Critical care nurses are uniquely exposed to the intricacies of caring for patients and families at the end of life (EOL). Exposure to caring for dying patients can lead to intense emotional responses on the part of the nurse. For example, patients’ families or health care providers may ask nurses to continue aggressive interventions at the EOL, despite low likelihood of survival or quality of life. This scenario is a commonly cited source of moral distress in the health care setting, particularly for nurses.1,2  The results of a 2005 survey showed that 80% of pediatric critical care nurses agreed with the statement “Sometimes I feel we are saving children who should not be saved.”

Moral distress occurs when one recognizes one’s moral responsibility in a situation, evaluates the potential courses of action, and identifies the decision deemed ethically correct...

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