Nursing Moral Distress and Intent to Leave Employment During the COVID-19 Pandemic
Katherine N Sheppard1, Barbara G Runk, Ralitsa S Maduro
1Sentara Williamsburg Regional Medical Center, Williamsburg, Virginia (Mss Sheppard, Runk, Fancher, Mayo, and Wilmoth); and Biostatistics (Dr Maduro) and Analytics Services (Dr Morgan), Clinical and Business Intelligence, Sentara Healthcare (Dr Zimbro), Norfolk, Virginia.
Background:
Complexity in nursing practice creates an intense and stressful environment that may lead to moral distress (MD) and registered nurses (RNs) seeking other employment.
Local Problem:
In 2020, the RN turnover rate was 8%, with postpandemic turnover projected to reach 13%.
Methods:
The Measure of Moral Distress for Health Care Professionals (MMD-HP) was used to measure the frequency and level of RNs' MD.
Results:
t tests showed significant differences for 16 of 27 MMD-HP items in RN intent to leave. RNs had 2.9 times the odds of intent to leave (P = .019) due to perceived issues with patient quality and safety and 9.1 times the odds of intent to leave (P < .001) due to perceived issues with the work environment. Results explained 40.3% of outcome variance.
Conclusions:
MD related to work environment or patient quality and safety were significant factors in RN intent to leave their position.
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