Degree Name

Master of Science in Nursing (MSN)

Document Type

Major Paper


School of Nursing



Date of Original Version



With healthcare moving toward greater outpatient and preventative approaches, hospitalizations are increasingly intended for those who are critically ill. Frequently this requires the need for highly specialized nursing as well as resource utilization. Technological advances have aided in providing this type of intensive care but they have also compelled practitioners to make treatment decisions that did not previously exist. The conflict of maintaining one’s life without ascertaining whether there will be quality of life is just one example of a difficult situation that can lead to moral distress. The purpose of this study was to explore the effects of moral distress on critical care nurses. The project employed a survey design. After obtaining IRB approval, a convenience sample of 28 nurses was obtained from a small community hospital’s ICU and CCU. Each participant completed the Moral Distress Scale-Revised (MDS-R) measure and some demographic questions. Results confirmed that moral distress was present among the participants at low to moderate levels: 18 nurses (64%) scored low with seven nurses (25%) scoring in the moderate range. The most morally distressing experiences were related to end of life care. The most morally distressing and frequent event was that of “follow the family’s wishes to continue life support even though I believe it is not in the best interest of the patient”. There was no correlation between nurses’ age, level of experience and moral distress. Limitations included a small sample size and lack of diversity in age and experience. It is possible that the researcher’s affiliation with the unit could have affected participants’ responses regarding leaving their current position. The findings suggest that more research should be done on exploring the ethical climate and other factors that effect moral distress.