Moral Injury in Nursing: A Quantitative Descriptive Study

Abstract

Purpose: The purpose of this study was to 1) describe the level of moral injury among nurses working in the inpatient, adult hospital setting, 2) to examine the associations between work environment, patient/family interactions, job satisfaction, turnover intention, and moral injury, and 3) to explore the demographic relationships with moral injury. Background: Moral injury in nursing is an important concept related to job satisfaction, nurse well-being, and turnover intention. The destressing work conditions brought on by the COVID-19 pandemic have put forward the concept of moral injury to the forefront in healthcare, especially in nursing. Research Design: A cross-sectional quantitative research design. Methods: This study used a cross-sectional and descriptive design with logistical and linear regression analyses to describe levels of moral injury and relationships between the work environment, patient/family factors, job satisfaction, and turnover intention among nurses working in the inpatient, adult hospital setting. Results: This study examined descriptive statistics of the instruments, analyzed correlations associated with moral injury in nursing, identified predictors of moral injury in nursing, and described the demographic characteristics of the participants. Independently, work environment, job satisfaction, and turnover intention were significant predictors of moral injury, while patient/family factors were not. When analyzed as a multivariant model, work environment, patient/family factors, and turnover intention were significant, while job satisfaction was not. Conclusion: Moral injury present in 97% of the study population identified concerns for nurses leaving the profession may be more than burnout, moral distress, or compassion fatigue. All of these are real and substantial on their own, but the wearing down of one’s moral code and beliefs, moral injury, may supplicate a lifelong challenge and lead to changing professions of many outstanding nurses and precipitate mental health concerns for the nurse. Organizations must address the work environment to improve nurses’ job satisfaction, work-life balance, and well-being.