Moral distress, first described within the discipline of nursing by Jameton (1984)

Moral distress, first described within the discipline of nursing by Jameton (1984), is a negative state of painful psychological distress seen when nurses are unable to implement a course they believe to be right due internal or external constraints.  Jameton identified three categories in this phenomenon: moral uncertainty, moral dilemma, and moral distress.  Discussion questions (links to objectives #1, #2).

Discussion questions:

1. Summarize a clinical experience that resulted in you experiencing moral distress.  Please include specifics related to the moral distress symptoms you experienced, for example, frustration, anger, or anxiety. Do not identify any specific information that could identify the hospital, patient, or staff involved. Based on this experience, describe the effect it had/has on you, and identify ways of effectively coping with moral distress.  Was reactive distress  a component of this experience, for example, powerlessness, guilt, loss of self-worth, self-criticism, low self-esteem, or physiological responses.
2. How might you identify moral distress in colleague? Do you believe that nurses have a responsibility to support colleagues who are demonstrating symptoms of compassion fatigue? Why or why not? Describe second victim syndrome.

3. Describe the crescendo effect and why this exists within nursing.