Travel nurses' experience with ethical challenges in practice: A qualitative descriptive study

BackgroundNursing turnover rates are among the highest measured in recent years, contributing to financial and staffing challenges in the healthcare industry. Citing ethical challenges and subsequent moral distress, nurses have increasingly turned to travel nurse positions. Current literature regarding moral distress and ethical challenges has largely focused on staff nurses, and it is unknown how travel nurses experience ethical challenges and any associated moral distress.AimTo explore travel nurses' experiences with ethical challenges, inclusive of how they respond and feel or mitigate moral distress related to these challenges. Sources of support will be identified, with a focus on personal and organizational resources.Research designA qualitative descriptive study conducted through individual interviews. Participants were recruited with a purposive sampling strategy through flyers and social media. The data was analyzed using inductive and deductive content analysis. Participants and research context: Nurses (n = 15) working as travel nurses in the United States of America. Data was collected between August 2024 and February 2025.Ethical considerationsThis study received approval by the Institutional Review Board at the UMass Chan Medical School and Baystate Medical Center.FindingsThree themes described the participants' experience of ethical challenges. Strategies that travel nurses use to address and cope with ethical challenges include reflective thought, formation of a support network, and contemplation of action strategies.DiscussionTravel nurses' experience with ethical challenges has some unique qualities, and coping strategies have some distinctions from recommended strategies to avoid and mitigate moral distress.ConclusionThis study will inform practice models of travel nursing and strategies to support all nurses encountering ethical challenges in their practice. Nursing leaders should foster strategies for feedback from travel nurses, including ways to improve the ethical environment.