The lived experience of moral distress among intensive care unit nurse practitioners

This study explored the lived experience of moral distress among intensive care unit (ICU) nurse practitioners (NPs). Although ICU NPs were interviewed, many reflected on their prior experience as registered nurses (RNs) to describe the differences in responsibility, authority, and moral burden in their advanced practice role.

This study aimed to describe the lived experience of moral distress in ICU NPs, specifically emphasizing its effect on their professional and personal lives.

The researcher used a descriptive phenomenological study design to examine moral distress among the ICU NP population. Employing purposive sampling, the researcher conducted one-on-one interviews with 17 ICU NPs to explore moral distress, identify themes, and provide thematic analyses using the Colaizzi method.

The overarching theme, A Unique NP Experience, captured how moral distress was shaped by the dual expectations of advanced clinical decision making and constrained authority in hierarchical care settings. Three themes supported this experience: moral distress causes, negative emotional and psychological effects, and participants' reflective interpretations. Moral distress was described as distinct from that experienced in RN roles, often surfacing during ethically complex ICU cases such as end-of-life decisions.

This research aimed to catalyze a thoughtful conversation regarding moral distress as experienced by NPs and to promote interventions that mitigate moral distress and its negative effects.

The findings hope to encourage further moral distress research in NPs of all specialties, as well as to examine the perceived hierarchy that exists in the acute care setting.