Critical care nurse leaders addressing moral distress: A qualitative study

Abstract

Background: Moral distress (MD) occurs when clinicians are constrained from taking what they believe to be ethically appropriate actions. When unattended, MD may result in moral injury and/or suffering. Literature surrounding how unit-based critical care nurse leaders address MD in practice is limited.

Aim: The aim of this study was to explore how ICU nurse leaders recognize and address MD among their staff.

Study design: Qualitative descriptive with inductive thematic analysis.

Results: Five ICU nurse leaders participated in a one-time individual interview. Interview results suggest that (1) ICU nurse leaders can recognize and address MD among their staff and (2) nurse leaders experience MD themselves, which may be exacerbated by their leadership role and responsibilities.

Conclusions: Further research is needed to develop interventions aimed at addressing MD among nurse leaders and equipping nurse leaders with the skills to identify and address MD within their staff and themselves.

Relevance to clinical practice: MD is an unavoidable phenomenon ICU nurse leaders are challenged with addressing in their day-to-day practice. As leaders, recognizing and addressing MD is a necessary task relating to mitigating burnout and turnover and addressing well-being among staff within the ICU.

Keywords: COVID‐19; ethics; moral distress; nurse leader; nursing leadership.