Nurses Distress and Moral Obligation

Often, pandemics create strenuous, overwhelming, and emotionally challenging situations that distress practitioners. The COVID-19 pandemic contributed to nurses’ distress as nurses were torn between maintaining their health and providing healthcare services to patients. In addition, nurse leaders would face distress as they questioned their moral obligation; they felt powerless as they unintentionally misinformed their staff and teams. However, nurses should uphold their moral obligation to tell the truth.

Moral Distress Example

During the COVID-19 era, a morally distressing situation occurred when I dealt with a middle-aged man suffering from lung cancer (Stage III) and was on management care. While the hospital protocol dictated that the patient should be discharged to create more bed spaces for COVID-19 patients, his family begged me to retain him in the hospital. The family’s financial status challenged their ability to afford home-based management. I was distressed about the appropriate decision to make in the case. While the hospital’s protocol dictated that I should process his discharge, I felt obligated to ensure the patient acquired the best healthcare to prevent a relapse. Unfortunately, after a forced discharge, the patient succumbed to relapse after 1.5 months, and my distress and self-blame reemerged.

Methods of Addressing Moral Distress

Nurse leaders should express the capability to address moral distress for themselves and their teams. First, nurse leaders can address moral distress by gaining moral courage. These leaders can enhance their “moral courage by creating and sustaining an environment that facilitates the acquisition of information, support, and resources required to meet their responsibilities and moral obligations” (Hu et al., 2022, p.2). Second, nurse leaders can address their staff’s moral distress by addressing ethical conflicts and increasing their resilience in challenging ethical situations through education, communication, teamwork, support, and collaboration (Prestia, 2020; Özbaş & Kovanci, 2022). Lastly, nurse leaders should embrace authentic, trustworthy, truthful, mindful, and relevant communication with their subordinates to minimize instances of a challenged moral compass (Prestia, 2020). In addition, balancing interests is critical such that information or orders consider patient, staff, and organizational interests.

Impact of Moral Obligation on Staff and Nurse Leaders’ Responsibilities

Despite the moral distress experienced by nurse leaders and staff, healthcare practitioners must exert and understand their moral obligation for adequate care and the eradication of distress. Exercising moral obligation reduces nurses’ vulnerability and increases their moral courage when making critical decisions that carry moral dilemmas. Nurses exercising their moral obligation will critically evaluate between contending options and consistently choose morally admissible ones. Besides, moral obligations allow nurse leaders to reduce conflict, anxiety, confusion, and disrespect, creating effective leadership and guidance for distressed nurses (Prestia, 2020). Lastly, moral obligation enables nurses and nurse leaders to minimize the negative impacts of wrong decision-making practices and maximize the success of nursing staff (Prestia, 2020). Rather than bulldozing nurses to enforce unethical and contradicting guidelines, moral obligation inspires supportive and delegating leadership and resilient teams.

Conclusion

Moral obligation allows nurses to provide authentic and moral patient care as well as inspire quality outcomes. My experience of moral distress inspired me to consider my moral obligation in the future. Nurse leaders should use teamwork, authentic communication, moral courage, and truth-telling to address moral distress. Exercising moral obligation enables nurses and nurse leaders to eradicate distress, maximize healthcare outcomes, and develop resilient teams.