Do No Harm: Moral Distress in Healthcare
First Name Priscilla
Last Name Mondt
Terminal Degree(s) Ph.D.
Institution/Organization Veterans Healthcare System of the Ozarks (Retired)

The well-known summation of the Hippocratic Oath is “Do No Harm” and yet healthcare professionals often find themselves caught between systems issues and personal moral beliefs. Moral distress may be unique to helping professions where one knows what to do but faces institutional obstacles or simply believes the hierarchy will not support the employee (Dickerson, 2010; Oh & Gastmans, 2015; Rushton & Boss, 2013). Moral distress is not the same as moral injury although the distress could lead to a moral injury. Moral distress is not defined simply as an ethical dilemma. Rather, moral distress is limited to being caught between what the institution asserts as right and what the individual believes to be right based on the individual’s personal moral code. Moral distress situations include scenarios such as physicians being caught between patient desires and institutional limitations (Pendry, 2007), laboratory personnel awareness of an employee’s incapacitation that impacts patient care or a nurse faced with futility of care (Pendry, 2007). Healthcare employees discover the result is psychological distress, workplace dissatisfaction, burnout and higher turnover rates. A feeling of powerlessness, guilt or shame often accompanies moral distress (Walsh, 2018). The presenter participated in a national Veterans Administration ethics research project that investigated moral distress using mixed methods (quantitative and qualitative). Interventions were designed with significant outcomes. The topic of moral distress is known in the nursing profession but VA research revealed that non-medical disciplines equally experienced moral distress such as business policies negatively impacting patient care. Moral distress is an ethics issue from both the perspective of the employee and the institution. Poster highlights include definition, barriers (both institutional and personal), symptomology and suggestions for intervention.