Moral distress in certified registered nurse anesthetists: implications for nursing practice.

Registered nurses are frequently confronted with ethical dilemmas in their nursing practice. As a consequence of their decisions regarding ethical challenges, nurses report experiencing moral distress. This experience is often manifested by such feelings as anger, guilt, and sadness, and has been identified as a contributing factor to burnout and turnover in nursing. The purpose of this exploratory, descriptive study was to determine if Certified Registered Nurse Anesthetists (CRNAs) experience moral distress in their nursing practice. A random sample of 800 CRNAs from the registry of the American Association of Nurse Anesthetists was selected to participate in this study. Participating nurses were asked to complete a demographic data survey and the Ethics Stress Scale. Three hundred surveys were analyzed for this study. The data supported the assumption that CRNAs do experience moral distress in their nursing practice. Although a small number of nurse anesthetists experienced high levels of moral distress, CRNAs generally experienced moderate levels of moral distress. Moral distress was associated with situations in which anesthetists believed they were aware of the morally correct course of action but were unable to follow through with these behaviors. Also, CRNAs reported physical and psychological manifestations in relation to moral distress.