Nurses on the frontlines face ‘moral distress’

Nurses who have been on the frontlines of the COVID-19 pandemic since the early days in 2020 have all experienced “moral distress,” according to a recent study.

The study, published in SAGE Open Nursing, found nurses lacked support to provide high-quality nursing care based on their training. Researchers from DePaul University’s School of Nursing documented the emotions of 100 nurses who cared for patients early in the COVID-19 pandemic throughout the U.S. 

Between May and September 2020, nurses were asked to describe their emotions, and all reported moral distress related to knowing how to treat patients and protect themselves but lacking in staff, equipment or information needed. This discrepancy in resources led to feelings of fear, frustration, powerlessness and guilt. 

The study adds to the alarming trends that may contribute to a labor shortage in the future. The healthcare industry is facing large demand for professionals down the road, and some studies have shown many nurses plan to vacate the industry after the COVID-19 pandemic. In addition, an estimated 3,300 U.S. nurses, doctors, social workers and physical therapists died of COVID-19 between February 2020 and February 2021, according to DePaul researchers. The demands of the job during the pandemic have pushed healthcare professionals to the brink. The study’s documents could help inform future policies and laws to support nurses and avoid burnout and distress.

“People need to listen to nurses more, and nurses need to feel empowered to share their experiences at every level of leadership,” principal investigator Shannon Simonovich, assistant professor of nursing, said in a statement.

The study is thought to be the largest of its kind, capturing the true feelings of nurses even as news stories at the same time patented healthcare professionals as heroes. Nurses in these stories were typically white and female, while the reality was that the nurses on the frontlines came from all different personal, ethnic and geographic backgrounds with varying levels of education. Capturing a diverse voice was critical to researchers. The DePaul study cohort included 65% of nurses who identified as a member of a racial, ethnic or gender minority group.

“We captured the voices of diverse nurses caring for a diverse patient population that was being disproportionately impacted by COVID-19,” assistant professor and co-author Kashica Webber-Ritchey said in a statement.

Looking forward, researchers suggested more research into the burdens that nurses have carried throughout the COVID-19 pandemic. The media coverage of healthcare heroes should be more of a call to action. In addition, more clear, safe standards for nurses that are legally binding to hospitals and healthcare agencies are needed to hold these institutions accountable. 

“We go into nursing with the intention of saving lives and helping people to be healthy,” said Simonovich. “Ultimately, nurses want to feel good about the work they do for individuals, families and communities.”

Additionally, more investments in mental health resources could promote psychological resilience among nurses and reduce feelings of burnout and moral distress.

“Taking time to speak to nurses to understand their needs and provide support would help with addressing moral distress,” Webber-Ritchey concluded.

Amy Baxter

Amy joined TriMed Media as a Senior Writer for HealthExec after covering home care for three years. When not writing about all things healthcare, she fulfills her lifelong dream of becoming a pirate by sailing in regattas and enjoying rum. Fun fact: she sailed 333 miles across Lake Michigan in the Chicago Yacht Club "Race to Mackinac."

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