Reducing Nurses’ Moral Distress

Our current featured article is titled “Freirean Conscientization With
Critical Care Nurses to Reduce Moral Distress and Increase Perceived Empowerment: A Pilot Study” by Nancy A. Bevan, PhD, APRN, ACNS-BC and Amanda M. Emerson, PhD, RN. Dr. Bevan sent this message giving ANS readers some background about this work:

Moral distress in nursing is a significant problem that needs to be understood and addressed.  This paper reports some of the findings from my doctoral dissertation work that explored using Freirean Pedagogy as the theoretical basis for an educational intervention for nurses who have suffered moral distress. I have always been interested in research on the health of nurses. My long career in critical care nursing piqued my interest in moral distress in nurses because I have experienced it myself and witnessed it in others.

While reading the literature, I became intrigued by the discussion of nurse’s relative powerlessness as one of the causes of moral distress. There is strong evidence linking powerlessness arising from structural hierarchies embedded in health care to moral distress in nursing; this has led some to argue that nurses are an oppressed group.  Based on that,  like other oppressed groups, nurses may lack insight into their oppression and struggle ineffectually to overcome it on their own. A Freirean educational intervention was created with the help of an international expert in Freirean pedagogy and piloted in nurses who have suffered moral distress.  Results showed improved moral distress and mixed results in perceived personal and group empowerment. Further study is warranted, but we need to take care of our nurses, and start finding ways to address moral distress in a concerted way.