Relationship between ICU nurses' moral distress with burnout and anticipated turnover

Nurs Ethics. 2015 Feb;22(1):64-76. doi: 10.1177/0969733014534874. Epub 2014 Jun 19.


Background: Moral distress is one of intensive care unit nurses' major problems, which may happen due to various reasons, and has several consequences. Due to various moral distress outcomes in intensive care unit nurses, and their impact on nurses' personal and professional practice, recognizing moral distress is very important.

Research objective: The aim of this study was to determine correlation between moral distress with burnout and anticipated turnover in intensive care unit nurses.

Research design: This study is a descriptive-correlation research.

Participants and research context: A total of 159 intensive care unit nurses were selected from medical sciences universities in Iran. Data collection instruments included "demographic questionnaire," "ICU Nurses' Moral Distress Scale," "Copenhagen Burnout Inventory" and "Hinshaw and Atwood Turnover Scale." Data analysis was done by using SPSS19.

Ethical considerations: Informed consent from samples and research approval was obtained from Shahid Beheshti Medical Sciences University Research Ethics Board in Tehran.

Findings: The findings showed intensive care unit nurses' moral distress and anticipated turnover was high, but burnout was moderate. The results revealed that there was a positive statistical correlation between intensive care unit nurses' age, their work experience and the fraction of nurses' number to number of intensive care unit beds with their moral distress and burnout. However, there were no correlation between gender, marriage status, educational degree and work shift and moral distress.

Discussion: Some of the findings of this research are consistent with other studies and some of them are inconsistent.

Conclusion: Similarly, moral distress with burnout and anticipated turnover did not have statistical correlation. However, a positive correlation was found between burnout and anticipated turnover. The results showed that increase in the recruitment of young nurses, and nursing personnel, and diminishing intensive care unit nurses' moral distress, burnout and their turnover intention are essential.

Keywords: Burnout; intensive care unit; moral distress; nurse; turnover.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Attitude of Health Personnel
  • Burnout, Professional / etiology
  • Burnout, Professional / psychology*
  • Conflict, Psychological
  • Female
  • Humans
  • Intensive Care Units*
  • Iran
  • Male
  • Morals*
  • Nurses / psychology*
  • Personnel Turnover
  • Statistics as Topic
  • Stress, Psychological / complications*
  • Stress, Psychological / etiology*
  • Surveys and Questionnaires