Addressing Moral Distress

Unchecked, moral distress, moral residue and the moral residue crescendo, increase over time and can negatively impact our ability to care for ourselves and others at work. To address these issues at the individual, team, and system levels, Cynda Rushton in her book on moral resilience suggests a three-fold approach to fostering moral courage and moral resilience in the health care setting.

The outer circle represents our individual selves that we bring to each encounter. This includes our self-awareness, personal values, sense of integrity, and personal resilience creating practices that contribute to our own ability to be resilient in the face of struggle. The outer circle of being encompasses all we think or understand, and all we do.

The middle circle consists of recognizing, identifying, and giving voice to the patterns of behavior that can contribute to or detract from creating cultural and systemic practices that support moral integrity.

The inner circle includes specific strategies and tactics to address and remedy practice and policy gaps that increase the likelihood of moral distress. Actions to address moral adversity and foster moral integrity arise from a careful examination of ourselves, our teams, and our systems.

For reflection alone or together:

Rushton’s model begins with self-awareness. What practices help you deepen your self-awareness?

How might you bring this awareness to help identify systemic forces that contribute to moral distress?