Moral distress in public health practice: Case studies from nursing education

Peggy L. Wros, Launa Rae Mathews, Kristen Beiers-Jones, Patti Warkentin

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Moral distress in critical care nursing has been well studied; however, there is a gap in the literature related to moral distress among nurses and nursing students practicing in the community. This paper describes moral distress experienced during participation in the Interprofessional Care Access Network, a community-based nurse-led education and practice program providing longitudinal care coordination for underserved individuals and families in rural communities and urban neighborhoods. Two case studies represent client situations resulting in moral distress for nursing faculty and students. Contributing factors include unaddressed social determinants creating barriers to health and health care; inexperience and discomfort with people living in extreme poverty; lack of access to critical services for the most vulnerable; and powerlessness to influence discriminatory systems. Strategies are described to reduce moral distress and build moral resilience among students and faculty practicing in the community. Research is needed to expand understanding of causes, interventions, and consequences of moral distress in public health nursing.

Original languageEnglish (US)
Pages (from-to)1088-1094
Number of pages7
JournalPublic Health Nursing
Issue number6
StatePublished - Nov 1 2021


  • moral distress
  • moral resilience
  • public health nursing
  • undergraduate nursing education
  • underserved populations

ASJC Scopus subject areas

  • General Nursing
  • Public Health, Environmental and Occupational Health


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