Moral distress in critical care nursing practice: A concept analysis

Aim: To provide a critical analysis of the concept of moral distress (MD) in critical care (CC) nursing. Background: Despite extensive inquiry pertaining to the legitimacy of MD within nursing discourse, some authors still question its relevancy to the profession. However, amid the global COVID-19 pandemic, MD is generating a significant amount of discussion anew, warranting the further exploration of the concept within CC nursing to provide clarity and expand on the definition. Design: Rodger's Evolutionary Concept Analysis method was used to guide this analysis. Methods: Related terms, attributes, antecedents, and consequences of MD were identified using current literature. Results: The results of this analysis demonstrate strong congruence between the attributes, antecedents, and negative consequences pertaining to MD. However, a new theme has emerged from this review of the contemporary literature, highlighting the potential unexpected positive outcomes perceived by nurses who experience MD, including the provision of better care, increased levels of empathy, and enhanced opportunities for ethical reflection.