Exploring the moral distress of registered nurses

Patti Rager Zuzelo

doi:10.1177/0969733007075870

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Exploring the moral distress of registered nurses

Journal article

Peer reviewed

Exploring the moral distress of registered nurses

Patti Rager Zuzelo

Nursing ethics, v 14(3), pp 344-359

May 2007

DOI: https://doi.org/10.1177/0969733007075870

PMID: 17459818

Featured in Collection : UN Sustainable Development Goals @ Drexel

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Abstract

Attitude of Health Personnel

Burnout, Professional - prevention & control

Burnout, Professional - psychology

Conflict (Psychology)

Factor Analysis, Statistical

Frustration

Humans

Interprofessional Relations - ethics

Medical Futility - ethics

Morals

Nurse's Role - psychology

Nurse-Patient Relations - ethics

Nursing Methodology Research

Nursing Staff, Hospital - education

Nursing Staff, Hospital - ethics

Nursing Staff, Hospital - organization & administration

Nursing Staff, Hospital - psychology

Patient Advocacy - ethics

Personnel Staffing and Scheduling - ethics

Professional-Family Relations - ethics

Psychological Theory

Qualitative Research

Risk Factors

Self Care - methods

Self Care - psychology

Social Support

Surveys and Questionnaires

United States

Unnecessary Procedures - ethics

Registered nurses (RNs) employed in an urban medical center in the USA identified moral distress as a practice concern. This study describes RNs' moral distress and the frequency of morally distressing events. Data were collected using the Moral Distress Scale and an open-ended questionnaire. The instruments were distributed to direct-care-providing RNs; 100 responses were returned. Morally distressing events included: working with staffing levels perceived as 'unsafe', following families' wishes for patient care even though the nurse disagreed with the plan, and continuing life support for patients owing to family wishes despite patients' poor prognoses. One high frequency distressing event was carrying out orders for unnecessary tests and treatments. Qualitative data analysis revealed that the nurses sought support and information from nurse managers, chaplaincy services and colleagues. The RNs requested further information on biomedical ethics, suggested ethics rounds, and requested a non-punitive environment surrounding the initiation of ethics committee consultations.