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8613. Describe a clinical situation in which a registered nurse may encounter moral distress.  Answer the AACN’s Four A’s found on page 84 in your Butts and Rich text to further explain the situation, and the possible mitigation strategies. Nurses use the Four A’s plan as a guide to identify and analyze moral distress: •  Ask appropriate questions to become aware that moral distress is present. •  Affirm your distress and commitment to take care of yourself and address moral distress. •  Assess sources of your moral distress to prepare for an action plan. •  Act to implement strategies for changes to preserve your integrity and authenticity. Preventing moral distress requires nurses to recognize the at-risk dynamics and issues. An environment of good communication and respect for others is essential for decreasing the likelihood of experiencing moral distress.



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