Moral Distress, Coping Resilience, and Self-Care: A Study of Nurses in the Intensive Care Unit

Critical care nurses are regularly exposed to situations that may create moral distress. Moral distress has been correlated with higher rates of nursing burnout, emotional withdrawal, and traumatic stress syndrome.

This descriptive correlational study aimed to describe the relationships between moral distress, coping resilience, and self-care practices.

An electronic survey was sent to nurses in 5 intensive care units within 1 hospital system from February 2023 through April 2023. Nurses were asked to answer questions about their demographic characteristics, moral distress, coping resiliency, and self-care practices.

Seventy-four staff nurses participated in the survey. Overall, nurses reported the highest levels of moral distress from the following: a family's insistence on aggressive treatment, continuing to provide aggressive treatment despite unlikely effectiveness, and excessive documentation requirements. Results showed a statistically significant (but weak) positive correlation between mindful self-care and resilient coping (r65 = 0.27, P = .03).

A positive correlation between mindful self-care and coping resilience was identified, which suggests that self-care may influence resiliency. Participants indicated frequent use of outside support systems such as supportive structures and supportive persons. These systems may be ideal mechanisms through which to support nurses in the future.