Great content! Thank you!
Communication in a team is key. When it breaks down, many adverse effects can occur ie. patient outcomes, hostile workplace environment, staff turnover.
great
So much great information!
This is a heart-warming read.
GOOD PRESENTATION. THANK YOU!
great…important to team build and support each other during this difficult time
A good article that reminds us to take care of ourselves so we may take care of others better.
great article
great read. thank you for sharing!
Great article
interesting read during the pandemic
A culture of ethics starts with individuals who are committed to change.
Great information. It is important for us to be aware of the effects that the daily demands can take on us and how it can distract us from the importance of the job which is helping others. However, in order to help others, we must take the time to help ourselves and serve our energies so we can give care to those needing it.
great information ; thankyou
Moral resilience plays a vital part in the nursing profession and needs to be addressed more frequently
Working in a place that exceeds your expectations with team building and real compassion and empathy sure is a pleasant surprise after I have worked in places with bullying and clicks. Am glad to end my nursing career in a really great place!
Great article!
Nurses respect and honor others values and morals are important
great article
Helpful knowledge
Helpful article and comments
Thank you for all of the useful information. I found this article to be helpful and entertaining.
Excellent article demonstrating the importance of all nurses at every level to be leaders, provide respect, and look to selves to identify weaknesses and find ways to improve not only knowledge of medicine but of stressors and resources
Thank you for the valuable information especially during these times!!
Great Article!
Great article. Very pertinent information in any work area and topics to consider and be mindful of in life, in general.
good article
very interesting
Interesting article, very appropriate during this time of the pandemic. At times, nurses (we) pour our hearts and souls into taking care of others, and ensuring that everybody else is healthy, their needs are met, etc that we forget to practice self care.
thank you valuable information
Great article
Self care has never been more important in the field of nursing.
loved the presentation
This is an excellent article that provides clear definitions on moral distress. It also provides evidence-informed pathways to develop the resilience to overcome such distress. I am eager to disseminate what I have learned to my team!
Sincerely,
Felicia
The opportunities to think about the three core questions.
Who am I being at the moment ?
How do I want patients to remember me & how I want to be known? And, choosing a way act or not act that I feel I can live with?
All these concepts can aid any nurse who listens, and thinks before acting.
Great article!!!
Great article.
Thank you!
Great Article!
We must help one another through the difficult times and support our differences by discussing and seeking to understand.
good article
great!
A good read that reminds us to reaffirm with ourselves why we chose nursing.
Working with a team and building moral resilience is important in nursing.
great article.
Great article
good ideas
Great article!
great
Great article!
Empowering article.
useful info
Good information. Useful and timely.
This article is applicable to the work I do as a nurse.
This article was very helpful.
Excellent Information. Thank you.
Enjoyed the article– attempted to look up Zolli– clarify please
This is a very interesting article that discusses some important aspects of being a nurse today. It is important to be able to maintain your own morality while providing care for others. Nurses give so much to their patients and need to be reminded to care for their own selves.
Great article
Great Article
Nurses will always be faced with moral dilemmas. This article is a very good resource to offer suggestions and support strategies.
Great Article! Thank you!
This is a great article, thank you for the reminder!
Overcoming Moral Stress and building Moral Resilience takes a village! The entire team working together and communication is key. 2020 has been a challenging year for nurses, but we are resilient and spring back. Moral stress is real and we can help each other. Great article!
Every staff member should feel good at work and not stressed and overly tired. Yes it can be busy but working as a team and not just letting one person deal with the stress is a major factor.
Great
Great article.
Wonderful informational. Very beneficial to my life and practice.
Great article and will definitely keep the thought of moral resilience at work.
Good article
Great article
Great
Insightful and very appropriate to today’s life situations.
Great article. I especially liked “who am I being in this moment? Who do I want to be known as?” Sometimes it’s necessary to take a step back and think about those two very important things
Great article. It showed the importance of team support which is very vital in Nursing.
great article.
Great article
Very good article.
Thank you
Good articular to read, especially during our COVID situation.
Good article
Great article, thank you!
Great article to read during this pandemic.
completely agree!!
With a good foundation for moral resiliency, nurses are better able to name the ethical problem, inquire into the facts, and determine action that supports integrity.
Building Moral Resilience has to be a commitment of each nurse in their workplace.
Great article!
