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critical care, military, military medical services, moral distress, moral injury



  1. Wilson, Melissa A. PhD, APRN, CCNS


Purpose: The US military healthcare services provide the highest level of trusted medical care to its members and to the world population during catastrophic events. These services can be difficult, making moral and ethical situations commonplace. Moral distress results when actions are inconsistent with personal or professional beliefs, resulting in a loss of moral integrity. Moral distress research is well established in the civilian literature and results in poor outcomes and increased expenses. There is little research studying moral distress in military providers.


Description of the Project: A clinical nurse specialist-led workshop was conducted with military and civilian experts. The expert panel reviewed the literature, examined instruments, and reviewed tool items for applicability to military healthcare providers.


Outcome: The team determined the existing civilian moral distress tool was applicable to military providers. Twelve additional items were added to the modified tool. A tool testing plan was developed to test the tool in military critical care nurses on the last day of the workshop for the next phase of this project.


Conclusion: The civilian moral distress tool was adapted for a military version and will be tested in the next phase of the project.