Reducing Nurses’ Moral Distress

Moral distress in nursing is a significant problem that needs to be understood and addressed.  This paper reports some of the findings from doctoral dissertation work that explored using Freirean Pedagogy as the theoretical basis for an educational intervention for nurses who have suffered moral distress.

While reading the literature, the report’s author 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.