Moral distress in emergency and critical care nurses: A metaethnography

Moral distress has detrimental effects on nurses which impacts the entire healthcare cycle. Described as a crescendo effect, resolved situations of moral distress leave residue on the nurse with three potential outcomes: moral numbing, conscious objection to the situation, and burnout.

This metaethnography strives to achieve a fuller understanding of moral distress by interpreting the body of qualitative work of moral distress in emergency and critical care nurses.

This study used the Noblit and Hare's approach of interpretative synthesis. Ten studies met the criteria and were used in this synthesis.

Ethical issues were minimal since no human subjects were involved. Ethical requirements were respected in all study phases.

The synthesis of qualitative research on moral distress resulted in one central theme, "the battle within," and five subthemes.

The unique nature of this nursing specialty resulted in a lasting inner conflict for nurses that is consistent with the previously described crescendo effect. The effects are complex and long lasting and may potentially affect the nurses' future patient care.