Moral
distress occurs in a given situation when a health professional knows, or
believes she knows, the ethically appropriate course of action to take but is
unable to carry it out because elements in the circumstances are blocking it. In the 20 years since Andrew Jameton’s (1984) description,
moral distress has come to be recognized as a common experience that is poorly
understood and rarely discussed, not only for nurses but also for physicians
and other providers. Over time, moral distress can compromise health professionals’
moral integrity, a profoundly negative consequence that can, in turn,
compromise the care they provide. Jameton defined it as painful feelings and/or
the psychological disequilibrium that occurs when nurses are conscious of the
morally appropriate action a situation requires but cannot carry out
that action
because of institutionalized obstacles. These obstacles can include lack of
time,
supervisory reluctance, an inhibiting medical power structure, institution
policy,
or legal constraints.
This
paper will discuss and elaborate on the phenomenon of moral distress
particularly as it affects nurses; important elements will be shown and
possible solutions for dealing with it will be demonstrated.
