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Dating. You know you’ve reached a new season in life when your kids begin dating. As I am sure every parent feels, it came all too soon for the Miller kids. Although my preference would have been to lock them all in their rooms for life - it was inevitable that the day would come when an extremely immature human would capture my child’s heart - and most likely break it! Knowing locking them away wasn’t really an option, I went on the offensive. I challenged each of them to make a list of the character traits their “perfect” mate would possess and describe how they expected that mate would treat them and make them feel. We talked about their lists and what traits and behaviors they considered to be non-negotiables - meaning that if their perspective mate didn’t possess them, it was hasta la vista baby! We called these lists their “true north” when it came to dating and eventually choosing a potential spouse in the very distant future. I would love to say that they all adhered to their list and never compromised, but that’s not the case. I will say that in the case of all of their relationships gone wrong - it’s because they deviated from the list and it resulted in a lot of heartache and pain. For one, the distress was overwhelming for quite some time. Nurses and nurse leaders across the nation are reporting unprecedented levels of moral distress - the painful experience of being placed in a situation where they are either prevented from doing what is right due to lack of resources or other support, or due to institutional expectations. This is very different than burnout, although it can often lead there. ____________________________________________________________ “Moral distress is not a weakness. It is evidence that your values are intact - and worth protecting.” ————————————————————————————————— Know your non-negotiables before the pressure arrives. Values are easiest to articulate when nothing is at stake. This is why I had my kids make their “perfect mate” list before they actually had a boy/girlfriend. Take the time to name your values and non-negotiables in writing. Not abstract ideals like patient safety, dignity or compassion, but the concrete behaviors those values demand of you. What would you refuse to do regardless of who asked? What would you document even if no one wanted it documented? What would you say out loud in a room that didn’t want to hear it? Nurse leaders carry an additional layer of responsibility here. The values you model under pressure become that unit’s culture. Staff are watching when a policy conflicts with patient welfare, when a physician pushes back on your concern or when administration unknowingly makes a decision that doesn’t have patient safety at the forefront. How you respond in those moments teach more than any orientation every could. Let me be clear - I have encountered very few (if any) hospitals or other clinicians that intentionally ask others to go against their values or morals. Most often it is as a result of rushed processes, policies that are not vetted through multidisciplinary teams or environments that do not practice shared governance or intentional just culture. I do not believe anyone in healthcare purposefully creates moral distress for anyone, but I do believe that sometimes the environment unknowingly creates ethical conflict and that conflict deserves a response.
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