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  • I am writing to you in regards to “Ethics: Ethical Issues with Medical Errors: Shaping a Culture of Safety in Healthcare” (Sorrell, 2017). The number of deaths caused by medical errors in the United States is outrageously high, and I believe there are many things we, as nurses, can do to change that.

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Reply by author McCue to Howard on Using the AACN Framework to Alleviate Moral Distress

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March 10, 2011

Response by author Carol McCue to Kimberly R. Howard on "Using the AACN Framework to Alleviate Moral Distress" by Carol McCue (November 9, 2010)

It is gratifying that Ms. Howard has already utilized the first step of the AACN framework, “4A’s to Rise Above Moral Distress.” This awareness of moral distress, followed by appropriate actions, will enable nurses to manage moral distress as a part of the work environment. In our school of nursing the concept of moral distress and use of the AACN framework has been integrated into our senior level capstone nursing course in order to promote the smooth transition from student nurse to new graduate. The suggestion that this framework be included in the orientation and annual education for all nurses is a very wise and reasonable recommendation. Educators and Nurse Executives are well advised to address this most important issue of moral distress as we strive to improve working conditions in our complex healthcare environments.

Carole McCue RN MS CNE
Cochran School of Nursing
Yonkers, New York