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THE MORAL DISTRESS EDUCATION PROJECT
By the University of Kentucky Program for Bioethics
REVIEW: The Moral Distress Education Project is a free resource for nurses to explore and learn about the concept of moral distress, process personal experiences, and develop responses to moral distress. The project was conceived and created by Drs. Sara Rosenthal and Maria Clay and launched in 2015, after several years of creative work. I had the opportunity to meet Dr. Rosenthal in August 2016 when working on the Transforming Moral Distress into Moral Resilience in Nursing collaborative project JCN did with the American Journal of Nursing and the Johns Hopkins Berman Institute of Bioethics (see the Executive Summary, pp. 82-87 in this issue). Dr. Rosenthal is Professor of Bioethics and Director, Program for Bioethics, at the University of Kentucky, Departments of Internal Medicine, Pediatrics, and Behavioral Science. She is Chair of the University of Kentucky Medical Center's Hospital Ethics Committee and directs the clinical ethics consult service. She is an amazing, sensitive, and delightful woman. Dr. Clay is Professor and Chair, Department of Bioethics & Interdisciplinary Studies, at East Carolina University.
The project is a series of short documentary-style videos of interviews with ethics multidisciplinary experts. This self-guided web documentary currently consists of 12 professionally produced videos, ranging in length from 3 to 12 minutes, along with a bibliography of resources and stories. But the number of videos and resources will grow as the project collects more interviews, materials, and institutional sponsors. The goal is to educate, inform, and destigmatize moral distress, and help healthcare professionals process their personal experiences with moral distress. Free American Medical Association continuing education is available with the project—2 contact hours. At this point, nursing continuing education is not offered, but hopefully it will be in the future.
I found the videos engaging. From personal nursing practice, I resonated with the words and illustrations of the speakers. Listening to the origins of moral distress, signs, and short- and long-term consequences, validated my experiences. The discussion on prevention and solutions to moral distress is realistic and hopeful. The videos would be excellent for classroom use, teaching nursing students, or with practicing nurses and managers in staff meetings. The next time you find yourself frustrated about a morally distressing situation at work, take a look at this website.—KSS
AMERICAN SOCIETY FOR PAIN MANAGEMENT NURSING
BRIEF: The American Society for Pain Management Nursing is an organization of professional nurses dedicated to promoting and providing optimal care of individuals with pain, including the management of its sequelae. This is accomplished through education, standards, advocacy, and research. Goals include:
- Promote and provide education that supplies stimulation, knowledge, and skills required for professional and personal growth.
- Encourage nurses to specialize in the practice of pain management nursing.
- Facilitate effective communication among pain management nurses.
- Encourage and support systematic study, evaluation, and research related to pain management nursing care.
- Promote the delivery of high-quality pain management care.
- Speak for the nursing profession with governmental bodies and the public on issues that concern pain management.
- Establish standards of clinical nursing practice and nursing education in pain management.
Individual membership in the ASPMN is $125.00 annually.
AMERICAN CHRONIC PAIN ASSOCIATION
BRIEF: The mission of the American Chronic Pain Association is to facilitate peer support and education for individuals with chronic pain and their families so that these individuals may live more fully in spite of their pain. The association also seeks to raise awareness among the healthcare community, policy makers, and the public about issues of living with chronic pain. The site offers free information regarding multiple traditional and holistic pain treatment options, current clinical trials, and pain management techniques, such as communication tools and medication safety videos. The ACPA promotes Pain Awareness Month every September.
SMALL GROUP BIBLE STUDY
The Meaning of the Gospel
By Jack Kuhatschek
64 pp., Downers Grove, IL: InterVarsity Press, 2016, paperback, $9.00, eBook available.
BRIEF: Part of the LifeGuide Bible Study series (over 100 titles available), this just released nine-session study explores not only the question, “What must I do to be saved?” but also helps groups understand the meaning of the Good News: that is, the incredibly broad scope of what God has done, is doing, and will do in the future to reconcile all things to himself through Jesus Christ.
“The full contours of the gospel can only be seen and appreciated when we scan the biblical horizon from Genesis to Revelation. That explains, in part, why God wrote such a lengthy book rather than a gospel tract,” Kuhatschek writes. “Yet, if we want to recapture the spirit of the two disciples on the road to Emmaus, when their hearts burned with excitement and passion within them, then we'll need to begin with Moses and all the prophets to understand what was said in all the Scriptures concerning Jesus and his reason for coming.”
Kuhatschek adds, “I'm hoping that this LifeGuide will not only explain what we must do to be saved but also help you understand the background and far-reaching implications of the Good News we have believed.”
ABIDING IN CHRIST
By J. I. Packer and Carolyn Nystrom
64 pp., Downers Grove, IL: InterVarsity Press, 2009, paperback, $9.00, eBook available.
BRIEF: “As the Father has loved me, so have I loved you. Abide in my love” (John 15:9).
Before Jesus left this world, he gave specific encouragement and instructions to his disciples on what to expect and how to live after he had gone. These words apply to his disciples today.
In Abiding in Christ, trusted guides Packer and Nystrom lead you through an exploration of Jesus' farewell to his disciples, as found in John 14-17. These eight studies help you discover what it means to abide in Christ during the time between Christ's departure and his second coming.
This LifeGuide Bible Study features questions for group discussions and personal reflection, as well as a Now or Later section following each session to help you act on what you learn.
Going Deeper helps you dig deeper into JCN content, offering ideas for personal or group study with other nurses—great for Nurses Christian Fellowship groups!
- The Experience of Intense Pain: Read Kiser-Larson, 88-96.
Transforming Moral Distress into Moral Resilience: Read Rushton, Schoonover-Shoffner, & Kennedy, 82-87.
- Discuss compartment syndrome. How does it present?
- Compare and contrast the types or classifications of pain.
- Interact with the author's statement: “Diagnosis of neuropathic pain can be challenging, thus knowing the patient's history and making a careful assessment of pain are especially important. An accurate diagnosis of acute onset neuropathic pain is critical, in order to offer appropriate treatment.”
- What interventions does the author suggest are needed in pain assessment?
- Read Isaiah 43:2-3a. How might these verses offer comfort in the midst of intense pain?
Promoting Compliance: Read Lodge Haynes, 112-119.
- What evolving concept do the authors suggest as a response to moral distress?
- Discuss some of the essential steps for addressing moral distress and supporting the cultivation of moral resilience in individuals.
- Discuss some of the essential steps for building systems that support ethical practice.
- Have you experienced moral distress in your practice? Describe the situation and how you felt. What steps did you take to address the situation?
- Read James 1:2-8. How do these concepts relate to the matter of resilience? What insight does Colossians 3:22-25 add to this discussion?
- What two factors regarding healing does the author suggest need to be understood when working with some Christian patients?
- How does this statement shed light on compliance? “The influence of psychological motivations is reinforced by Lewin (2011), who postulated there are forces outside of the individual that either persuade the person toward or away from compliance. This can be particularly true of a close-knit religious community.”
- What themes emerged as a result of participant discussions?
- Discuss the author's statement: “By bringing the components of faith and belief into health, nurses can increase compliance and help create a healthier congregation.”
- Read James 5:13-16 in light of concepts learned in this article. To what degree can you sense the struggle for some believers regarding healthcare compliance? How might this increase your sensitivity?