Date of Submission
Doctor of Nursing Practice (DNP)
Jo Loomis, DNP, FNP-C, CHSE, CLC, ANLC, NCMP, CNL
Kathleen Raffel, MSW, MBA, PhD
Nurses and nurse practitioners (NPs) face greater responsibility to address the ethical challenges that present during the course of patient care, due to advances in medical technology and pharmaceutical innovation, and despite widening disparities within the U.S. healthcare system. These ethical questions, which arise during the course of routine patient care, are increasing in both number and complexity in nearly every patient care setting. Unresolved and/or ongoing ethical questions and conflicts encountered in patient care pose further issues such as the development of moral distress. The literature demonstrates that moral distress contributes to dissatisfaction, disengagement, and burnout which negatively affects patient safety, quality of care, labor costs, and sometimes the permanent loss of NPs who change careers due to this stress. The purpose of this article is to discuss the ethical problems encountered by NPs who work in a primary care setting, the distress that results from unresolved ethical dilemmas and conflicts as well possible solutions to mitigate the development of moral distress. Addressing this issue is vital to the health of the nursing profession: for 18 consecutive years, nursing has been voted the most honest and ethical profession by 85% of Americans in an annual poll conducted by Gallup (Reinhart, 2020). To maintain that trust, nurses and NPs must be trained in and comfortable with addressing moral distress in practice.
Straight, Kelly, "Moral Distress: Unaddressed Challenges for The “Most Honest and Ethical Profession”" (2020). DNP Qualifying Manuscripts. 33.