This article refreshes and reinforces the principles of ethics and assisting in providing a safe environment (Physical,Mental and Social) within my work environment.
Great article.
Great article!!!
thank you
Useful, well written and informative
Very informative
Great article.Thanks
All great comments. totally agree with the huddle to get your team motivated and address any concerns for the shift and get some positive energy going. Check in with coworkers periodically to see how everyone is managing and also give yourself a time out when you need it to reset and reenergize.
it is really great
Very informative article. Nursing is a complex field of work not made for everyone. We have to be open minded and be resilient to all the obstacles we face.
Thank you. This comes in a time of need.
Great article
Great Article
Good read..Reminder that it is important to make sure you take care of yourself.
great article
Great article.
great article. well written
Really good read
love the article
Great article, asking for help and reevaluate moral standards are important for a stable mental health. In order to provide great care it’s important to care for ourselves
I really enjoyed this reading as it hit home. Who am I being in this moment? How do I want to be known? Am I choosing to act or not act in a way that I can live with? These are wonderful questions to ask to make sure you feel comfortable with the task at hand.
I have been taking care of people all of my life and seem to not have time to take care of myself. Thank you for reminding me that it is ok to schedule time for myself, after all if I am not taking care of myself, who is? I like the fact that even in the work place I can stop and take the time to ask these questions to set me up to continue doing what I do best! Who am I being in this moment? How do I want to be known? Am I choosing to act or not act in a way that I can live with?
Such a great read thank you!!
Great article
Great article! Thanks!
Good article
yep
Great article!
I really enjoyed this article.
I appreciate the strategies to express my viewpoints and take care of myself. Nursing is perhaps the hardest job to love of all
Great article
Good
Moral Resilience is definitely a skill to acquire while working on the front line during this pandemic. With all the changes requiring flexibility, team work, handling loss all while calming down the frustration of family members who cannot visit their loved ones. Maintaining peace and having a strong spiritual foundation have been other keys to success during this current time. Great article.
Great reminder, Building moral and building a TEAM is a GREAT importance!!!
Very good information!!!
Great article!
Found the topic informative and applicable in my practice.
informative
great course!
This course is relevant and timely. I realize that self regulation and speaking up are important fo ease moral distress. O am being reminded of this at a time when these practices are important.
Insightful article.
Insightful! Thank you
This course spoke very loudly to me. As a nurse for over 40 yrs. I see too often moral problems in medical practices along with money driven companies that require nurses to factor in extra charges.
It is important for nurses to be able to respect and honor others values and morals.
Good read!
It is so important as nurses that we continue to have high standards and be ethical with our choices and decisions. We have a moral responsibility to no judge but to care, do not condemn but to offer help. Nursing is a deep-seated fiber of the work that we do to help any and all people. Excellent article.
Good info
Great article. Developing moral resilience is something I wish we’d discussed more in nursing school.
Thank you for this article. It made me aware of how I have a responsibility to by emotional and spiritual well being as well as my physical well being
Thank you! Even though we think this sometimes, we often don’t speak about it. It’s good to know there are people considering this for us.
Nurses rarely consider Resilience, they often come to work, punch in, receive an assignment and only in key cases, do RNs realize that if they consider how they adapt to change will be essential as to whether they will have a long career.
great
Great article!
Moral resilience is important in improving one’s self worth, as well his/her coworkers’.
This is definitely a great issue that needs dealing with.
This is definitely a great issue that needs dealing with. Nurses are almost always facing moral distress in the workplace.
I have found over my nursing career that if you use the correct tone and state the facts that you can change the outcome or path of care for a patient. That being said most nurses are very “passionate” and this is often times difficult to do. I like the three questions to ask myself and will use that in the future.
great
Great article
Well organized and informative
Great article
Food for thought
As a Hospice nurse, I seem to run into a lot of moral dilemmas. There is often disagreement between loved ones or other caregivers about what is best for the patient, or even between the patient and the family. It can be very tricky at times to navigate these problems. I like the part about reminding us to examine our views, as the patient and /or family or caregivers may not be at the same mindset as nurses are. I also liked the part about being true to ourselves and acting in a way we can live with.
Thank you for sharing this helpful resource. I am privileged to serve as a nursing leader and appreciate the reminders about how my behavior(s) impact others.
Thank you. This is a good one for anyone.
Thank you.
Very informative and a great resource tool for the workplace and beyond.
This was a good read.
