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CNOs Suffer Moral Distress in Isolation


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by Jennifer Thew, RN

Moral distress among chief nursing officers is seldom acknowledged. Two researchers, both RNs, hope their work will help address the elephant in the room.

The concept of moral distress in nursing—the disequilibrium resulting from the recognition of and inability to react ethically to a situation—has been around since the 1980s, and it's been acknowledged that some bedside nurses experience it during challenging situations such as when there is a conflict surrounding end-of-life care.

But what about chief nursing officers? They aren't providing direct care at the bedside, but do they still experience moral distress?

The answer, according to a qualitative study published in the Journal of Nursing Administration in February, is yes. It's just taboo to talk about it.

"There's shame and isolation when you do have the experience, so it can make it very difficult for people to feel like they can openly discuss it," says Rose O. Sherman, EdD, RN, NEA-BC, FAAN, professor and director of the Nursing Leadership Institute at Florida Atlantic University.

Sherman is one of the study's authors. "I think that the other piece of it is, CNOs might not always label it as moral distress. But these are uncomfortable situations where they're making decisions against their values systems."

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