Moral Resilience

Suffering is an unavoidable reality in health care. Not only are patients and families suffering but also the clinicians who care for them. Commonly the suffering experienced by clinicians is moral in nature, in part a reflection of the increasing complexity of health care, their roles within it, and the expanding range of available interventions. Moral suffering is the anguish that occurs when the burdens of treatment appear to outweigh the benefits; scarce human and material resources must be allocated; informed consent is incomplete or inadequate; or there are disagreements about goals of treatment among patients, families or clinicians. Each is a source of moral adversity that challenges clinicians' integrity: the inner harmony that arises when their essential values and commitments are aligned with their choices and actions. If moral suffering is unrelieved it can lead to disengagement, burnout, and undermine the quality of clinical care. The most studied response to moral adversity is moral distress. The sources and sequelae of moral distress, one type of moral suffering, have been documented among clinicians across specialties. It is vital to shift the focus to solutions and to expanded individual and system strategies that mitigate the detrimental effects of moral suffering. Moral resilience, the capacity of an individual to restore or sustain integrity in response to moral adversity, offers a path forward. It encompasses capacities aimed at developing self-regulation and self-awareness, buoyancy, moral efficacy, self-stewardship and ultimately personal and relational integrity. Clinicians and healthcare organizations must work together to transform moral suffering by cultivating the individual capacities for moral resilience and designing a new architecture to support ethical practice. Used worldwide for scalable and sustainable change, the Conscious Full Spectrum approach, offers a method to solve problems to support integrity, shift patterns that undermine moral resilience and ethical practice, and source the inner potential of clinicians and leaders to produce meaningful and sustainable results that benefit all.

Suffering is an unavoidable reality in healthcare. Not only are patients and families suffering, but more and more the clinicians who care for them are also experiencing distress. The omnipresent, daily presence of moral adversity is, in part, a reflection of the burgeoning complexity of healthcare, clinicians' role within it, and the expanding range of available interventions that must be balanced with competing demands. There is an urgent need to design solutions that address the myriad factors that create the conditions for imperiled integrity within the healthcare system. Moral resilience is a pathway to transform the effects of moral suffering in healthcare. Dr. Rushton and colleagues offer a novel approach to addressing moral suffering that engages transformative strategies for individuals and systems alike and leverages practical skills and tools for a sustainable workforce that practices with integrity, competence, and wholeheartedness, and dismantles the systemic patterns that impede ethical practice. This is a must-read for clinicians - front line nurses to physicians to system leaders and policymakers - because it will require collective collaboration, aligned values, shared language and intentional design to make our healthcare organizations and their clinicians healthy again.

Morality in context is a timely topic. A debate between philosophers and social scientists is a good way to approach it. Why is there such a booming interest in morality and why does it focus on context? One starting point is the change in the sociostructural and sociocultural conditions of modern societies. This involves change in the empirical conditions of moral action and in the social demand on morality. As these changes are accounted for and analyzed in the social sciences, new perspectives emerge that give rise to new ways of framing issues and problems. These problems are best addressed by way of cooperation between philosophers and social scientists. As Habermas (1990) has pointed out in a much cited paper, philosophers depend on social science to fill in the data they require to answer the questions raised by philosophy in its "placeholder" function. The reverse also holds true: Social science needs the conceptual clarifications that philosophy can provide. With respect to morality, such mutual interchanges are of particular importance the contributions to this book show convincingly.

The nursing profession is under pressure. Financial demands, student debt, the target culture, political scrutiny in the wake of major care scandals and increasing workloads are all taking their toll on professional morale and performance. This timely book considers the meaning of resilience in this adverse context and explains why measures to preserve individual nurses’ and students’ well-being are flawed if they don’t take into account wider political and organizational perspectives. Arguing that healthcare can be thought about and experienced differently, this book: provides a summary of the latest research on resilience, explaining its relevance and also limitations for nurses; considers debates about compassion and highlights the effects of policy agendas on nurse education and nursing work; re-evaluates nursing’s professional identity, including where nursing has come from and the effects of class, gender and race on its powerbase; assesses the role of politics and social media, both in driving change and feeding resistance; and introduces the idea of critical resilience as a complete framework for resisting bullying and fostering survival and change in the nursing workforce. Direct, upbeat, at times provocative and witty, this agenda-setting book enables nurses to understand why they feel the way they do. It also lists what opportunities are available to them to change, resist and survive in what has become a complex, challenging – if still deeply rewarding – line of work.

Gain the knowledge and skills you need to provide psychiatric mental health nursing care in Canada! Varcarolis's Canadian Psychiatric Mental Health Nursing, 3rd Edition uses a practical clinical perspective to provide a clear understanding of this often-intimidating subject. It provides a foundation in nursing techniques and a guide to psychobiological disorders such as bipolar and depressive disorders, trauma interventions, and interventions for distinct populations such as children and older adults. Adapted to meet the needs of Canadian nurses by Cheryl L. Pollard and Sonya L. Jakubec, this market-leading text prepares you for practice with real-world examples presented within a Canadian legal, ethical, and cultural context. Canadian focus throughout includes key considerations such as our nation’s cultural and social diversity with federal/provincial/territorial distinctions. Canadian research and statistics reflect mental health and mental health practice in Canada. Research Highlight boxes are updated with examples of Indigenous research methodologies by Indigenous researchers and settler allies. DSM-5 boxes provide criteria for disorders covered by the American Psychological Association. Learning features include key terms and concepts, learning objectives, key points to remember, critical thinking, and chapter reviews, reinforcing important information and helping to apply textbook content to the clinical setting. Assessment Guidelines boxes summarize the steps of patient assessment for various disorders. Drug Treatment boxes feature the most current generic and trade names for drugs used in Canada. Patient and Family Teaching boxes provide important details that should be discussed with patients and care givers. Integrative Therapy boxes highlight the different types of therapy may be used to enhance treatment. Considering Culture boxes discuss the importance of cultural safety in providing competent care to diverse populations within various clinical situations. NEW! Safety Tip boxes highlight important issues of safety for psychiatric mental health care, patient experiences, and nursing interventions. NEW! Added mental health content covers Indigenous populations, migrant populations, and gender differences with a focus on cultural safety, equity-informed approaches, relational and trauma-informed practices. Updated Chapter 29 covers recovery, survivorship, and public mental health approaches. Enhanced topics include substance use disorders, harm reduction, and support among nurses; changes related to Medical Assistance in Dying (MAiD) legislation; and mental health in view of climate change and the COVID-19 pandemic.

The Navy SEAL, humanitarian and best-selling author of The Heart and the Fist draws on ancient wisdom and personal experience to counsel readers on how to promote personal resilience and overcome obstacles through positive action. 100,000 first printing.