TY - JOUR
T1 - Mindful ethical practice and resilience academy
T2 - Equipping nurses to address ethical challenges
AU - Rushton, Cynda Hylton
AU - Swoboda, Sandra M.
AU - Reller, Nancy
AU - Skarupski, Kimberly A.
AU - Prizzi, Michelle
AU - Young, Peter D.
AU - Hanson, Ginger C.
N1 - Funding Information:
ACKNOWLEDGMENTS The MEPRA team is deeply grateful for the philanthropic support of Dean Patricia Davidson to develop the MEPRA program through a Dean’s Award and dissemination through funding from Sibley Memorial Hospital and Maryland Health Services Cost Review Commission, Nursing Support Program I grant from Johns Hopkins Hospital. We are grateful to Meredith Caldwell for her excellent editorial support. We are inspired by all the participants of the MEPRA program, who remind us of the purpose of our work and their integral role in health care delivery.
Publisher Copyright:
© 2021 American Association of Critical-Care Nurses.
PY - 2021/1
Y1 - 2021/1
N2 - 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.
AB - 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.
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U2 - 10.4037/ajcc2021359
DO - 10.4037/ajcc2021359
M3 - Article
C2 - 33385208
AN - SCOPUS:85099124138
SN - 1062-3264
VL - 30
SP - e1-e11
JO - American Journal of Critical Care
JF - American Journal of Critical Care
IS - 1
ER -