Moral Distress and Related Factors among Emergency Department Nurses

Introduction: Moral distress is one of the recurring issues in the nursing profession that has gained importance by creating changes in the health care system, including increasing the number of legal roles, protocols, and clinical guidelines, and greater emphasis on accountability, and acts as an obstacle to achieving personal and social development goals. This study was conducted to determine moral distress and related factors.
Material and Methods: A cross-sectional and analytic-descriptive study was conducted, in which 180 nurses working in emergency education and health centers in Rasht using a census in accordance with the conditions of entry were considered. For data collection, questionnaires assessing related factors and moral distress were used. Data were analyzed using descriptive statistics (frequency percentage, mean, and standard deviation) and inferential statistics (t-test, ANOVA, and logistic regression) with the software SPSS 22.
Results: The findings showed that moral distress in emergency nurses (4.93 ± 1.08) was high. Most moral distress was in the area of professional-functional competence (5.21 ± 1.17) in the item of "unsafe conditions” (5.55 ± 1.45). No statistically significant correlation was found between age and experience with moral distress among nurses in the emergency department. From the perspective of nurses in the study, organizational factors including barriers to education were the strongest factor influencing moral distress.
Conclusions: Given that moral distress in nurses participating in the study was very high, it seems that workshops to reduce moral distress in nurses and planning to promote professional-functional competency of nursing practice are essential.