As most nurses know, sometimes you’re faced with some really…umm…uncomfortable situations that can really test your nerves. Some situations can really be a challenge to one’s ethics.

That said, there was an article in Nurse.com about how to deal with “moral distress.” Interesting terminology, but fair enough, it is an issue. However, the examples they gave are just so lame. There are so many real and pressing issues that can cause real “moral distress” in any nurse with half a conscience, so I have no idea how they came up with these watered down silly scenarios.

Story #1

Rick is a nurse at a health clinic that provides vaccines required for school entry to eligible children at no charge. However, his agency does not provide additional vaccines that recently have been recommended by the Centers for Disease Control and Prevention for free as well, including rotavirus and human papillomavirus.

Rick is frustrated because he cannot reconcile his belief that the policy is a barrier to his responsibility to care for the health needs of the public. He also experiences feelings of anxiety and anger because of a policy that conflicts with his beliefs about professional practice and the commitment he made to protect the health of the public. He questions whether he made the right career choice.

Is this really a case for severe moral distress? The guy works in a clinic that provides school entry vaccines for children free of charge. Repeat, it supplies required vaccines that children need to attend school. Rotavirus and HPV are not required for school entry. There are other places that people can go to obtain those vaccines if they want them. So what is Rick’s problem? That he can’t provide everyone who enters his clinic with every kind of healthcare need and desire? Is that a moral dilemma?

Doesn’t he think that what he’s doing helps a lot of people? Is it an all or nothing proposition? The guy sounds a little mentally unstable to me.

Story #2

Sue is a staff nurse in an orthopedic unit. The nurse/patient ratio is adequate for the level of patient acuity, but Sue believes multitasking and assisting agency staff prevent her from delivering the level of care she expects from herself and the standard of care she perceives her patients deserve. She feels guilty that sometimes an hour passes before she can respond to a patient’s request. Sue also experiences feelings of frustration, anxiety, and anger because of this recurring situation, which conflicts with her beliefs about professional practice. Sue’s sensitivity to patient vulnerability and the trust that patients place in her contribute to her distress.

Sue begins to question her effectiveness as a nurse, and because Sue is dissatisfied with her work situation, she contemplates a transfer to another unit.

Well Sue, join the club. And in this case, most nurses would not question their effectiveness as a nurse (unless, of course, they are endowed with the martyr/angel of mercy complex), but would question the staffing and the practices of the facility. Again, this is a silly scenario because there is no moral distress here, just poor staffing practices. And Sue shouldn’t be questioning her competence–she should be demanding better staffing and more help; or working to organize/unionize the facility so that patient care improves.

What is it with these nursing articles? Why are they so afraid of speaking on a level that is meaningful to readers? Why not give real examples of hard choices and situations that nurses are in, rather than this silly drivel?