Registered nurses' perceptions of moral distress and ethical climate



Pauly B, Varcoe C, Storch JL & Newton LJ (2009) Registered nurses' perceptions of moral distress and ethical climate. Nursing Ethics, 16 (5), pp. 561-573.

Moral distress is a phenomenon of increasing concern in nursing practice, education and research. Previous research has suggested that moral distress is associated with perceptions of ethical climate, which has implications for nursing practice and patient outcomes. In this study, a randomly selected sample of registered nurses was surveyed using Corley's Moral Distress Scale and Olson's Hospital Ethical Climate Survey (HECS). The registered nurses reported moderate levels of moral distress intensity. Moral distress intensity and frequency were found to be inversely correlated with perceptions of ethical climate. Each of the HECS factors (peers, patients, managers, hospitals and physicians) was found to be significantly correlated with moral distress. Based on these findings, we highlight insights for practice and future research that are needed to enhance the development of strategies aimed at improving the ethical climate of nurses' workplaces for the benefit of both nurses and patients.

ethical climate; ethical practice; moral distress; nursing ethics; quality work environments;

Nursing Ethics: Volume 16, Issue 5

Publication date01/09/2009
Publication date online11/08/2009

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Professor Bernadette Pauly

Professor Bernadette Pauly

Honorary Professor, Faculty of Social Sciences