Moral distress and intention to leave work among nurses: a prospective survey study in Oman

Abstract

Background/Aims Moral distress can have a substantial impact on nurses, contributing to burnout and staff turnover. This study aimed to assess the level of moral distress, identify the situations considered to cause the most moral distress and measure the relationship between moral distress, demographic factors and intention to leave one's role or the nursing profession in a hospital in Oman. Methods A descriptive correlational design was used. The study sample comprised 167 nurses working in intensive care, oncology, medical or surgical units in a referral hospital in Muscat, Oman. A survey was distributed to participants in their place of work. Data were collected using the Measure of Moral Distress – Healthcare Professionals tool, measuring frequency of morally distressing events and the level of distress caused. The survey also collected demographic details and information on whether participants were currently considering (or had ever considered) leaving their role because of moral distress. Results were summarised using descriptive statistics, with relationships between variables analysed using Mann–Whitney and Kruskal–Wallace tests, Spearman's rho and logistic regression. Results The mean total moral distress score was 81.0 (±59.4) out of a possible score range of 0–432. The situations that participants found the most morally distressing were excessive documentation requirements that compromise patient care and feeling pressured to provide what they considered to be unnecessary or inappropriate tests and treatments. Area of work was not significantly associated with level of moral distress, but moral distress was significantly higher in participants with less nursing experience and those considering leaving their role. Conclusions Practical solutions are required to support nurses who may be at high risk of experiencing moral distress. This could include mentoring schemes and strategies to reduce or streamline clinical documentation requirements.