Nurse Health: Moral Distress Causes Nurse Burnout

Written by LeAnn Thieman, CSP, August 7th, 2015

Moral distress occurs when a person believes he or she knows the ethically ideal or right action to take, but is prevented from doing so because of internal or institutional barriers. It can result in depression, anxiety, emotional withdrawal, frustration, anger and a variety of physical symptoms. It also leads to burnout.

nurse moral distressResearchers at Loyola University Medical Center in Maywood, Ill., published a study of emotional and psychological anguish, known as moral distress, experienced by nurses in an ICU for burn patients.

The pilot study included 13 nurses in Loyola’s burn ICU who participated in a month-long educational intervention to decrease moral distress. The intervention consisted of four one-hour weekly sessions. The first session outlined the study aims, definitions of moral distress and related concepts. Session two focused on signs and symptoms. Session three dealt with barriers to addressing moral distress. And in session four, nurses were encouraged to identify strategies they could use to deal with moral distress.

The nurses completed a questionnaire that measured the intensity and frequency of moral distress. They were divided into two groups: One group completed the survey before the intervention, and the other, after completing the sessions.

Researchers had expected the group taking the survey after the intervention would have lower moral distress scores. But they found just the opposite: The group taking the survey after the intervention had a median moral distress score of 92, which was significantly higher than the 40.5 median score of the group that filled out the survey before taking the course. Researchers concluded that the reason moral distress scores were higher after the educational sessions because of heightened awareness.

“They indicated that learning the definition of moral distress was valuable, found it helpful to learn that others in similar work environments were experiencing moral distress and appreciated hearing what others do to cope with moral distress. Participants expressed a desire for this type of intervention to continue in the future and for more time to be spent on coping strategies.”

To learn how to identify and cope with moral distress and decrease nurse burnout, visit SelfCare for HealthCare™. Contact me today to talk about your challenges as a nurse leader.

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