What Can Be Done About Moral Distress?

There is a persistent and growing need to educate and retain nurses who are prepared to address patient care needs within complex health care systems. Approximately 17% of newly registered nurses leave the profession within the first year of practice. Moral distress contributes to this dilemma. Moral distress is defined as feeling constrained from acting upon one’s ethical knowing. It is associated with powerlessness, compassion fatigue, apathy, and burnout. My research focuses on identifying factors causing moral distress among nursing students and implementing curriculum promoting moral agency.

This work is important because students who develop moral distress in nursing school have an increased risk for becoming apathetic – new nurses reported “going along to get along” in the workplace. In a national three-site study, student nurses reported moral distress when they witnessed daily dilemmas such as compromised infection control, unsafe medication administration practices, and inadequate resources to alleviate human suffering. These situations were pervasive across workplace settings. The findings resulted in curricular strategies to promote resilience.

We taught ethical decision making and conflict communication strategies in the classroom and rehearsed in simulation labs. We also provided education for nurses working with our students in clinical settings. We emphasized resilience protective factors such as social support, goal efficacy, and communication techniques.