Moral distress in critical care nurses: a phenomenological study

AIM: To explore and understand moral distress from the perspective of and as experienced by critical care nurses in Korea. BACKGROUND: The concept of moral distress among critical care nurses must be more broadly explored using a qualitative approach. DESIGN: Giorgi's phenomenological research approach was used. METHODS: A purposive sampling was used to select 14 critical care nurses. In-depth face-to-face interviews were performed in Korea from March 2012-December 2013. FINDINGS: Five main themes of moral distress emerged: (1) ambivalence towards treatment and care (notably prioritizing work tasks over human dignity, unnecessary medical treatments and the compulsory application of restraints); (2) suffering resulting from a lack of ethical sensitivity; (3) dilemmas resulting from nurses' limited autonomy in treatments; (4) conflicts with physicians; and (5) conflicts with institutional policy. CONCLUSION: Staff shortages are aggravated by high staff turnover caused by ethical suffering. The resulting lack of staff can, in turn, give rise to added ethical conflicts as part of a vicious circle, leading to decreased patient satisfaction.