Janet Sirilla1, Kathrynn Thompson2, Todd Yamokoski3, Mark D Risser4, Esther Chipps5. 1. Service Line Administrator, Hematology, BMT, and Inpatient Medical Oncology, The Ohio State University Comprehensive Cancer Center-Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, OH, USA. 2. Mental Health Clinical Nurse Specialist, The Ohio State University Comprehensive Cancer Center-Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, OH, USA. 3. Clinical Nurse Specialist, The Ohio State University Wexner Medical Center, Columbus, OH, USA. 4. Postdoctoral Fellow, Lawrence Berkeley National Laboratory, Berkeley, CA, USA. 5. Clinical Nurse Scientist, The Ohio State University Wexner Medical Center and Associate Professor of Clinical Nursing, The Ohio State University College of Nursing, Columbus, OH, USA.
Abstract
BACKGROUND: Moral distress is the psychological response to knowing the appropriate action but not being able to act due to constraints. Previous authors reported moral distress among nurses, especially those that work in critical care units. AIMS: The aims of this study were: (1) to examine the level of moral distress among nurses who work at an academic health system, (2) to compare the level of moral distress in nurses who work across specialty units at an academic health system, (3) to compare moral distress by the demographic characteristics of nurses and work experience variables, and (4) to identify demographic characteristics and type of clinical setting that may predict which nurses are at high risk for moral distress. METHODS: A cross-sectional survey design was used with staff nurses who work on inpatient units and ambulatory units at an academic medical center. The moral distress scale-revised (MDS-R) was used to assess the intensity and frequency of moral distress. RESULTS: The overall mean MDS-R score in this project was low at 94.97 with mean scores in the low to moderate range (44.57 to 134.58). Nurses who work in critical care, perioperative services, and procedure areas had the highest mean MDS-R scores. There have been no previous reports of higher scores for nurses working in perioperative and procedure areas. There was weak positive correlation between MDS-R scores and years of experience (Rho = .17, p = .003) but no correlation between age (Rho = .02, p = .78) or education (Rho = .05, p = .802) and moral distress. LINKING EVIDENCE TO ACTION: Three variables were found useful in predicting moral distress: the type of unit and responses to two qualitative questions related to quitting their job. Identification of these variables allows organizations to focus their interventions.
BACKGROUND: Moral distress is the psychological response to knowing the appropriate action but not being able to act due to constraints. Previous authors reported moral distress among nurses, especially those that work in critical care units. AIMS: The aims of this study were: (1) to examine the level of moral distress among nurses who work at an academic health system, (2) to compare the level of moral distress in nurses who work across specialty units at an academic health system, (3) to compare moral distress by the demographic characteristics of nurses and work experience variables, and (4) to identify demographic characteristics and type of clinical setting that may predict which nurses are at high risk for moral distress. METHODS: A cross-sectional survey design was used with staff nurses who work on inpatient units and ambulatory units at an academic medical center. The moral distress scale-revised (MDS-R) was used to assess the intensity and frequency of moral distress. RESULTS: The overall mean MDS-R score in this project was low at 94.97 with mean scores in the low to moderate range (44.57 to 134.58). Nurses who work in critical care, perioperative services, and procedure areas had the highest mean MDS-R scores. There have been no previous reports of higher scores for nurses working in perioperative and procedure areas. There was weak positive correlation between MDS-R scores and years of experience (Rho = .17, p = .003) but no correlation between age (Rho = .02, p = .78) or education (Rho = .05, p = .802) and moral distress. LINKING EVIDENCE TO ACTION: Three variables were found useful in predicting moral distress: the type of unit and responses to two qualitative questions related to quitting their job. Identification of these variables allows organizations to focus their interventions.
Authors: Subha Perni; Lauren R Pollack; Wendy C Gonzalez; Elizabeth Dzeng; Matthew R Baldwin Journal: BMC Med Educ Date: 2020-03-23 Impact factor: 2.463
Authors: Maria Christodoulou-Fella; Nicos Middleton; Elizabeth D E Papathanassoglou; Maria N K Karanikola Journal: Biomed Res Int Date: 2017-10-25 Impact factor: 3.411
Authors: Subha Perni; Lauren R Pollack; Wendy C Gonzalez; Elizabeth Dzeng; Matthew R Baldwin Journal: BMC Med Educ Date: 2020-03-23 Impact factor: 2.463