The newly hired public health nurse understands that which of the following is an example of moral distress?

A. Communicate concern with chain of command: Addressing moral distress requires advocating for ethical concerns. Reporting issues to supervisors or the chain of command can initiate discussions and potential solutions.

B. Seek support from ethics committees: Ethics committees provide guidance and a structured way to resolve ethical dilemmas, helping nurses navigate morally distressing situations.

C. Be proactive: Taking a proactive approach—such as staying informed on ethical policies and seeking resolution early—can help prevent worsening distress.

D. Examine ways to work toward addressing the stressors: Identifying specific causes of moral distress and finding ways to address them, whether through self-reflection or systemic changes, promotes resilience and ethical practice.

E. Avoid discussing with others situations leading to moral distress: Suppressing concerns can worsen distress and lead to burnout. Open discussions with trusted colleagues, mentors, or support groups can help process emotions and develop solutions.

A. Having the knowledge and skill set needed to advocate for the patient, but not being able to act on it due to not having the authority to do so. Moral distress occurs when a nurse knows the right action to take but is constrained by external factors such as policies, hierarchy, or legal limitations.

B. Having the authority to call off a code, then realizing the decision was harmful to the patient. This describes moral regret or ethical uncertainty, not moral distress. Moral distress occurs when a nurse is unable to act according to their ethical beliefs.

C. Having the authority to override a physician's order for pain medication. This describes an ethical dilemma rather than moral distress. Moral distress arises when a nurse cannot act despite knowing the right course of action.

D. Having the knowledge and skill set needed to provide culturally competent care. Cultural competence is an important aspect of nursing, but it does not describe moral distress, which involves ethical conflict and external barriers.