Moral Distress

Moral Distress in Nursing: What You Need to Know

Moral distress is a complex and challenging experience that can have a significant negative impact on the healthcare team — from hindering our ability to advocate for patients to leaving our job or the profession.

Moral distress occurs when you believe you know — or you are uncertain of — the ethically correct action to take and you are constrained from taking it. What distinguishes moral distress from other forms of distress experienced by nurses is that it threatens our core values and has ethical implications. Symptoms of moral distress may be difficult to recognize. They may manifest as physical, emotional and/or psychological symptoms.

Common situations that can trigger moral distress include end-of-life treatment choices, inadequate staffing, value conflicts, challenging team dynamics and duty conflicting with safety concerns, among others. If you suspect you may be experiencing moral distress, it is important to identify, assess and address it, and seek assistance as needed.

AACN is committed to supporting nurses in managing moral distress and offers resources to help.

Recognizing Moral Distress … and What to Do About It

There are four key components to addressing moral distress.

Determine What You Are Experiencing

Distinguish between moral distress, burnout and compassion fatigue. All three cause distress but involve different mitigation strategies.

Gauge the Severity of Your Distress

Familiarize yourself with common symptoms, and rate your distress from 1 to 10 to help you prioritize mitigation efforts.

Identify the Causes and Constraints

Recognize the situations and factors that contribute to your moral distress. Use this knowledge to guide your next steps.

Take Action to Help You Move Forward

Consider all options for addressing your moral distress. What resources do you have personally? What’s available in your unit or organization?

Key Resources

Managing moral distress requires an understanding of its causes, symptoms and solutions. Whether you are experiencing moral distress yourself or want to support someone who is, these featured resources from AACN can help.

AACN Position Statement: Moral Distress in Times of Crisis

Read AACN’s perspective on moral distress – especially during a crisis – and the call to action for hospitals and nurses to mitigate the harmful effects.

Moral Distress in a Crisis: What, Why and How to Cope

This podcast explores the causes, impact and mitigation of moral distress, which is heightened during crises.

Creating a Healthy Work Environment: Caring Is Critical!

Learn how a pair of innovative cardiovascular ICU nurses led an initiative to reduce moral distress and improve communication on their unit.

Transforming Moral Suffering: Resilience and Ethical Practice

Gain a deeper understanding of moral suffering – and its most common form, moral distress – plus the connection to resilience and ethical practice.

Moral Distress, Mattering and Secondary Traumatic Stress in Burnout

This article differentiates aspects of burnout syndrome and discusses healthcare organizations as moral communities.

Potentially Inappropriate Treatment: Ethical Considerations

Overriding patients’ and families’ life-sustaining medical treatment preferences can also have a lasting negative impact on clinician well-being.

Understanding Moral Distress: An Expert’s Perspective

One of the biggest challenges in overcoming moral distress is recognizing the condition in ourselves. Longtime critical care clinical nurse specialist Natalie Correll-Yoder, a national expert and frequent presenter on moral distress, helps nurses, other healthcare staff and organizations identify and address this challenging issue. Her video interview offers guidance for nurses grappling with moral distress. Topics include:

What Is Moral Distress? | Effects of Moral Distress | Support for Moral Distress | Importance of Self-Care

There's still a lack of recognition of what moral distress is. A lot of times nurses are feeling these symptoms or emotions, and they don't know what it is. They can't put a name to it.
Natalie Correll-Yoder, MN, RN, CCRN, CCNS

Additional Resources

Explore AACN’s full collection of resources for recognizing, evaluating and overcoming moral distress. This compilation includes journal articles, webinars, recorded conference sessions and other materials to support you and your colleagues in resolving moral challenges.