Moral Distress in Nursing discussion

Discussion Prompt #1

  • Describe a clinical situation in which a registered nurse may encounter moral distress. Answer the AACN’s Four A’s found on page 84 in your Butts and Rich text to further explain the situation, and the possible mitigation strategies.

Discussion Prompt #2

  • Describe different ways that social media use can violate ethical nursing practices. How can ethical social media use be beneficial to health care professionals and their patients?

Expert Solution Preview


As a professor in charge of creating college assignments and answers for medical college students, it is important to provide valuable insights into real-life clinical situations. This article will discuss two different topics related to nursing ethics and moral distress. The first topic emphasizes a common clinical situation where a registered nurse may encounter moral distress. The second topic explores the risks and benefits associated with social media use in nursing practice.

Discussion Prompt #1:

Clinical Situation: Imagine a scenario where a registered nurse in an emergency room is in charge of controlling the flow of patients and decides to prioritize patients based on the severity of their illness. Suddenly, a patient is brought in who is a severely injured homeless man with no health insurance. Despite the severity of the injury, the nurse finds that the other patients waiting in the emergency room have health insurance and so prioritizes them over the homeless man.

AACN’s Four A’s: In this situation, the nurse may encounter moral distress, as prioritizing patients based on their ability to pay for medical services would be considered an ethical violation. The AACN’s Four A’s (1) Ask: identify the problem, (2) Affirm the distress: acknowledge the emotions and values that are being challenged, (3) Assess options: determine the situation and weigh the options available, and (4) Act: take action to resolve the problem or seek help to address the situation, can be used to evaluate possible mitigation strategies.

Possible Mitigation Strategies: The nurse can act in several ways to alleviate moral distress, such as seeking support from colleagues or supervisor, speaking up in favor of the homeless man, or asking for an ethics committee consultation. By using the Four A’s, the nurse can also assess alternative options, such as assessing the patient’s immediate needs and transfer them to another hospital willing to treat them.

Discussion Prompt #2:

Ethical Violations on Social Media: One of the most common ethical violations on social media is the breach of confidentiality, where nurses share patient information without their consent. This includes taking photos or videos of patients and sharing them on personal or professional social media accounts. Another risk includes nurse-patient boundary violations, such as accepting friend requests from patients on social media channels.

Ethical Benefits on Social Media: Ethical use of social media can benefit nursing practice in various ways. For example, social media can be used to educate patients on health promotion practices, advocate for public health policy changes, and to help peers and patients find resources to better manage their health conditions. Ethical social media policies can be in place to ensure that nurses utilize social media platforms in a responsible and professional manner.


In conclusion, as healthcare professionals, it is crucial for nurses to recognize ethical dilemmas and implement strategies that promote ethical and safe patient care practices. By using the Four A’s model in clinical situations and social media policies, nurses can mitigate moral distress and provide better care to their patients.

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