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Moral distress in medical surgical nurses

WCU Author/Contributor (non-WCU co-authors, if there are any, appear on document)
Susan Lane Kahl Aft (Creator)
Western Carolina University (WCU )
Web Site:
Linda Comer

Abstract: Aim/Purpose The purpose of this mixed method study was to evaluate the intensity and frequency of moral distress in medical surgical nurses using the Moral Distress Scale (MDS). The study also included three qualitative questions to obtain descriptions of situations of moral distress, its impact on the nurse physically, emotionally, and spiritually and the effect on others (i.e. patient, family, colleagues, manager, organization, etc.). Method The study was conducted on a random sample obtained from the North Carolina Board of Nursing database. The survey, containing a section for demographic questions, the MDS scale, and qualitative questions, was mailed to a sample of 1,000 self-identified medical surgical nurses who reside in the state of North Carolina The mean and standard deviation were done on both the intensity and frequency of each of the 38 questions. Correlations were determined between each of the demographic characteristics and the intensity and frequency of the 38 questions. ANOVA single factor variance was analyzed between respondents and questions to verify there was statistically significant variance. 11 The three qualitative questions were evaluated for common themes using phenomenological methods. Triangulation was done to ensure the trustworthiness of the themes. Results The results of the study indicated there were statistically significant correlations in the demographics and responses. Using Pearson?s correlation coefficient and a p < 0.01, there was no significant correlations between demographics and the frequency of factors of the MDS. There was one positive and six negative correlations between age and experience related to intensity of moral distress. Overall medical surgical nurses in the study experienced low intensity and frequency of moral distress (M = 2.17, M = 1.32). Comparatively, respondents reported greater experiences of intensity than frequency. Moderate levels of moral distress related to staffing, incompetence of nurses, nursing assistants and physicians and futility of care. The most frequent distress centered on inadequate staffing, incompetence, and futility. The most prominent theme in morally distressing situations was the lack of informed consent/disclosure. Nurses described how they were impacted emotionally, physically, and spiritually as well the effects of moral distress on colleagues, patients, and families. There were also accounts of burned out nurses leaving a unit or the profession. Implications The implications of this study revealed that medical surgical nurses experienced moral distress with more intensity than frequency. This is vital information for nursing leaders concerned about turnover and the impact on staff. Nurse administrators have a responsibility to create a healthy organizational climate to alleviate burnout and prevent distressing situations. Keywords: burnout, ethical climate, medical surgical nurses, moral distress, turnover

Additional Information

Language: English
Date: 2011
burn out, ethical climate, medical surgical nurses, moral distress, turnover
Nurses -- Job stress
Nursing ethics
Surgical nursing -- Moral and ethical aspects