Moral anxiety

When I take into consideration moral suffering, I might describe it as a nagging, desperate feeling born of perceived injustice. The underlying aspects are highly variable and include lack of essential resources needed to offer the usual of look after patients, interpersonal or interprofessional conflict, particularly involving ethically difficult situations with patients, families, providers or colleagues, and errors and distressing treatment decisions. It encompasses a constellation of emotions that nurses have likely felt because the dawn of our career. If left to fester without effective intervention, moral distress can result in disillusionment, disillusionment, and even lack of commitment to the nursing career.

In over 30 years of practice, I actually have not only observed moral distress amongst colleagues, but I actually have experienced it personally on several occasions. I did not have a reputation for it until recently. My earliest memories of what I might now call moral distress normally resulted from being party to treatment decisions that I simply couldn’t fathom – they involved care that was either too aggressive (and seemingly offensive) for patients who simply didn’t have hope for any kind of recovery or care that was not aggressive enough in patients who did. These were the times before evidence-based care pathways and palliative care services existed. I felt outraged that the hospital where I worked on the time didn’t seem to debate these issues with the medical staff. The nurse, experienced and hardened by years of ethically difficult tasks, disregarded my suffering when… “Just do as ordered; it’s our job,” she advised. However, my very own skilled experience didn’t allow me to accept this recommendation because I believed that patients deserved significantly better. As this case repeated itself over and yet again, I felt like something needed to vary, but I didn’t know the best way to affect that change at that time. Just being indignant wasn’t constructive.

Unfortunately, many nurses, especially those at a young age, cope with a majority of these challenges by hopping ship seeking calmer seas and greener pastures. In my opinion, the actual shock of reality is that no sea is all the time calm and no pasture is all the time greener. The secret is to learn to cope with resilience and fortitude, while at the identical time developing strategies to effectively address the foundation causes of situations that result in moral distress.

Mentoring and supportive relationships are essential amongst colleagues, nurse educators, and leaders to assist individuals facing moral distress sort through their feelings, discover causative aspects, plan an answer, and regain healthy emotional balance. Sometimes worker assistance programs are one of the best choice to help nurses cope with the emotional toll of highly sensitive and confidential matters when discussions with co-workers or leaders wouldn’t foster the open dialogue needed to sort through feelings and develop potential solutions.

For nurse leaders, listening and statement skills are key to identifying problematic situations and their impact on staff. Continued vigilance and diligence are required to cope with problems in our health care facilities that cause moral distress amongst nurses. Frankly, these issues ought to be very high on the agenda of all healthcare leaders. The solutions should not all the time easy, quick and straightforward, but they’re essential to maintaining quality and safety in patient care, in addition to nursing itself as a long-term profession alternative.