Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct:72:103279.
doi: 10.1016/j.iccn.2022.103279. Epub 2022 Jun 6.

Critical care nurses' perception of moral distress in intensive care during the COVID-19 pandemic - A pilot study

Maria Andersson  1 , Anna Nordin  2 , Åsa Engström  3
Affiliations

Critical care nurses' perception of moral distress in intensive care during the COVID-19 pandemic - A pilot study

Maria Andersson et al. Intensive Crit Care Nurs. 2022 Oct.

Abstract

Objectives: To describe critical care nurses' perception of moral distress during the second year of the COVID-19 pandemic.

Design/methods: A cross-sectional study involving a questionnaire was conducted. Participants responded to the Italian version of the Moral Distress Scale-Revised, which consists of 14 items divided in dimensions Futile care (three items), Ethical misconduct (five items), Deceptive communication (three items) and Poor teamwork (three items). For each item, participants were also invited to write about their experiences and participants' intention to leave a position now was measured by a dichotomous question. The data were analysed with descriptive statistics and qualitative content analysis. The study followed the checklist (CHERRIES) for reporting results of internet surveys.

Setting: Critical care nurses (n = 71) working in Swedish adult intensive care units.

Results: Critical care nurses experienced the intensity of moral distress as the highest when no one decided to withdraw ventilator support to a hopelessly ill person (Futile care), and when they had to assist another physician or nurse who provided incompetent care (Poor teamwork). Thirty-nine percent of critical care nurses were considering leaving their current position because of moral distress.

Conclusions: During the COVID-19 pandemic, critical care nurses, due to their education and experience of intensive care nursing, assume tremendous responsibility for critically ill patients. Throughout, communication within the intensive care team seems to have a bearing on the degree of moral distress. Improvements in communication and teamwork are needed to reduce moral distress among critical care nurses.

Keywords: COVID-19; Ethics; Intensive Care; Moral distress; Nursing.

PubMed Disclaimer

References

    1. Andersson M., Nordin A., Engström Å. Critical care nurses’ experiences of working during the first phase of the COVID-19 pandemic –Applying the person-centred practice framework. Int. Crit. Care Nurs. 2021 doi: 10.1016/j.iccn.2021.103179. - DOI - PMC - PubMed
    1. Allen R., Butler E. Addressing moral distress in critical care nurses: a pilot study. Int J. Crit. Care Emerg. Med. 2016;2(1) doi: 10.23937/2474-3674/1510015. - DOI
    1. Andersson M. Philosophical knowledge is warranted for the successful implementation of person-centred care. Nord. J. Nurs. Res. 2021;41(3):117–120. doi: 10.1177/2057158521991476. - DOI
    1. Asgari S., Shafipour V., Taraghi Z., Yazdani-Charati J. Relationship between moral distress and ethical climate with job satisfaction in nurses. Nurs. Ethics. 2019;26(2):346–356. doi: 10.1177/0969733017712083. - DOI - PubMed
    1. Bergman L., Falk A.C., Wolf A., Larsson I.M. Registered nurses' experiences of working in the intensive care unit during the COVID-19 pandemic. Nurs. Crit. Care. 2021;26(6):467–475. doi: 10.1111/nicc.12649. - DOI - PMC - PubMed