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According to Connie Ulrich, constantly making judgments in stressful situations often drive clinicians to question their moral strength and ability to provide care, ultimately diminishing workplace resiliency.

Credit: Alykhan Lalani

School of Nursing professor and nurse-bioethicist Connie Ulrich is calling for more research to be done to find a solution for moral distress among health care professionals.

Ulrich's Sept. 23 commentary piece, “Moral Distress and Moral Strength Among Clinicians in Health Care Systems: A Call for Research,” asserts that health care professionals often experience moral stress because they have to use their judgment to deal with ethically complex, stressful situations. These issues may drive clinicians to question their moral strength and ability to provide care, ultimately diminishing workplace resiliency. 

The commentary was co-authored by Christine Grady, chief of the Department of Bioethics at the National Institutes of Health. It was published in the National Academy of Medicine’s NAM Perspectives, a journal that discusses issues in health, science, and policy.

This past spring, a complementary Penn Nursing study generated through the synthesis of 16 years of research supported the need for healthy nurse working conditions in order to provide better patient care and positive hospital environments.

As the first nurse-bioethicist at Penn, Ulrich previously advocated for the importance of ethics education at Penn and in the study of nursing, testifying to the Presidential Bioethics Commission on the issue. She also authored “Nursing Ethics in Everyday Practice” as a guideline for moral decision making.

The commentary also argued that while moral distress may be unavoidable, the negative consequences that arise from it have the potential to be prevented. The authors cited institutional support and organizational reform as possible pathways to progress, adding that more research is needed to create changes that address these issues.

“If we do nothing to mitigate the stress, moral distress, and emotional damage endured by health care clinicians, we fail to honor the skills and expertise they bring to patients and families," the report concluded.