Study examines program effects of ethical practice and resilience

May 19, 2023

According to research published in the American Journal of Critical Care (AJCC), a program developed by Cynda Hylton Rushton, PhD, RN, FAAN, and her team from Johns Hopkins University led to “sustained improvements in nurses' ability to effectively address ethical challenges.” The study was intended to “examine the long-term impact on nurses who completed an experiential educational program designed to improve their skills in mindfulness, resilience and competence in confronting ethical challenges.”

“It’s increasingly important that we address ethical concerns in a sustainable way and support the integrity and well-being of nurses. In our sample, more than 95 percent of participating nurses reported confronting ethical challenges in their workplace, but only 15 percent had previously received formal ethics training,” Rushton said. “Our findings offer a promising path forward in strengthening the skills, tools and resources for nurses to address moral adversity in clinical practice and to amplify their moral resilience, she added.” 

Rushton pointed out that current threats to the nursing workforce require targeted interventions with long-term impact, and many interventions are one-time programs that have not been systematically evaluated or been accompanied by efforts to sustain the gains that were made. 

The 12-week study, titled “The Mindful Ethical Practice and Resilience Academy: Sustainability of Impact,” involved surveys of 245 nurses at four points during the intervention: at baseline, immediately after completing the program, and at three and six months afterward. This work was performed at Johns Hopkins Hospital, Baltimore, and Sibley Memorial Hospital, Washington, D.C.

Among the results, improvements noted were in “ethical confidence, moral competence, resilience, work engagement and mindfulness, and decreased emotional exhaustion, depression and anger. Turnover intentions were reduced initially and at three months, but improvements were not sustained at six months. Some outcomes, including anxiety and empathy, were not improved immediately after the intervention but were significantly improved at three months.” 

AACN release