Addressing Moral Distress in Correctional Nursing: A Call to Action

Abstract

In 1984, Jameton defined moral distress in nursing practice as the negative experience that occurs ''.when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue.'' (p. 6). Little research has been done about the magnitude and impact of moral distress among nurses working in correctional settings. All correctional nurses (CNs) will experience some form of moral distress during their careers. Consequences include burnout syndrome, blurred professional boundaries, and impaired ethical reasoning. There is a need for strong CN leaders who model professional behavior and provide orientation and mentoring for new CNs. A research agenda is needed to inform strong orientation and continuing education programs to introduce the concept of moral distress and related resources to CNs and to assist them in preventing or mitigating the consequences of moral distress.

Devaluing Incarcerated Populations: Deprioritizing Incarcerated Populations for COVID-19 Vaccination

“…35,44 In addition, correctional nurses are navigating additional challenges within correctional settings, such as a punitive prison culture, differences in philosophy between correctional nurses and correctional officers, and ethical dilemmas with providing and expressing care to patients, all of which can lead to high rates of moral distress and burnout. 45 Correctional nurses experienced more pandemic-related job responsibilities, longer work hours, and fewer sleep hours when compared with community nurses. 21 This increased strain on correctional nurses is of particular concern when considered alongside prisons as epicenters of COVID-19 outbreaks and concerns for overwhelmed health care resources in prisons and jails.…”

Unsafe and Unsettling

“…In line with our results, other reports have noted that security protocols in the correctional environment often override the quality or frequency of nursing healthcare priorities for incarcerated persons (Dhaliwal & Hirst, 2016), contributing to moral distress (Kalra et al, 2016). Moral distress is described as the negative experiences resulting from when a nurse knows what the right action is and is unable to act on it based on certain obstacles like institutional pressures or policies (Jameton, 1984; Smith et al, 2021). The phenomenon of moral distress could be investigated more within the correctional nurse environment in future studies.…”

“…Making changes toward a safer workplace environment may be seen as a positive effort from management to understand staff's needs and may improve the relationship between healthcare personnel and the organization. Additional support from supervisors could help correctional nurses to better maintain their sense of professional identity and uphold their code of ethics to practice with compassion and respect, promote health, and advocate for the rights of their patients (American Nurses Association, 2015; Smith et al, 2021).…”