Objectives: To determine what relationships exist between moral distress, perceived leadership integrity, ethical climate, and turnover intent among adult critical care nurses and the moderating effect of leadership integrity and ethical climate on moral distress and subsequent turnover intent; to obtain a richer and fuller understanding of how critical care nurses experience moral distress within the context of critical care work.
Participants: Adult critical care nurse members of AACN (n=254), 22-70 years old, recruited February – March 2016.
Methods: A Qualtrics survey posted on the AACN eNewsline included the moral distress scale-revised, perceived leadership integrity scale, hospital ethical climate survey, turnover intent analog scales, and open ended questions to elicit qualitative data.
Results: The direct effects of moral distress and leadership integrity and moral distress and ethical climate on intent to leave position were significant (R2 = .248, Adj R2 = .241, p < .001; R2 = .256, Adj R2 = .249, p < .001). The direct effects of moral distress and leadership integrity and moral distress and ethical climate on intent to leave profession were also significant (R2 = .234, Adj R2 = .224, p < .001; R2 = .175, Adj R2 = .165, p < .001). Neither outcome variable was moderated by leadership integrity or ethical climate significantly.
Conclusion: Hospital ethical climate is a significant independent predicator variable and played a major role in the participants’ decision to change their current position and leave the nursing profession.
Date of publication
Susan Yarbrough, PhD, Danita Alfred, PhD, Pam Martin, PhD, & Shelly Marmion, PhD
Doctorate of Philosophy In Nursing
Johnson Makiya, Desha L., "MORAL DISTRESS, LEADERSHIP INTEGRITY, ETHICAL CLIMATE AND TURNOVER INTENT IN CRITICAL-CARE NURSES" (2016). Nursing Theses and Dissertations. Paper 65.