Manuel Silva

Degree Name

Master of Science in Nursing (MSN)

Document Type

Major Paper


School of Nursing



Date of Original Version



Moral distress is a common but frequently overlooked concept in the nursing profession, though not exclusive to nursing. Many professionals experience this distress, but nurses encounter this phenomenon more often than other professions. Moral distress can cause many physical and emotional symptoms that affect how a person perceives satisfaction in his/her profession. These include anxiety, fear, frustration, feeling of powerlessness, poor sense of safety and security, nursing turnover, and nursing professionals leaving the profession. This project targeted medical-surgical nurses and aimed to provide them with education to identify moral distress as well as appropriate coping skills that may be used to deal with the moral situation. The AACN Rise Above Moral Distress education plan, which uses the 4 A’s of Ask, Affirm, Assess and Act, was utilized for the staff education sessions. Nurses on the unit believed that they knew how to define moral distress, identify moral distress situations, have institutional support services, and are able to be a support resource to co-workers to help identify moral distress situations Comparison of pre-post surveys showed a 40% increase in knowledge, a 30% increase in moral distress confidence and a 15% increase in co-worker support confidence. Institutions often lack required employee education for identifying ethical and moral distress situations or the appropriate coping skills to be utilized. Training on dealing with ethical situations and development of uniform coping skills are needed. Recommendation from this study focused on the need for increased training on moral distress in specific areas.

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