Moral distress, moral resilience, and job embeddedness among pediatric nurses

Background Nurses often face ethical issues in their daily work that can have an impact on their level of job embeddedness. And positive job embeddedness is essential to reduce burnout among nurses and improve professional retention in the medical industry. However, few studies have focused on the relationship between moral distress, moral resilience, and job embeddedness.Objectives To investigate the relationship between moral distress, moral resilience, and job embeddedness, and explore the mediating role of moral resilience between moral distress and job embeddedness among nurses.Design A quantitative, cross-sectional study.Methods Nurses from a number of tertiary general hospitals in central China were surveyed and assessed using the Moral Distress Scale, the Nurse Moral Resilience Scale, and the nurse job embeddedness Scale from February to March 2023. The study was conducted in line with the 1964 Declaration of Helsinki.Ethical consideration All study procedures were approved by the Ethics Committee of Hunan Normal University (No. 2023-313).Findings Moral distress was positively correlated with moral resilience (beta = 0.525, p < 0.01) and negatively correlated job embeddedness (beta = -0.470, p < 0.01). Moral resilience partially mediated the relationship between moral distress with job embeddedness (beta = -0.087, p < 0.01).Discussion The findings reveal a relationship between moral distress, job embeddedness, and moral resilience among nurses.Conclusion Moral distress and moral resilience are important correlates of job embeddedness in nurses. Interventions to reduce moral distress and increase moral resilience may have potential benefits for improving nurses' job embeddedness. It is recommended that clinical nursing administrators create a favorable ethical atmosphere, educate nurses about ethics, and increase nurses' moral resilience.