Impact of end-of-life education on nurses' moral distress

Abstract

Moral distress is a state of concern or anxiety that occurs when there is a correct action to take but an individual’s ability to take that action is constrained in some way. Nurses, especially those who work in intensive care units (ICUs), may struggle with moral distress due to feelings of futility when caring for end-of-life patients. The purpose of this 1-group pretest–posttest quasi-experimental study, guided by Lazarus’s theory of stress, coping, and adaptation, was to determine whether End-of-Life Nursing Education Consortium (ELNEC) education reduces moral distress in ICU nurses caring for end-of-life patients. A revised Moral Distress Survey (MDS-R 2017) by Hamric was given before and after ELNEC education to determine whether ELNEC reduced ICU nurses’ moral distress level in relation to providing end-of-life care. Participants were 56 ICU nurses recruited from several healthcare institutions in the northeastern United States. Dependent t-test results showed that there was a significant difference (p = .002) in the intensity and frequency of moral distress in ICU nurses before versus after participating in an ELNEC education program. Recommendations for future study include investigating the potential long-term effects of ELNEC education on moral distress, using a larger sample size, and including nurses who work in areas other than ICU. This study may contribute to the development of interventions to reduce moral distress in nurses to make them less likely to leave their employers, subject to lower levels of moral distress, and able to achieve greater emotional and physical well-being. In showing that providing nurses with additional education can decrease their moral distress, this study may promote decreased job turnover and increased physical well-being for nurses, as well as improved nursing care at the end of life which may affect positive social change.