JOSEPH: Once I recognized my distress, I had to identify the constraints I was under and what values were in conflict. From there I could decide what to do, like speaking with my team or engaging leadership. When I thought about the situation with Chester, this is what I identified.
PIC 12: Several bullet points appear on screen.
JOSEPH: Moral distress isn’t only tied to dramatic situations. For example, being short-staffed could also cause moral distress.
PIC 13: Several bullet points appear on screen.
JOSEPH: Working through this stuff was maybe less fun than exercising or meditating. And I haven’t always been able to solve the root problem. But it has let me recover from tough situations without feeling like I have to care less to do the job. We can’t deal with moral distress entirely on our own. We also need to have a resilient team. Let’s discuss a few ways we can support a colleague experiencing moral distress. Ask Open-Ended Questions to build rapport and encourage sharing. Learn about their feelings, how they’re constrained, and what values are threatened.
PIC 14: A banner across the screen reads “Ask Open Ended Questions: build rapport and encourage sharing. Identify moral distress.”
JOSEPH: This can help to identify the experience as moral distress. Open-Ended Questions are neutral, imply no judgment, and invite more than a one-word answer. Closed questions keep the conversation short and can imply judgment. “Why” questions can also imply judgment, even though they sound open-ended.
PIC 15: The titles “Ask Open-Ended Questions” and “Avoid Closed Questions” appear onscreen. “Ask Open-Ended Questions” expands into bullet points reading:
“Avoid Closed Questions” expands into bullet points reading:
PIC 16: A series of bullet points appear, reading, “Avoid Asking Closed Questions like:”
A second bullet appears, reading “Avoid Asking “Why Questions like:”
PIC 17: A series of bullet points appear, reading, “Open-Ended Questions.”
JOSEPH: Once someone shares their experience and feelings with me, I want to keep building rapport, show respect for their position, and validate their experience. I can use affirmations to do this. Affirmations are genuine. They state something objectively true, preferably a strength.
PIC 18: A banner across the screen reads “Affirm their perspective. Be genuine, focus on strengths.”
PIC 19: A series of bullet points appear under the title “Affirmations”.
JOSEPH: The next thing I can do is direct their feelings towards something productive. I helpthem reframe the problem from something with no good solution, to something that’s actionable. A good reframe points toward possible action steps to take.
PIC 20: A banner across the screen reads “Reframe Feelings. No Solution to Potential Action.”
PIC 21: A screen titled “Reframe Feelings” appears, containing two boxes. The first box reads, “If I don’t spend more time with patients I might miss something, but if I do spend more time, I’ll get in trouble with my job and throw off the schedule.”
This box has an arrow pointing towards the next box, which reads,
“It’s important to make sure you don’t miss something when meeting with your patients, and having more time would help. What else might help? “
Two new boxes appear. The first box reads,
“I can’t keep doing this every day; it’s not what the patient wants and it’s causing more suffering, but I’m required to do it anyways. “
This box has an arrow pointing towards the next box, which reads,
“You want to respect the patient’s wishes and prevent unnecessary suffering. How can we make sure the next patient’s wishes are documented and followed?”
JOSEPH: I can also use these techniques in self-reflection. I’ll ask myself how I’m feeling, affirm my motivations, and reframe my frustrations into action steps.
PIC 22: Three bullet points appear under the title, “Self Reflection” reading,
JOSEPH: You can practice supporting a colleague who is experiencing moral distress in the following virtual conversation. You’ll help Rashad talk about how he’s feeling, identify the source of his conflict, affirm and validate his feelings, and reframe the problem.
PIC 23: An overview screen called “Talk with Rashad” appears, with several sections.
Scenario: Colleagues Devon and Rashad run into each other in the break room. Rashad seems upset. As Devon, help Rashad process what’s upsetting him.
Goals:
Techniques: