Institution-Wide Moral Distress Among Nurses
Adam T Booth1, Bridget F Dobson, Becky J Christian
1Author Affiliations: Nurse Researcher (Dr Booth), Office of Professional Practice Education, Nursing Research, and Nursing Excellence, University of Louisville Health; and Staff Nurse (Dobson), Surgical Intensive Care Unit, University of Louisville Hospital, Kentucky; Professor and PhD Program Director (Dr Christian), School of Nursing, University of Kansas; and Assistant Professor (Dr Clark) and Assistant Professor and Biostatistician (Dr Sha), School of Nursing, University of Louisville, Kentucky.
Background:
Moral distress is the inability to do the right thing due to imposed constraints.
Objective:
Explore the presence of moral distress among nurses.
Methods:
A quantitative, exploratory, cross-sectional study at a level 1 trauma center using the Measure of Moral Distress for Healthcare Professionals (MMD-HP).
Results:
Ninety-seven nurses completed the MMD-HP. The top 3 items contributing to moral distress included inadequate staffing, inadequate resources, and lack of administrative support. Nurses who considered leaving had more moral distress. Moral distress explained 28.5% of the variance associated with nurses' "intent to leave" and "primary unit" ( P < 0.001). Moral distress for nurses 40 to 49 years of age was higher compared with nurses 50 years or older.
Conclusions:
Moral distress involved deficiencies in staffing, resources, and administrative support. Research should explore interventions to mitigate moral distress among nurses by promoting safe staffing levels, the provision of adequate resources, and increased administrative support.
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