Nursing Moral Distress and Intent to Leave Employment During the COVID-19 Pandemic
Katherine N. Sheppard, Barbara G. Runk, Ralitsa S. Maduro, Monica Fancher, Andrea N. Mayo, Donna D. Wilmoth, Merri K. Morgan, Kathie S. Zimbro
Abstract
BACKGROUND: Complexity in nursing practice creates an intense and stressful environment that may lead to moral distress (MD) and registered nurses (RNs) seeking other employment. LOCAL PROBLEM: In 2020, the RN turnover rate was 8%, with postpandemic turnover projected to reach 13%. METHODS: The Measure of Moral Distress for Health Care Professionals (MMD-HP) was used to measure the frequency and level of RNs' MD. RESULTS: t tests showed significant differences for 16 of 27 MMD-HP items in RN intent to leave. RNs had 2.9 times the odds of intent to leave (P = .019) due to perceived issues with patient quality and safety and 9.1 times the odds of intent to leave (P < .001) due to perceived issues with the work environment. Results explained 40.3% of outcome variance. CONCLUSIONS: MD related to work environment or patient quality and safety were significant factors in RN intent to leave their position.