The statistic alone can cause distress: One third of newly licensed registered nurses leave the field after just two years. And yes, distress-; moral distress, as it was named by ethicist Andrew Jameton-; is a key culprit in the alarming burnout rate, says Professor Cynda Rushton of the Johns Hopkins School of Nursing.
So far, about 150 nurses have volunteered for the Mindful Ethical Practice and Resilience Academy (MEPRA), Rushton's brainchild for helping nurses identify ethical dilemmas, address them, and move on in a healthy manner. The six-session program teaches nurses how to stabilize their nervous systems through meditation, discern and analyze ethical challenges, and confidently communicate when discussing them with patients or physicians.
Years ago, Rushton-;as a nurse with three to four years of experience in a pediatric intensive care unit-;cared for a child in a persistent vegetative state. The parents wished to discontinue life support. The medical team refused, and the child languished for "month after month" before dying. Rushton remembers feeling caught, dutifully caring for the body even as staff began to de-personalize the child: "It's not something I'm proud of, but you got through however you could."
In 1992, she finally picked up a pen and tried a new coping strategy. A scholarly article titled "Care-giver Suffering in Critical Care" became a turning point as moral distress in nursing was forced out into the open. And today with MEPRA, she's teaching a new generation what she wishes someone had taught her.
"This is a very gratifying program," she says. "Nurses arrive discouraged, dispirited, depleted, and slowly begin to open up, like lotus flowers."