The Effect of Nursing Moral Distress on Intent to Leave Employment

Objective: This study explored the impact of moral distress (MD) and respondent characteristics on intent to leave employment.

Background: Managing patient care, within organizational constraints, may create physical discomfort or mental peace disturbances such as MD, negatively impacting RN retention.

Methods: Responses from 948 RNs were collected using an anonymous online survey. The impact of MD on intent to leave employment was explored.

Results: MD was significantly higher among RNs intending to leave employment. System-level and team-level integrity attributes were significant factors predicting intent to leave, controlling for potential confounders. The odds of intending to leave were 147% higher for new graduate RNs, 124% higher for direct care RNs, and 63% higher for 2nd-career RNs. Gender and race were not significant predictors.

Conclusion: Exploring root causes contributing to MD frequency and severity is critical to maintain a healthy work environment. Mitigating MD in the work environment may enhance nursing practice and improve patient care. Support for new graduate and 2nd-career RNs can be realized, further reducing turnover for these vulnerable populations of the nursing workforce.