Relationship Between Moral Distress and Intent to Leave a Position Among Neonatal Intensive Care Nurses

Abstract

Background: The phenomenon of moral distress is prevalent in the literature, but little is known about the experiences of nurses working in the neonatal intensive care unit (NICU). In addition, a paucity of literature exists exploring the relationship between moral distress and intent to leave a position in NICU nurses. Purpose: To explore the phenomenon of moral distress in NICU nurses using the Measure of Moral Distress for Health Care Professionals (MMD-HP) survey. Methods: A cross-sectional, descriptive, correlational study was conducted nationally via an electronic survey distributed to NICU nurses who are members of National Association of Neonatal Nurses (NANN). Participants were asked to electronically complete the MMD-HP survey between March 27 and April 8, 2020. Findings: A total of 75 NICU nurses completed the survey, and 65 surveys were included for data analysis. Five situations from the survey had a composite MMD-HP score of more than 400. Results indicated that 41.5% of the NICU nurses surveyed considered leaving a clinical position due to moral distress, and 23.1% of the nurses surveyed left a position due to moral distress. Implications for Practice: NICU nurses experiencing high MMD-HP scores are more likely to leave a position. Further research is needed to develop strategies useful in mitigating moral distress in and prevent attrition of NICU nurses. Implications for Research: Many NICU nurses experiencing high levels of moral distress have left positions or are considering leaving a clinical position. Longitudinal interventional studies are vital to understand, prevent, and address the root causes of moral distress experienced by NICU nurses.

Moral distress among Iranian neonatal intensive care units’ health care providers: a multi-center cross sectional study

“…In a systematic review by YektaKooshali et al, the intensity and frequency of moral distress among nurses were reported to be moderate in 2018 ( 12 ). Hally et al concluded that the NICU nurses who scored high in measure of moral distress for health care professionals are more likely to leave their work ( 31 ).…”

Provider moral distress in caring for tracheostomy and ventilator dependent children: A single institution cross‐sectional evaluation

“…Understanding moral distress is important due to the significant impact, it has on burnout and staff turnover, as well as uncertainty about clinical outcomes. 3,8,9,[20][21][22][23][24][25][26] We found that moral distress levels were moderately correlated with burnout, as well as weakly correlated with uncertainty about the benefit of treatment. These correlations are similar to those found in studies in pediatric critical care units and indicate a similar level of unease in our unit.…”

“…Understanding moral distress is important due to the significant impact, it has on burnout and staff turnover, as well as uncertainty about clinical outcomes 3,8,9,20–26 . We found that moral distress levels were moderately correlated with burnout, as well as weakly correlated with uncertainty about the benefit of treatment.…”

Redmann Provider moral distress in caring for tracheostomy and ventilator dependent children: A cross-sectional evaluation.

“…Understanding moral distress is important due to the significant impact it has on burnout and staff turnover (3,(8)(9)(20)(21)(22)(23)(24)(25)(26). In addition, burnout is associated with poorer quality of care, and significant expenses due to decreased clinical productivity and early retirement (24)(25)(26).…”