Nurses gather at the Johns Hopkins School of Nursing to address this growing problem.
A nurse struggles to reconcile repeated surgeries and transfusions for a premature infant with the child’s slight chance of survival. An oncology nurse knows a patient wants to refuse treatment but doesn’t do so because his physician and family want him to “fight on.” A nurse on a geriatric unit knows she is not giving needed care to patients because of inadequate staffing.
From left, Katherine Brown-Saltzman,
Paula Goodman-Crews, Lisa Lehmann, Heidi Holtz
Situations like these are not rare for nurses and often give rise to moral distress—that is, when nurses recognize their responsibility to respond to care situations but are unable to translate their moral choices into action.
Moral distress in nursing has risen to unprecedented levels, contributing to burnout and staff shortages and imperiling safe, quality health care.
Seeking solutions.
Nursing researchers, clinicians, organization representatives, and other stakeholders convened in Baltimore on August 11-12 for an intense invitational workshop called State of the Science Symposium: Transforming Moral Distress to Moral Resiliency in Nursing. The meeting focused on how to best address moral distress.
The 46 participants heard from experts on what’s known from research and what’s still being debated, potential avenues for study, and what, despite the dearth of hard data, appear to be promising practices for dealing with moral distress. (For more on the intersection of moral distress and moral resiliency, see “Moral Distress: A Catalyst for Building Moral Resilience” in the July issue of AJN.)
After identifying what seem to be the essential elements of helpful initiatives and models, participants worked in groups to brainstorm strategies for developing resilience and creating healthy work environments that will promote safe, quality care for patients and their families.
The result of the two days of work was a consensus on recommendations for practice, education, research, and policy areas to address moral distress and build moral resilience. The papers and proceedings will be collated into a report and widely disseminated; participants were vocal and committed to moving the work forward.
The program 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, with in kind support from the Johns Hopkins School of Nursing and the American Journal of Nursing.
Look for a full report in February!
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