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Advanced Practice

Moral Distress: One Unit’s Recognition and Mitigation of This Problem

Susan D. Bruce
Deborah “Hutch” Allen
CJON 2020, 24(1), 16-18 DOI: 10.1188/20.CJON.16-18

Moral distress experienced by staff has been well documented in the intensive care work areas, but less described in oncology nursing. Factors that contribute to moral distress include ethical dilemmas, mismatched goals of care among patients and their families and providers, and perceptions of futility of care. This article describes recognizing the risk of moral distress in a newly formed medical-surgical oncology unit and steps taken to mitigate developing moral distress, illustrating that moral distress is present in oncology nursing and warrants further study.


  • Moral distress is a psychological disequilibrium between one’s awareness of the morally appropriate action that a situation requires and the inability to act on it.
  • The problem of moral distress threatens the integrity of healthcare providers and is reported by oncology nurses.
  • Oncology advanced practice nurses can inform and implement moral distress mitigation strategies.

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