title: A health care chaplain's pastoral response to moral distress.
abstract: This article offers health care chaplains a pastoral response to moral distress experienced by health care professionals. The article offers a broad definition, explores its impact on health care professionals, and looks at various interventions to ameliorate its effects. The article goes on to clarify the concept of moral distress by differentiating it from the experience of moral dilemmas, and looking closer at the aspects of initial and reactive distress. After defining moral distress, the article explores two clinical models that create a better context to understand the phenomenon. Finally, the article proposes a pastoral response to moral distress from the integration of the five functions of pastoral care: "healing," "sustaining," "guiding," "reconciling," and "nurturing" based on the work of William Clebsch, Charles Jaekle, and Howard Clinebell. The author then applies the pastoral response to moral distress by illustrating the outcome of a scenario with a critical care nurse.
authors.affiliation: a Spiritual Care Department , Presbyterian St. Luke's Medical Center, Rocky Mountain Hospital for Children , Denver , Colorado , USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Guthrie
mesh_terms: D003220:Conflict, Psychological; D064648:Critical Care Nursing; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008960:Models, Psychological; D009014:Morals; D009741:Nursing Staff, Hospital / Q000523:psychology; D010327:Pastoral Care / Q000379:methods*; D013315:Stress, Psychological; D009626:Terminology as Topic