The potential for noncaring when dealing with difficult patients: strategies for moral decision making

The potential for noncaring when dealing with difficult patients is a very real concern in nursing. Noncaring, manifested by distancing and withdrawal or punitive behaviors, exacts a high toll on the nurse-patient relationship. Noncaring may result in missed diagnoses and interventions, social isolation, and minimal or negative contact with the nurse. The purpose of this article is to share strategies for moral decision making that support the patient, family, and nurse in all care settings. Decisions to care must be based on professional, ethical, and moral principles rather than personal preferences. Scrutinizing one's personal biases and actions with application of ethical principles provides the framework for these strategies.