Nurses gather at the Johns Hopkins School of Nursing to address this growing problem.

A nurse struggles to reconcile repeated surgeries and transfusions for a premature infant with the child’s slight chance of survival. An oncology nurse knows a patient wants to refuse treatment but doesn’t do so because his physician and family want him to “fight on.” A nurse on a geriatric unit knows she is not giving needed care to patients because of inadequate staffing.

Situations like these are not rare for nurses and often give rise to moral distress—that is, when nurses recognize their responsibility to respond to care situations but are unable to translate their moral choices into action.

Moral distress in nursing has risen to unprecedented levels, contributing to burnout and staff shortages and imperiling safe, quality health care.

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