The Effect of Nursing Moral Distress on Intent to Leave Employment

Abstract

OBJECTIVE This study explored the impact of moral distress (MD) and respondent characteristics on intent to leave employment. BACKGROUND Managing patient care, within organizational constraints, may create physical discomfort or mental peace disturbances such as MD, negatively impacting RN retention. METHODS Responses from 948 RNs were collected using an anonymous online survey. The impact of MD on intent to leave employment was explored. RESULTS 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. CONCLUSION 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.