In this episode, I talk with Sue Smith, MSN RN CCHP-RN and Mary Muse, MS, RN, CCHP-A, CCHP-RN. Sue is a correctional nurse educator with extensive past experience in a variety of roles in the Ohio Prison System. Mary is Chief Nursing Officer for the Wisconsin Department of Corrections and member of the NCCHC Board of Directors. They  presented a session on Cultivating Moral Resilience in Correctional Nurses at the NCCHC Spring Conference on Correctional Health Care in Minneapolis April 21-24, 2018.

Resilience is the ability to bounce back or cope successfully despite adversity. So moral resilience is the capacity of the person to preserve or restore integrity in response to moral adversity.  It is the ability and willingness to speak and take right and good actions in the face of moral/ethical adversity.

 

A Great Need in Correctional Practice

This is important in correctional nursing practice because the correctional environment presents unique moral and ethical challenges to nurses and other healthcare staff. All areas of health care present certain moral/ethical challenges.  One way or another, nurses receive at least some education about the moral/ethical challenges in most community settings. But this may not be adequate for intense situations.

Correctional settings present different challenges not usually encountered in community settings. For example:

• Prisoners are held against their will.
• Prisoners often have maladaptive ways of behaving or interacting in society.
• Healthcare provision takes a back seat to the greater concerns of safety and security.
• There is a strong bias inside and outside of correctional facilities against prisoners.
• Many members of society believe that prisoners do not deserve healthcare or that their healthcare needs are less important than healthcare needs of those in the free world.

Correctional nurses in some settings may be faced with daily ethical challenges. Being able to continually cope with these challenges requires moral resilience.

 

Cultivating Moral Resilience

Smith and Muse suggest several ways to personally cultivate moral resilience.

• Self-awareness. Be aware of your own values, needs, and strengths.
• Skill Development. Develop and practice skills in communication, negotiation, conflict resolution and interprofessional collaboration. Seek out educational opportunities to develop and practice these skills.
• Mindfulness. Mindfulness is a moment-to-moment awareness that focuses attention, notices those emotions and thoughts that are distracting and promotes relaxation.
• Self-care. Take care of yourself. Maintain good physical and emotional health.
• Have a strong support system. Develop and maintain close relationships with co-workers, friends, and family.

 

Organizational Support

Organizations have a responsibility to promote and encourage moral resilience, too. Here are some ways to provide an organizational framework and culture that encourages moral resilience.

• Create a public dialog about moral/ethical challenges in the work environment.
• Support staff in stepping out to acknowledge and manage moral issues.
• Model moral/ethical behavior for staff.
• Create opportunities to discuss situations with ethical implications such as at staff meetings.

 

How about you? How do you deal with moral and ethical challenges in your correctional practice? Share your thoughts in the comments section of this post.

This post is part of a series discussing topics addressed during sessions of the 2018 Spring Conference on Correctional Health Care. All posts in this series can be found HERE.