Moral Resilience

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.

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.

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.

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.

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.

Stress Resilience: Molecular and Behavioral Aspects presents the first reference available on the full-breadth of cutting-edge research being carried out in this field. It includes a wide range of basic molecular knowledge on the potential associations between resilience phenomenon and biochemical balance, but also focuses on the molecular and cellular mechanisms underlying stress resilience. World-renowned experts provide chapters that cover everything from the neural circuits of resilience, the effects of early-life adversity, and the transgenerational inheritance of resilience. This unique and timely book will be a go-to resource for neuroscientists and biological psychiatrists who want to improve their understanding of the consequences of stress and on how some people are able to avoid it. Approaches resilience as a process rather than as a static trait Provides basic molecular knowledge on the potential associations between resilience phenomenon and biochemical balance Presents thorough coverage of both the genetic and environmental factors that contribute to resilience