Great
After more than 30 years of bedside nursing I am just realizing the core of my deep frustration with the nursing profession. That the power for the most part to have a chance to have the ability to meaningfully contribute to the patients plan of care has not really been in the nurses corner. This is why being a doctor always looked so attractive. The ability to make decisions in the patients plan of care has not really been much of an option for nurses which leaves us frustrated. This is a shame. No wonder nurses feel so frustrated. Nursing has gotten a lot more empowering but it is still a career that leaves (mostly woman still) a great deal of feeling powerless which is not a healthy place to be. At least this article and others like it are helping nurses to be more self aware so we can feel like we have made valuable contributions to people’s outcomes and lives which we have done.
One should be true to oneself. Nurses must recognize that we all are human with emotions. We must take care to take care of ourselves so that we can help others in a time when the patient is experiencing emotional distress.
Great info!
Great info, everyone needs to read it.
great article
Great recommendations.
Good read!
Very good information.
This was a great article and provides self insight. Wonderful reminder we are not alone, what we are experiencing has a name, and taking care of ourselves emotionally and psychologically is our strength in moral dilemmas.
Great article! Very helpful!
Thank you for the insight!
Great article, thank you for the resources
Excellent reading
Interesting
this is great, thank you
very knowledgeable for nursing.
Thank you.
This was an interesting article, thanks for sharing.
Nice article!
I agree to the comments. This is a great article.
Awesome information to remind us that we need to care for ourselves before we are truly able to care properly for others.
Excellent topic!
good article
This is a great overview of the issues of moral distress and I gave this assignment to RN>BSN completion students and the array of moral issues that they must deal with, and be resilient to, was daunting. This provides a framework for helping them achieve their resilience, but I would like more strategies for them to safely address these moral dilemmas. THey are not in positions of power.
Great Reminder to keep yourself grounded.
how can a nurse also have empathy for the patient which allows insight for beneficial and productive ways of being a positive advocate for each patient?
I believe I take better care of my family, friends, patients and staff. Whatever is left, is mine. This has been going on FAR TOO long and I prescribe to doing better beginning today.
I love my job. There’s just too much of it and higher acuity patients. I arrive early work, skip all breaks everyday, and work through lunch almost everyday. The first thing I think about is retiring early. Second thought is I have to pay the bills. Then I get to work and repeat the same thing day after day. I am praised for my ability to handle the case load and precept students and interns even on the worst of days. My job partner does the same thing. We discuss our retirements together and know that the light is now closer to the end of the tunnel than we thought. Right now stocking shelves or working retail looks like a happier place to be.
I have to sell this to myself almost every day. I MUST take care of myself-please get the walk in on the greenway… you need it SOO much & so does the puppy 🙂
Good thoughts
Excellent information and very pertinent to obstacles and experiences faced early in nursing career. Thank you
interesting
good info
Great article!
Helpful
Helpful.
We have experience a lot of this in the work place. Sometimes we are so busy taking care of others that we tend to ignore our own self care. Thank you for the strategies and tips to help us as nurses maintain our moral resilience
I enjoyed this article very much! We as nurses are so busy taking care of others that we forget we must also take care of ourselves.
This is very useful information in life in general, not just pertaining to the nursing field
Very Good
Very good article!
great article!
very informative. good information and thought provoking. self care is very important and a lot of nurses do not do this, including myself! thank you
This applies to many more situations than nursing! Valuable information for everyone!
This article is spot on. Meeting with other nurses to discuss relevant issues and journaling can be beneficial to understanding situations that require us to question how we perceive ethical issues.
Great article!
Great article!
nursing as a calling…
really enjoyed the article.
I really enjoyed this article, will share with family. Thanks
Good article, we all need a moral boost, redirection and positivity to stay engaged in our jobs.
Excellent strategies given for nurses to be more resilient in better caring for themselves, co-workers which eventually helps in care of the patients.
Everything goes back to yourself, an answer to the question, a self reflection.. What made me decide to become a nurse? As a nurse, a strong foundation the reason behind why you what to be a nurse, eventually will make you morally resilient.
Years ago nursing was built on moral resilience, in the 80’s we continued being taught that it was expected. Today, many students and new grads stray far from this, it is our duty to practice this and be examples for the new generation of nurses.
