Division of Neonatology, Department of Pediatrics, Massachusetts General Hospital, Boston (Ms Hally and Drs Settle and Nelson); and School of Nursing, Endicott College, Boston (Ms Hally); and Harvard Medical School, Boston (Dr Nelson).
Adv Neonatal Care. 2021 Dec 1;21(6):E191-E198. doi: 10.1097/ANC.0000000000000891.
The phenomenon of moral distress is prevalent in the literature, but little is known about the experiences of nurses working in the neonatal intensive care unit (NICU). In addition, a paucity of literature exists exploring the relationship between moral distress and intent to leave a position in NICU nurses.
To explore the phenomenon of moral distress in NICU nurses using the Measure of Moral Distress for Health Care Professionals (MMD-HP) survey.
A cross-sectional, descriptive, correlational study was conducted nationally via an electronic survey distributed to NICU nurses who are members of National Association of Neonatal Nurses (NANN). Participants were asked to electronically complete the MMD-HP survey between March 27 and April 8, 2020.
A total of 75 NICU nurses completed the survey, and 65 surveys were included for data analysis. Five situations from the survey had a composite MMD-HP score of more than 400. Results indicated that 41.5% of the NICU nurses surveyed considered leaving a clinical position due to moral distress, and 23.1% of the nurses surveyed left a position due to moral distress.
for Practice: NICU nurses experiencing high MMD-HP scores are more likely to leave a position. Further research is needed to develop strategies useful in mitigating moral distress in and prevent attrition of NICU nurses.
Many NICU nurses experiencing high levels of moral distress have left positions or are considering leaving a clinical position. Longitudinal interventional studies are vital to understand, prevent, and address the root causes of moral distress experienced by NICU nurses.
道德困境现象在文献中很普遍，但人们对新生儿重症监护病房（NICU）护士的经历知之甚少。此外，几乎没有文献探讨道德困境与 NICU 护士离职意愿之间的关系。
使用医疗保健专业人员道德困境量表（MMD-HP）调查来探讨 NICU 护士的道德困境现象。
这是一项全国性的横断面描述性相关性研究，通过电子调查的方式向 NANN 成员的 NICU 护士分发。参与者被要求在 2020 年 3 月 27 日至 4 月 8 日之间通过电子方式完成 MMD-HP 调查。
共有 75 名 NICU 护士完成了调查，其中 65 份调查用于数据分析。调查中有 5 种情况的综合 MMD-HP 评分超过 400。结果表明，41.5%的接受调查的 NICU 护士因道德困境而考虑离开临床岗位，23.1%的护士因道德困境而离职。
对实践的启示：经历高 MMD-HP 评分的 NICU 护士更有可能离职。需要进一步研究以制定有用的策略来减轻 NICU 护士的道德困境并防止其流失。
许多经历高度道德困境的 NICU 护士已经离职或正在考虑离开临床岗位。纵向干预性研究对于理解、预防和解决 NICU 护士经历的道德困境的根本原因至关重要。
