A public health nurse is struggling with moral distress. What are actions the nurse can take to handle moral distress? (Select all that apply)

Communicate concern with chain of command.

Seek support from ethic committees.

Be proactive.

Examine ways to work toward addressing the stressors.

Avoid discussing with others situations leading to moral distress.

Answer and Explanation

Correct Answer : A,B,C,D

A. Communicate concern with chain of command: Addressing moral distress requires advocating for ethical concerns. Reporting issues to supervisors or the chain of command can initiate discussions and potential solutions.

B. Seek support from ethics committees: Ethics committees provide guidance and a structured way to resolve ethical dilemmas, helping nurses navigate morally distressing situations.

C. Be proactive: Taking a proactive approach—such as staying informed on ethical policies and seeking resolution early—can help prevent worsening distress.

D. Examine ways to work toward addressing the stressors: Identifying specific causes of moral distress and finding ways to address them, whether through self-reflection or systemic changes, promotes resilience and ethical practice.

E. Avoid discussing with others situations leading to moral distress: Suppressing concerns can worsen distress and lead to burnout. Open discussions with trusted colleagues, mentors, or support groups can help process emotions and develop solutions.

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Correct Answer is A

Explanation

A. Appreciate that the family has made the decision that it feels is best and take no further action if it is clear the family has made an informed choice: Respecting autonomy is a key ethical principle in nursing. If the family has made an informed decision without coercion, the nurse should respect their choice. Beneficence and nonmaleficence do not override autonomy in this case.

B. Try to convince the agency to give the care for free, even if it means economic stress for the agency, because the medical need is obvious: While advocacy is important, it is unethical to place financial strain on an agency without proper policy in place. This option disregards justice (fair distribution of resources).

C. Stress that each individual in society has a right to healthcare and the family will have to create some way to raise funds for the needed treatment: While healthcare access is a concern, pressuring the family to raise funds imposes unrealistic expectations and does not respect their right to decline care.

D. Talk to the media to see whether a campaign to raise funds for the family can be created: Disclosing a family's personal health information without consent violates confidentiality and privacy rights under ethical and legal guidelines.

A. Having the knowledge and skill set needed to advocate for the patient, but not being able to act on it due to not having the authority to do so. B. Having the authority to call off a code, then realizing the decision was harmful to the patient. C. Having the authority to override a physician's order for pain medication. D. Having the knowledge and skill set needed to provide culturally competent care.

Correct Answer is A

Explanation

A. Having the knowledge and skill set needed to advocate for the patient, but not being able to act on it due to not having the authority to do so. Moral distress occurs when a nurse knows the right action to take but is constrained by external factors such as policies, hierarchy, or legal limitations.

B. Having the authority to call off a code, then realizing the decision was harmful to the patient. This describes moral regret or ethical uncertainty, not moral distress. Moral distress occurs when a nurse is unable to act according to their ethical beliefs.

C. Having the authority to override a physician's order for pain medication. This describes an ethical dilemma rather than moral distress. Moral distress arises when a nurse cannot act despite knowing the right course of action.

D. Having the knowledge and skill set needed to provide culturally competent care. Cultural competence is an important aspect of nursing, but it does not describe moral distress, which involves ethical conflict and external barriers.

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A public health nurse is struggling with moral distress. What are actions the nurse can take to handle moral distress? (Select all that apply)

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