Correctional Nurse . Net

Moral Distress and Correctional Nursing

Just returned from a fantastic National Commission on Correctional Health Care (NCCHC) conference. This year the Nurse Manager Round Table tackled moral distress and burnout for correctional nurses. It was an energizing discussion as about 40 nurse leaders from jails and prisons around the country grappled with the issue and suggested some remedies.

Moral distress in nursing is described as a psychological imbalance or disequilibrium that occurs when nurses finding themselves in situations where they feel unable to do the right thing. This conflict can cause physical, emotional and spiritual suffering. The residual build up of continuing moral distress can lead to burnout and burden.

Correctional nurses have unique situations that lead to moral distress. Examples include conflict with custody over inmate access to care, a higher volume of healthcare needs than resources available to meet them, and continuing need for guarded evaluation of potential manipulative patient behaviors. Other potential sources of moral distress include nurse-physician conflict, disrespectful interactions, workplace violence, and clinical ethical dilemmas.

Nurse Managers at the round tables had many ideas to combat moral distress:

• Acknowledge that moral distress exists in our practice.
• Educate staff on the causes and symptoms of moral distress.
• Provide venues for verbalizing distress and seeking solutions such as an open-door management practice, support groups facilitated by an outsider, and constructive solution seeking during staff meetings.
• Seeking ways to reduce moral distress through communication among the disciplines and across disciplines with custody.
• Establishing policies about civility and actions to take when in a morally distressing situation.

These suggestions are aligned with those recommended by the American Association of Critical Care Nurses in 2006.

Have you found correctional nursing to be morally distressing? How do you deal with it? Share your experiences in the comments section.

Photo Credit: © olly – Fotolia.com

October 20, 2011 Posted by Lorry Schoenly | Nursing Practice | Correctional, correctional healthcare, Correctional Nurse, correctional nursing, Corrections, ethical dilemma, Jail, jail nursing, Lorry Schoenly, Moral Distress, Nurse, Nursing, nursing ethics, Prison, prison health, prison nursing | 6 Comments