What is the significance of moral distress for Christian nurses? 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. There are significant underlying spiritual aspects of moral distress. Spiritual, as in that search for what is right action (i.e., correct, true), how we figure out what is right, what helps us 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. The action of doing right is righteousness. Kings in ancient Israel were appointed by God “to execute justice and righteousness for all his people” (1 Kings 10:9; 1 Chronicles 18:14). How did they know what was just and right? They studied God's laws and instructions and walked in fellowship with God. As they sought wisdom and insight, God led them in paths of righteousness (Psalm 23:3). Proverbs 2 (and many other Scriptures) explains how seeking skillful and godly wisdom leads to doing right:
If you seek skillful and godly wisdom as you would silver and search for her as you would hidden treasures; then you will understand the [reverent] fear of the Lord [that is, worshiping Him and regarding Him as truly awesome] and discover the knowledge of God. For the Lord gives [skillful and godly] wisdom; From His mouth come knowledge and understanding. He stores away sound wisdom for the righteous [those who are in right standing with Him]; He is a shield to those who walk in integrity [those of honorable character and moral courage], He guards the paths of justice; and He preserves the way of His saints (believers). Then you will understand righteousness and justice [in every circumstance] and integrity and every good path. For [skillful and godly] wisdom will enter your heart. (vs. 4-10, AMP)
At the risk of oversimplifying complicated morally distressing situations, 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’s about the small steps involved in taking right action in everyday and crisis situations. Countless times in my nursing work in intensive care to behavioral health to being NCF Director, I have been grateful for time spent in Bible study and prayer that has 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’m 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.
Kathy Schoonover-Shoffner is the Editor-in-Chief of the Journal of Christian Nursing and Director of Nurses Christian Fellowship.
Peruse the JCN article collection on the topic of moral distress: https://journals.lww.com/journalofchristiannursing/Lists/Topical%20Collection%20Items/AllItems.aspx?FilterField1=TopicalCollection&FilterValue1=Moral+Distress
