Addressing moral distress in nurse managers through facilitated ethical discussions

Area of Science:

• Nursing Leadership
• Healthcare Ethics
• Organizational Psychology

Background:

• Moral distress significantly impacts nurse managers, leading to burnout, disengagement, and turnover.
• Existing interventions for moral distress in nurse leaders are limited.
• This issue has substantial organizational and financial repercussions.

Purpose of the Study:

• To evaluate the effectiveness of facilitated ethical discussions in reducing moral distress among nurse managers.
• To assess the impact of this intervention on nurse managers' intent to leave their positions.
• To explore a practical, evidence-based approach for addressing moral distress in nursing leadership.

Main Methods:

• A pretest-posttest design was employed with 10 nurse managers at a community hospital.
• Participants engaged in four monthly facilitated ethical discussions based on the Unit-Based Ethics Conversations model.
• Moral distress and intent to leave were measured pre- and post-intervention.

Main Results:

• Mean moral distress scores decreased significantly (from 16.8 to 14) with a medium effect size.
• While intent to leave did not change, all participating nurse managers remained in their roles.
• The majority of participants recommended the facilitated ethical discussions to colleagues.

Conclusions:

• Facilitated ethical discussions show potential for reducing moral distress in nurse managers.
• This intervention may enhance nurse manager retention, offering clinical and financial benefits.
• The low-cost nature of this approach supports its broader implementation in nursing leadership.