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Moral courage, distress, and resilience

Nurses face increasingly complex ethical dilemmas where our ability to do the right thing can be hindered by conflicting beliefs of other healthcare providers. Some confront the ethical issues directly while others turn away. Upholding our commitment to patients requires significant moral courage. Moral courage helps us address ethical issues and take action when doing the right thing is not easy (American Nurses Association, 2020). Moral courage involves the willingness to assert ourselves when tempted to just “go with the flow”.

My patient “Mr. Smith”, was admitted with a wound vac and several comorbidities.

A&O x4, but his pain medication was barely taking the edge off though he was receiving Norco Q4 and morphine IV in between. The rounding Dr. added a fentanyl patch to the regimen, and I had 3 days off. When I returned I received report that he was stable and had not changed, but when I woke him to give him his 8AM meds, I could tell he was LOC was dramatically altered. His ammonia levels were creeping up, and when I alerted the doctor, he ordered a Quinton cath to be placed. Long story short, it couldn’t be placed til the next day and everyone was ok with that, but because I seemed to be the only one who realized the sparkle in his eyes was gone, I pressed to get him to a facility that could place it STAT. It was very uncomfortable to express my concerns to the charge nurse and to the doctor because its not in my nature to be assertive, but I knew I had to advocate for him.

His wife arrived in hysterics and chewing out the charge nurse who in turn chewed her out. I showed the wife compassion and validated her feelings. She gave me a big hug when transport came to transfer them. Four days later, he came back to my pod with the sparkle back in his eyes! I was never so happy to see an admit! The ethical principle used was beneficence which is at the heart of every nursing practice– preventing harm and promoting good.

American Nurses Association. (2020). Ethics Topics and Articles. Retrieved from…

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