Great article
Needed this information after 30 years of practice
Great article, makes ne think about one’s own accountability
Moral distress happens frequently in mental health with coming to terms with other’s beliefs in their practice. This article is a reminder of what can be done to care for others and ourselves.
Very well said and relatable. I feel as being a leader, one of my priorities is to constantly being on watch and identify when the team starts to pull back and become less engaged, using it as a warning sign. That is when I bring them in and switch up their assignment, giving them redirection to focus on new tasks positively versus the repetitive duties creating negatives. This article is very helpful!
Great reminder to the nursing profession’s code
Interesting, informative article. Ethical principles and actions are such a daily practice in every nurse’s life.
Good article
informative
Thank you.
Very good, thought provoking and great ideas to help the staff nurse before they get burned out
Thanks
An excellent reminder to care for ourselves as well as others.
I think there should be more opportunities for nurses to “debrief” or “unload” after particularly distressing days.
Thanks for the encouragement and inspiration.
interesting article
Great article, thank you.
reaffirming why we became nurses will help us to refocus. We never said we became nurses to take care of ourselves, but how can we effectively care for others if we don’t care for ourselves?
This article gave good pointers on dealing with issues we are faced with in healthcare that conflict with our personal beliefs. We must remind ourselves why we joined this profession, but also remain true to who we are as we go through our day. We should not feel compelled to do something that violates our personal beliefs because at the end of the day we have to be happy with our choices.
Good information for new nurses like me. Thank you!
Moral resilience vs moral stress
A lot of information packed in this article, some old, but a lot of it is new to me
I can see how moral resilience is important in many situations where you question what you are doing. I love the questions to ask yourself for the commitment to moral resilience because it gives you a way to reflect on yourself.
Article very informative, thank you.
I LOVE this article and the fact that ANA has included statement 5, which speaks to self care.
It is a personal quest of mine to achieve self care.
Great article!
Very good read with a lot of good information
Great Atricle
Very informative article that will help me to continue to improve my moral resilience and become a better nurse by doing this which will give my patient’s the best care that they deserve.
Developing and checking the self-regulation “muscle” is important for every nurse in order to continue to learn, educate, and maintain a healthy, professional status.
Good article!
Moral resilience is increasingly important when accountability by peers is valued less.
Resiliency is difficult but necessary in times of work or medical change for nurses, other staff AND our clients/patients.
Moral Resiliency needs continuous support and reassessment for maintenance of personal strength with ever changing expectations.
Refocusing on the important things in life, and why I am a nurse is something I always have to remind myself of.
If everyone works together and is willing to help out fellow co-workers, it will help to eliminate some of the stress
Thank you for the presentation today.
Who am I being in this moment? How do I want to be known? Am I choosing to act or not act in a way that I can live with? Great questions to ask yourself when you’re feeling overwhelmed or need to re-center yourself
Thank you for your input.
Great
I think it’s very important to have a regular “re-set” button that reminds us why we became nurses in the first place and that is to take care of other people. When we break it down to this basic insight, many of the other issues that we deal with on a daily basis seem to resolve themselves. I think it’s very important that we take time when outside of work to participate in calming activities and also share experiences with our fellow staff members.
Good food for thought:)
Who am I being in this moment?
How do I want to be known?
Am I choosing to act or not act in a way that I can live with?
I think all nurses should read this to remind us to take care of ourselves s that we can be the best nurses for our patients.
very important for nurses!
Excellent information
I thought this was a very thought provoking article that made practical suggestions of how to prevent burnout
It emphasized the importance of team support
Its focus on the mind, body spirit aspects of nursing was a reminder of the importance of maintaining a balance in order to be an effective health professional
great article
It is important for nurses to be able to respect and honor others values and morals. Nurses play an exceptional role in people’s everyday lives.
This is a great reminder to help ourselves while helping others.
I’m going to put a lot of thought into the tem approach to self care and think of how I can incorporate these skills at work
Moral resilience needs to be discussed more in all specialties of nursing as it is a key component to nursing. Good article.
It is important for a nurse to reaffirm and/or recall why becoming a nurse was important in the first place. Remember the defining moment when an individual realized that being a nurse was the most important goal in his or her life.
Building Moral Resilience can be a team effort. Spirituality in the workplace makes staff calmer and able to handle emerging situations with tact and professionalism.
Sometimes, a five minute huddle in the middle of a busy work day to pray touches the entire group and has a ripple effect on the rest.
great