Mindful ethical practice and resilience academy: Equipping nurses to address ethical challenges

Cynda Hylton Rushton, Sandra M. Swoboda, Nancy Reller, Kimberly A. Skarupski, Michelle Prizzi, Peter D. Young, Ginger C. Hanson

Research output: Contribution to journalArticlepeer-review


Background Ethical challenges in clinical practice significantly affect frontline nurses, leading to moral distress, burnout, and job dissatisfaction, which can undermine safety, quality, and compassionate care. Objectives To examine the impact of a longitudinal, experiential educational curriculum to enhance nurses’ skills in mindfulness, resilience, confidence, and competence to confront ethical challenges in clinical practice. Methods A prospective repeated-measures study was conducted before and after a curricular intervention at 2 hospitals in a large academic medical system. Intervention participants (192) and comparison participants (223) completed study instruments to assess the objectives. Results Mindfulness, ethical confidence, ethical competence, work engagement, and resilience increased significantly after the intervention. Resilience and mindfulness were positively correlated with moral competence and work engagement. As resilience and mindfulness improved, turnover intentions and burnout (emotional exhaustion and depersonalization) decreased. After the intervention, nurses reported significantly improved symptoms of depression and anger. The intervention was effective for intensive care unit and non–intensive care unit nurses (exception: Emotional exhaustion) and for nurses with different years of experience (exception: Turnover intentions). Conclusions Use of experiential discovery learning practices and high-fidelity simulation seems feasible and effective for enhancing nurses’ skills in addressing moral adversity in clinical practice by cultivating the components of moral resilience, which contributes to a healthy work environment, improved retention, and enhanced patient care.

Original languageEnglish (US)
Pages (from-to)e1-e11
JournalAmerican Journal of Critical Care
Issue number1
StatePublished - Jan 2021

ASJC Scopus subject areas

  • Critical Care


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