Selangor.Exploring Strategies to Mitigate Moral Distress among Critical Care Nurses: A Discussion Paper

Moral distress, a pervasive challenge in critical care nursing, arises when external constraints prevent nurses from acting in alignment with their ethical convictions. This phenomenon significantly impacts nurses, patients, and healthcare systems, leading to burnout, ethical disengagement, and systemic inefficiencies. This review synthesizes existing literature to explore the evolution, causes, and consequences of moral distress in critical care settings. Key contributors include systemic factors like resource limitations and rigid organizational policies, interpersonal conflicts, and high-stakes clinical challenges such as end-of-life care and futile treatments. The review emphasizes the profound implications of moral distress, highlighting its role in reduced job satisfaction, compromised patient care, and increased turnover. Strategies to mitigate moral distress include fostering supportive ethical climates, implementing ethics education, and promoting self-care and resilience-building practices. Additionally, it underscores the need for systemic reforms, longitudinal research, and the integration of technology in ethical decision-making. Addressing moral distress is vital for enhancing nurse well-being, improving patient outcomes, and sustaining healthcare systems.