Identifying Moral Distress in Emergency Nurses

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 sarah.taylor@unmc.edu or Kelly Betts, Ph.D. at Kelly.betts@unmc.edu

What is your age in whole numbers?

What is your gender?

How many years of experience do you have working in an Emergency Department?

What best describes your primary role during the COVID-19 pandemic?

What best describes your practice setting during the COVID-19 pandemic?

What best describes your exposure to the COVID-19 pandemic?

Do you belong to a professional nursing organization?

Yes

reset

Witness healthcare providers giving "false hope" to a patient or family.

Follow the family's insistence to continue aggressive treatment even though I believe it is not in the best interest of the patient.

Be unable to provide optimal care due to pressures from administrators or insurers to reduce costs.

Continue to provide aggressive treatment for a person who is most likely to die regardless of this treatment when no one will make a decision to withdraw it.

Be pressured to avoid taking action when I learn that a physician, nurse, or other team colleague has made a medical error and does not report it.

Be required to care for patients whom I do not feel qualified to care for.

Participate in care that causes unnecessary suffering or does not adequately relieve pain or symptoms

Watch patient care suffer because of a lack of provider continuity.

Follow a physician's or family member's request not to discuss the patient's prognosis with the patient/family.

Witness a violation of a standard of practice or a code of ethics and not feel sufficiently supported to report the violation.

Participate in care that I do not agree with but do so because of fears of litigation.

Be required to work with other healthcare team members who are not as competent as patient care requires.

Witness low quality of patient care due to poor team communication.

Feel pressured to ignore situations in which patients have not been given adequate information to ensure informed consent.

Be required to care for more patients than I can safely care for.

Experience compromised patient care due to lack of resources/equipment/bed capacity.

Experience lack of administrative action or support for a problem that is compromising patient care.

Have excessive documentation requirements that compromise patient care.

Fear retribution if I speak up.

Feel unsafe/bullied amongst my own colleagues

Be required to work with abusive patients/family members who are compromising quality of care.

Feel required to overemphasize tasks and productivity or quality measures at the expense of patient care.

Be required to care for patients who have unclear or inconsistent treatment plans or who lack goals of care.

Work within power hierarchies in teams, units, and my institution that compromise patient care.

Participate on a team that gives inconsistent messages to a patient/family.

Work with team members who do not treat vulnerable or stigmatized patients with dignity and respect.

Have you ever left or considered leaving a clinical position due to moral distress?

Are you considering leaving your position now due to moral distress?

Yes

reset

You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.