Nurse Leaders Face Moral Distress Alone

Jennifer Thew, RN, September 15, 2017

Researchers hope to bring the discussion about moral distress among chief nursing officers into the open.

Rose O. Sherman, EdD, RN
Rose O. Sherman, EdD, RN

Ethical challenges are not left at the bedside when nurses move into leadership positions.

Chief nursing officers still experience moral distress—the disequilibrium resulting from the recognition of and inability to react ethically to a situation—it's just taboo to talk about it, finds a qualitative study published in the Journal of Nursing Administration in February 2017.

"There's shame and isolation when you do have the experience, so it can make it very difficult for people to feel like they can openly discuss it," says Rose O. Sherman, EdD, RN, NEA-BC, FAAN, professor and director of the Nursing Leadership Institute at Florida Atlantic University.

Sherman is one of the study's authors. "I think that the other piece of it is, CNOs might not always label it as moral distress. But these are uncomfortable situations where they're making decisions against their values systems."

The Causes of Moral Distress

Through oral interviews, Sherman and her co-author, Angela S. Prestia, PhD, RN, NE-BC, discussed chief nursing officers' experiences of moral distress, including its short and long-term effects. Prestia is corporate chief nurse at The GEO Group.

The study's 20 participants described their experiences of moral distress, and several said they experienced it on more than one occasion. It was often related to issues like:

  • Staff salaries and compensation
  • Financial constraints
  • Hiring limits
  • Increased nurse-to-patient ratios to drive productivity
  • Counterproductive relationships
  • Authoritative improprieties.
Jennifer Thew, RN

Jennifer Thew, RN is the senior nursing editor at HealthLeaders Media.

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