6th Edition of World Nursing Science Conference 2026

Abstract

Have you ever finished work and sat in your car and cried? Have you ever finished work and gone straight home to tell the family “That’s it” I’m resigning, only to find the next morning you put your uniform on and head back into work to care for your patients. Have you ever considered that you may have been experiencing a period of moral distress or injury?

Nurses are amazing, they are smart, compassionate, determined and resilience. COVID demonstrated this. What we are not good at is saying when we are not OK, we don’t look for sympathy or an extra hour off work, nurses keep going. The question is, but should we? There is an abundance of information that has discussed the impact of moral injury and the fact it contributes to nurses leaving our profession. How can we stop this? What can we do as a community of practice to collaborate with national leaders to address this key workforce issue that sees amazing nurses leave our profession.

I am interested in researching moral distress and injury because I feel have experienced moral distress first hand as a Chief Nurse leading through the Covid pandemic and as a CEO following the COVID crisis. I know how it feels to want to do the right thing, not being able to do it. Before the pandemic, the term moral distress was already being discussed by Jameton, 1984 who first spoke about moral distress as the painful feelings and/or psychological disequilibrium arising ‘when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action.’  I personally know how it feels to deny a person the right to die at home. During COVID I could not secure the necessary home care to allow individuals to go home. I know this impacted negatively upon me.

It has been documented that there are psychological and physical manifestations for individuals who experience moral distress, this can be moral sensitivity, guilt, anger, decrease in the quality of patient care and the desire to leave their job or profession, (Helmes et al, 2020). Rushton, (2016) discusses moral distress as being different from emotional distress commenting that emotional distress is more common and can be found in stressful work environments for example healthcare.

Some argue that long-term exposure to events that cause moral distress can also result in moral residue (Webster & Bayliss,2000). This can be integrated into people’s thoughts and views of their self. This is seen as an aspect of moral distress, it is the residue that remains, if left unchecked can damage the self and people’s careers especially if it is a threat to moral integrity. Lamberson, (2016) sees moral integrity as a sense of wholeness and self-worth that comes from having clearly defined values that are congruent with one’s perceptions and actions.

So, the question is what we can do as an international community to raise the profile with the commissioners of health and care to make sure they factor in preventing nurses and other staff being exposed to situations where moral dilemmas and distress can occur. The answer may lie in nurses advocating more self-love, compassionate leadership and not being ashamed of saying “I am not OK.”