Moral distress occurs when professionals cannot carry out what they believe to be ethically appropriate actions because of constraints or barriers. A shortage of literature exists to quantify the levels of moral distress; thus, this study is needed to address the information gap of the moral distress impact on emergency nurses and determine (1) whether higher MD scores result in nurses intending to leave the profession and (2) which factors result in higher MD scores. This survey lists situations that occur in clinical practice. If you have experienced these situations, they may or may not have been morally distressing to you.

Please indicate how frequently you have experienced each item. Also, rank how distressing these situations are for you. If you have never experienced a particular situation, select "0" (never) for frequency. Even if you have not experienced a situation, please indicate how distressed you would be if it occurred in your practice. There are no known or anticipated risks for participating in this study. This study is designed to gain information that can benefit emergency department nurses to improve self-care during stressful infectious disease outbreaks. This study is specific to nurses with emergency nursing experience during the COVID-19 pandemic.

Contact Information

This survey tool is being used with permission of Dr. Phyllis Whitehead. This origin of this tool can be found: Epstein, E.G., Whitehead, P.B., Prompahakul, C., Thacker, L.R., & Hamric, A.B. (2019). Enhancing understanding of moral distress: the measure of moral distress for healthcare professionals. AJOB Empirical Bioethics. DOI: 10.1080/23294515.2019.1586008.

If you have questions about the study (IRB # 0536-21-EX) or your part in it, concerns, or complaints about this study, please contact Sarah Taylor at or Kelly Betts, Ph.D. at

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