The 4A’s Framework was established to help nurse leaders overcome the moral distress they face due to the numerous ethical dilemmas they encounter. Such distress can adversely affect their effectiveness in the performance of their duties (Edmonson, 2010). When seeking to deal with moral distress, the first thing nurse leaders should do is identify the source of their internal distress. Doing this requires them to engage in extensive self-reflection coupled with the willingness to view situations and responses through a different lens. Once this is done, the next step revolves around affirming that they can address the source of the moral distress they are experiencing. At times, nurse leaders might require to consult with colleagues to do this. After this comes the assessment phase, which entails using higher reasoning and critical assessment skills in the location, labeling, and preparation to deal with the sources of their moral distress
