title: Defining and addressing moral distress: tools for critical care nursing leaders.
abstract: 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.
authors.affiliation: Johns Hopkins University, School of Nursing and Children's Center, Baltimore, MD 21287, USA. crushton@son.jhmi.edu
authors.forename: Cynda Hylton
authors.initials: CH
authors.lastname: Rushton
mesh_terms: D000223:Adaptation, Psychological; D001291:Attitude of Health Personnel; D002055:Burnout, Professional / Q000517:prevention & control* / Q000523:psychology; D015984:Causality; D002755:Choice Behavior; D032781:Codes of Ethics; D003142:Communication; D003220:Conflict, Psychological; D003422:Critical Care / Q000941:ethics / Q000458:organization & administration / Q000523:psychology*; D003625:Data Collection; D006801:Humans; D007400:Interprofessional Relations; D007857:Leadership; D016294:Models, Nursing; D008960:Models, Psychological; D009014:Morals; D009718:Nurse Administrators / Q000941:ethics / Q000458:organization & administration / Q000523:psychology*; D024802:Nurse's Role / Q000523:psychology; D009741:Nursing Staff, Hospital / Q000941:ethics / Q000458:organization & administration / Q000523:psychology*; D009745:Nursing, Supervisory / Q000458:organization & administration; D017009:Professional Autonomy; D012944:Social Support