Defining and addressing moral distress: Tools for critical care nursing leaders

AACN Advanced Critical Care

Volumn 17, Issue 2, 2006, Pages 161-168

  Rushton, Cynda Hylton ^a,b  

^a JOHNS HOPKINS CHILDREN S CENTER   (United States)

^b JOHNS HOPKINS UNIVERSITY SCHOOL OF NURSING   (United States)

Author keywords

Change process models; Critical care nursing; Moral distress; Nursing leadership

Indexed keywords

ADAPTIVE BEHAVIOR; BURNOUT; CONFLICT; DECISION MAKING; EPIDEMIOLOGY; ETHICS; HEALTH PERSONNEL ATTITUDE; HUMAN; INFORMATION PROCESSING; INTENSIVE CARE; INTERPERSONAL COMMUNICATION; LEADERSHIP; MEDICAL ETHICS; MODEL; MORALITY; NURSE ADMINISTRATOR; NURSE ATTITUDE; NURSING; NURSING STAFF; ORGANIZATION AND MANAGEMENT; PROFESSIONAL PRACTICE; PSYCHOLOGICAL ASPECT; PSYCHOLOGICAL MODEL; PUBLIC RELATIONS; REVIEW; SOCIAL SUPPORT;

ADAPTATION, PSYCHOLOGICAL; ATTITUDE OF HEALTH PERSONNEL; BURNOUT, PROFESSIONAL; CAUSALITY; CHOICE BEHAVIOR; CODES OF ETHICS; COMMUNICATION; CONFLICT (PSYCHOLOGY); CRITICAL CARE; DATA COLLECTION; HUMANS; INTERPROFESSIONAL RELATIONS; LEADERSHIP; MODELS, NURSING; MODELS, PSYCHOLOGICAL; MORALS; NURSE ADMINISTRATORS; NURSE'S ROLE; NURSING STAFF, HOSPITAL; NURSING, SUPERVISORY; PROFESSIONAL AUTONOMY; SOCIAL SUPPORT;

EID: 33745887489     PISSN: 15597768     EISSN: 15597768     Source Type: Journal    
DOI: 10.1097/01256961-200604000-00011     Document Type: Review

References (42)

