title: Influence of moral distress on the professional practice environment during prognostic conflict in critical care.
abstract: Study purpose was to describe critical care nurses' levels of moral distress and the effects of that distress on their professional practice environment. A descriptive, correlational, prospective, survey design was used. The intensity of moral distress was inversely related to physician/nurse collegial relationships and the frequency of moral distress was inversely related to all aspects of the professional practice environment except foundations for quality of care. It is important to monitor the frequency of moral distress. Strategies to improve the nurse's sense of control over practice, teamwork, communication, and autonomy need to be developed and tested in future research.
authors.affiliation: Medical Intensive Care Unit, Froedtert Hospital, Milwaukee, Wisconsin, USA. nmcandre@froedterthealth.org
authors.forename: Natalie S
authors.initials: NS
authors.lastname: McAndrew
authors.forename: Jane S
authors.initials: JS
authors.lastname: Leske
authors.forename: Annette
authors.initials: A
authors.lastname: Garcia
mesh_terms: D001291:Attitude of Health Personnel; D002055:Burnout, Professional / Q000523:psychology*; D003220:Conflict, Psychological; D003422:Critical Care / Q000941:ethics* / Q000523:psychology; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D028681:Moral Obligations; D024802:Nurse's Role; D009741:Nursing Staff, Hospital / Q000941:ethics*; D016272:Occupational Health; D011364:Professional Practice; D011446:Prospective Studies; D011787:Quality of Health Care