What About Moral Distress?

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Moral distress is huge in healthcare. We encounter moral distress when we believe that an action is right but, because of real or perceived constraints, we either cannot, or do not, take the action. Has this happened to you?

Moral distress has long been associated with negative consequences for both people and systems, leading to burnout and job dissatisfaction, or increased staff turnover and poor patient outcomes. Yet there have been few solutions proposed.

I am struck by the underlying spiritual aspects of moral distress. Spiritual, as in that search for what is right action, what helps us to do right, and how we deal with the distress of not doing right.

As Christians, God calls us to do the right thing. In the Bible, God delineates what is right. Being in right relationship with God, called righteousness, leads to doing right.

At the risk of oversimplifying complicated situations that are morally distressing, Scripture teaches that being in right relationship with God and seeking him will help us know the right thing to do, how to do it, and give moral courage. This isn’t about being dogmatic; it is about the small steps involved in taking right actions in everyday and crisis situations.

Countless times in my work as a nurse and now as the NCF Director, I have been grateful for time spent in Bible study and prayer that helped me learn what God teaches about right thinking and action and drew me close to Jesus.

As I encounter moral decisions, I ask myself, Does Scripture shed light here? When I need to speak up or advocate, I ask the Holy Spirit what to do, and for courage to do the right thing and speak right words (instead of walking away or reacting negatively). When I do the wrong thing, I ask forgiveness from God and colleagues. I don’t do the right thing every time, but God continues to teach me.

I am aware that complicated systems and relationships interfere with being able to do the right thing. I know figuring out the right thing to do is not always clear. But as Christian nurses, we have a Source to go to for wisdom and moral courage.

The issue of moral distress is near to my heart. For four years, I worked on a collaborative project with the American Journal of Nursing, Johns Hopkins Berman Institute of Bioethics and School of Nursing, and representatives from the American Association of Critical Care Nurses and the American Nurses Association. I encourage you to read our "Executive Summary: Transforming Moral Distress into Moral Resilience in Nursing," in Journal of Christian Nursing, April-June, 2017. The full report is free at AJN’s Moral Distress Supplement.

As Christian nurses, it is vital to examine these practices. Find out how you can address moral distress and foster moral resilience through individual and organizational strategies.

Kathy Schoonover-Shoffner, PhD, RN NCF National Director Editor-in-Chief, Journal of Christian Nursing

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Read Kathy’s full editorial, What About Moral Distress?, in Journal of Christian Nursing, Apr/June 2017. Become a member of NCF and receive Journal of Christian Nursing as a member benefit throughout the year.

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