1. Jameton A. Nursing Practice, the Ethical Issues. Englewood Cliffs: Prentice-Hall, 1984.
2. Redman BK, Fry ST. Nurses' ethical conflicts: what is really known about them? Nurs Ethics. 2000;7(4):360-366.
3. Millette BE. Using Gilligan's framework to analyze nurses' stories of moral choices. West J Nurs Res. 1994;16(6):660-674.
4. American Association of Critical-Care Nurses (AACN). Moral Distress Position Statement. Aliso Viejo, Calif: AACN, 2004.
5. Corley MC. Ethical dimensions of nurse-physician relations in critical care. Nurs Clin North Am. 1998;33(2):325-337.
6. Corley MC, Elswick RK, Gorman M, et al. Development and evaluation of a moral distress scale. J Adv Nurs. 2001;33(2):250-256.
7. Rodney P. Moral distress in critical care nursing. Can Crit Care Nurs J. 1988;5(2):9-11.
8. Peter E, Liaschenko J. Perils of proximity: a spatiotemporal analysis of moral distress and moral ambiguity. Nurs Inq. 2004;11(4):218-225.
9. Hanna DR. Moral distress: the state of the science. Res Theory Nurs Pract. 2004;18(1):73-93.
10. Kalvemark S, Hoglund AT, Hansson MG, et al. Living with conflicts-ethical dilemmas and moral distress in the healthcare system. Soc Sci Med. 2004;58(6):1075-1084.
11. Solomon MZ, O'Donnell L, Jennings B, et al. Decisions near the end of life: professional views on life-sustaining treatments. Am J Public Health. 1993;83(1):14-23.
12. Corley MC. Moral distress of critical care nurses. Am J Crit Care. 1995;4(4):280-285.
13. Hefferman P, Heilig S. Giving "moral distress" a voice: ethical concerns among neonatal intensive care unit personnel. Camb Q Healthc Ethics. 1999;8(2):173-178.
14. Kelly B. Preserving moral integrity: a follow-up study with new graduate nurses. J Adv Nurs. 1998;28(5): 1134-1145.
15. Wilkinson JM. Moral distress in nursing practice: experience and effect. Nurs Forum. 1988;23(1):16-29.
16. Reich WT. Speaking of suffering: a moral account of compassion. Soundings. 1989;72(1):83-108.
17. Gordon S. Nursing Against the Odds. Ithaca: Cornell University Press, 2005.
18. Rushton CH. Care-giver suffering in critical care nursing. Heart Lung. 1992;21(3):303-306.
19. American Association of Critical-Care Nurses (AACN). The 4 A's to Rise Above Moral Distress. Aliso Viejo, Calif: AACN, 2004.
20. Jameton A. Dilemmas of moral distress: moral responsibility and nursing practice. AWHONNS Clin Issues Perinat Womens Health Nurs. 1993;4(4):542-551.
21. American Association of Critical-Care Nurses (AACN). 4 A's To Rise Above Moral Distress Toolkit. Aliso Viejo, Calif: AACN; 2006.
22. American Nurses Association. Code of Ethics for Nurses With Interpretive Statements. Washington: The Association, 2001.
23. American Association of Critical-Care Nurses. AACN Ethics Web site: Nursing Code of Ethics. Available at: http://www.aacn.org/AACN/practice.nsf/ ad0ca3b3bdb4f33288256981006fa692/794ec7896ddad0ce88257015006e76a6?OpenDocument. Accessed June 2005.
24. Winslow GR. From loyalty to advocacy: a new metaphor for nursing. Hastings Cent Rep. 1984;14(3):32-40.
25. Henry J, Henry L. Self-care begets holistic care. Reflect Nurs Leadersh. 2004;30(1):26-27, 56.
26. Rushton CH. The other side of caring: caregiver suffering. In Carter BS, Levetown M, eds. Palliative Care for Infants, Children, and Adolescents: A Practical Handbook. Baltimore, Md: The Johns Hopkins University Press, 2004; 220-243.
27. Vachon ML. Staff stress in hospice/palliative care: a review. Palliat Med. 1995;9(2):91-122.
28. Vachon ML. Reflections on the history of occupational stress in hospice/palliative care. Hosp J. 1999;14(3-4):229-246.
29. Sherman DW. Nurses' stress & burnout: how to care for yourself when caring for patients and their families experiencing life-threatening illness. Am J Nurs. 2004;104(5):48-56.
30. Mount BM. Dealing with our losses. J Clin Oncol. 1986;4(7):1127-1134.
31. Marino PA. The effects of cumulative grief in the nurse. J Intraven Nurs. 1998;21(2):101-104.
32. American Association of Critical-Care Nurses (AACN). AACN Standards for Establishing and Sustaining Healthy Work Environments. Aliso Viejo, Calif: AACN, 2005.
33. Rushton CH, Brooks-Brunn JA. Environments that support ethical practice. New Horiz. 1997;5(1):20-29.
34. Pike AW. Moral outrage and moral discourse in nurse-physician collaboration. J Prof Nurs. 1991;7(6):351-362.
35. Rushton CH. Reflections on the change process: integrating palliative care into a tertiary pediatric setting. American Association of Hospital and Palliative Medicine, and Hospice and Palliative Nurses Association Annual Assembly, Phoenix, Ariz, 2004.
36. Curtis JR, Engelberg RA, Wenrich MD, et al. Studying communication about end-of-life care during the ICU family conference: development of a framework. J Crit Care. 2002;17:147-160.
37. Curtis JR, Patrick DL, Shannon SE, et al. The family conference as a focus to improve communication about end-of-life care in the intensive care unit: opportunities for improvement. Crit Care Med. 2001;29(suppl):N26-N33.
38. Rooney JJ, Vanden Heuvel LN. Root cause analysis for beginners. Quality Progress. 2004;37(7);45-53.
39. Rushton CH, Williams MA, Sabatier KH. The integration of palliative care and critical care: one vision, one voice. Crit Care Nurs Clin North Am. 2002;14(2):133-40, vii.
40. Kirchhoff KT, Beckstrand RL. Critical care nurses' perceptions of obstacles and helpful behaviors in providing end-of-life care to dying patients. Am J Crit Care. 2000;9(2):96-105.
41. Wocial LD. Achieving collaboration in ethical decision making: strategies for nurses in clinical practice. Dimens Crit Care Nurs. 1996;15(3):150-159.
42. Schneiderman LJ, Gilmer T, Teetzel HD, Dugan DO, Blustein J, Cranford R et al. Effect of ethics consultations on nonbeneficial life-sustaining treatments in the intensive care setting: a randomized controlled trial. JAMA. 2003;290(9):1166-1172.