The experience of moral distress in ICU nurses: A qualitative study

Advances in technology, medical and nursing knowledge, changes in role of nurses, professionalization and specialization of professional relationships within and between professionals cause moral distress in nurses. These moral distresses may cause negative physical and psychological effects on nursesو especially in ICU nurses, so, recognition of these distresses is critical. Since moral distresses must be described in cultural context, it is necessary to do basic researches. This study was conducted to explain the experiences of nurses in the intensive care unit. This study was a qualitative study with content analysis approach that conducted with unstructured and deep interviews with 18 individual and two group interviews with clinical nurse and nurse educators whom working in different cities in Iran. A purposive sample is selected and data analysis with qualitative content analysis was done. During the process of content analysis, five themes eventually revealed the nature of ICU nurses’ experiences. These themes include: "institutional barriers and constraints", "communication problems", "death/worsening patient’s condition", “futile actions, malpractice and medical/care errors" and "inappropriate allocation of responsibilities, resources and care workers competencies”. Findings showed that intensive care nurses are faced with several moral distresses. Results of this study were suggested that the nursing leaders with program planning and more precise control in this issue can reduce moral distress factors in ICU nurses and prevent harmful outcomes.