Author Affiliations: Manager (Dr Sheppard), Sentara Williamsburg Regional Medical Center; System Director (Dr Smith), Sentara Health, Norfolk; Manager (Dr Morgan), Sentara Obici Hospital, Suffolk; Chief Nursing Officer (Wilmoth) and Biostatistician (Dr Toepp), Sentara Health, Norfolk; and Professor Emeritus (Dr Rutledge) and Nurse Scientist (Dr Zimbro), Old Dominion University, Virginia Beach, VA.
J Nurs Adm. 2024 Sep 1;54(9):488-494. doi: 10.1097/NNA.0000000000001465.
This study explored the impact of moral distress (MD) and respondent characteristics on intent to leave employment.
Managing patient care, within organizational constraints, may create physical discomfort or mental peace disturbances such as MD, negatively impacting RN retention.
Responses from 948 RNs were collected using an anonymous online survey. The impact of MD on intent to leave employment was explored.
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.
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.
本研究探讨了道德困境（MD）和应答者特征对离职意向的影响。
在组织限制内管理患者护理，可能会导致身体不适或精神平静干扰，如 MD，对注册护士（RN）的保留产生负面影响。
使用匿名在线调查收集了 948 名 RN 的回复。探讨了 MD 对离职意向的影响。
计划离职的 RN 中 MD 显著更高。系统级和团队级完整性属性是预测离职意向的重要因素，控制了潜在的混杂因素。与新毕业的 RN 相比，打算离职的可能性高 147%，直接护理 RN 高 124%，第二职业 RN 高 63%。性别和种族不是显著的预测因素。
探索导致 MD 频率和严重程度的根本原因对于维持健康的工作环境至关重要。减轻工作环境中的 MD 可能会增强护理实践并改善患者护理。为新毕业和第二职业的 RN 提供支持，可以进一步减少这些脆弱的护理劳动力群体的离职率。
