The concept of moral distress can be defined in different ways. Generally speaking, when individuals make moral decisions about the right course of action in a situation but are unable to implement them, they experience moral distress. A man named Andrew Jameton defined moral distress in 1984 as "a phenomenon that occurs when one knows what to do, but institutional constraints make it almost impossible to pursue the right course of action." (Nursing Forum, 2007). Because of their unique position in the medical world and their conflicting responsibilities, nurses are particularly prone to moral distress. Whether they realize it or not, nurses are becoming increasingly involved in making ethical decisions regarding their patients. However, the doctor's policy always takes precedence over the nurse's and the patient's wishes must always be respected. The consequences of not being heard by colleagues or having your action plan overridden by other policies can often be frustrating and upsetting for a nurse. Although there is no data directly linking the effects of moral distress and the quality of care provided by nurses, it can be inferred that feelings of moral outrage, frustration, and anger drive nurses to care for their patients less effectively. A nurse in conflict with herself and those around her will have difficulty treating a patient with the best care. To practice the nursing profession, you must respect the Code of Ethics provided for nurses. Nurses must consider the good of the patient as their most important value; this is the ultimate goal of the nursing profession. They must treat each patient as an individual, caring for them with respect...... middle of paper ... even if their beliefs are violated. Silence is usually the first sign of a nurse in moral distress. As previously stated, they feel helpless and therefore don't feel like they can talk to who they need to. There is no real solution to moral distress and some nurses burn out and leave the field in which they work, or even the profession. There is no happy outcome in this area; You either deal with it or get out of it. In a recent study by Mary C. Corley, two groups of critical care nurses were surveyed. In the first group, 18% of nurses had considered or actually left their field of study due to moral distress. In the second, 26% of nurses had left their previous field due to distress (Hamric, Davis, Childress p. 2). Are nurses under too much pressure in the field of work or is it the training they received before leaving their field? in the real world?