Defining and Addressing Moral Distress

Tools for Critical Care Nursing Leaders

Rushton, Cynda Hylton DNSc, RN, FAAN

Johns Hopkins University, School of Nursing and Children's Center, Baltimore, Md.

Reprint requests to Cynda Hylton Rushton, Johns Hopkins University, School of Nursing, 525 North Wolfe Street Box 420, Baltimore, MD 21287 ([email protected]).

AACN Advanced Critical Care 17(2):p 161-168, April-June 2006.

Nurse clinicians may experience moral distress when they are unable to translate their moral choices into moral action. The costs of unrelieved moral distress are high; ultimately, as with all unresolved professional conflicts, the quality of patient care suffers. As a systematic process for change, this article offers the AACN's Model to Rise Above Moral Distress, describing four A's: ask, affirm, assess, and act. To help critical care nurses working to address moral distress, the article identifies 11 action steps they can take to develop an ethical practice environment.