Consequences of moral distress in the intensive care unit: A qualitative study

Abstract

Background Moral distress is common among person- nel in the intensive care unit, but the consequences of this distress are not well characterized. Objective To examine the consequences of moral distress in personnel in community and tertiary intensive care units in Vancouver, Canada. Methods Data for this study were obtained from focus groups and analysis of transcripts by themes and subthemes in 2 tertiary care intensive care units and 1 com- munity intensive care unit. Results According to input from 19 staff nurses (3 focus groups), 4 clinical nurse leaders (1 focus group), 13 phy- sicians (3 focus groups), and 20 other health profession- als (3 focus groups), the most commonly reported emotion associated with moral distress was frustration. Negative impact on patient care due to moral distress was reported 26 times, whereas positive impact on patient care was reported 11 times and no impact on patient care was reported 10 times. Having thoughts about quitting working in the ICU was reported 16 times, and having no thoughts about quitting was reported 14 times. Conclusion In response to moral distress, health care providers experience negative emotional consequences, patient care is perceived to be negatively affected, and nurses and other health care professionals are prone to consider quitting working in the intensive care unit.