Doing the best I can do: moral distress in adolescent mental health nursing.




Musto, Lynn Corinne

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The purpose of this research was to explore the process used by mental health nurses working with adolescents to ameliorate the experience of moral distress. Using grounded theory methodology, a substantive theory was developed to explain the process. All the incidents that lead to the experience of moral distress were related to safety and resulted in the nurse asking themselves the question, “Is this the best I can do?” Engaging in dialogue was the primary means nurses used to work through the experience of moral distress. Engaging in dialogue was an ongoing process and nurses sought out dialogue with a variety of people as they tried to make sense of their experience. Participants identified qualities of dialogue that were helpful or unhelpful as they sought to resolve their moral distress. Participants who had a positive experience of dialogue were able to answer the question, and continue working with adolescents with a renewed focus on the therapeutic relationship. Participants who have a negative experience of dialogue are unable to answer the question and either leave the unit or agency, or talk about leaving.



moral distress, mental health nurses, adolescents