Nurses' moral suffering, burnout and turnover intentions: A two-wave study

Area of Science:

• Nursing Research
• Psychology
• Organizational Behavior

Background:

• The COVID-19 pandemic exposed nurses to a high volume of potentially morally injurious events (PMIEs).
• The long-term impact of these events on nurses' well-being and organizational outcomes is not well understood.
• Understanding these impacts is crucial for developing effective support strategies.

Purpose of the Study:

• To investigate if psychological basic need thwarting in episodic memories of PMIEs predicts burnout and turnover intentions 2 years later.
• To differentiate the effects of enacted (self-PMIEs) versus witnessed (other-PMIEs) events.
• To inform interventions aimed at mitigating long-term psychological distress in nurses.

Main Methods:

• A quantitative, two-wave longitudinal study design was employed (2022 and 2024).
• 463 Romanian nurses participated in 2022, with 350 followed up in 2024.
• Participants reported on need thwarting associated with PMIE memories, burnout, and turnover intentions.

Main Results:

• Need-frustration linked to self-PMIE memories significantly predicted burnout and turnover intentions 2 years post-event.
• The association between other-PMIE memories and these outcomes became non-significant over time.
• This highlights the persistent impact of personally experienced moral injury.

Conclusions:

• Episodic memories of self-inflicted potentially morally injurious events (self-PMIEs) have lasting effects on nurses' burnout and turnover intentions.
• There is a need for organizational support, including counseling, to help nurses reframe these memories.
• Creating a safe environment for disclosing ethical concerns is essential for processing and mitigating harm.