Moral Distress in a Non-Acute Continuing Care Setting: the Experience of Registered Nurses

Abstract

The moral distress experiences of Registered Nurses who work in non-acute, continuing care settings were examined using qualitative methods. Previous research suggests that in general, nurses experience moral distress when they are not able to pursue actions in accordance with their moral conscience. Moral distress in nurses is expressed negatively in both the nurses’ professional and personal lives. However, most research on moral distress among nurses has focused on acute care settings.

Registered Nurse participants were recruited from non-acute continuing care settings and described their experiences of moral conflict and distress. Particular attention was placed on the nurses’ experiences and reactions to their experience. The findings from this study indicated that as in other settings, moral distress is present in Registered Nurses practicing in non-acute continuing care. The nurses’ practicing in non-acute continuing care settings experienced moral distress after facing a barrier to their moral conscience involving organizational functioning, end of life decisions, patient advocacy, and resource utilization. Nurses experienced feelings including powerlessness, concern, regret, disappointment, suspicion of others, and feeling devalued. Future studies may focus further on the subspecialties in the non-acute continuing care sector. Research on strategies to resolve moral distress and research on the effectiveness of current interventions to combat moral distress among Registered Nurses in this setting should be pursued.