title: Chief Nursing Officers' Experiences With Moral Distress.
abstract: OBJECTIVE
  This study explores if moral distress and its lingering residue were experienced by chief nursing officers (CNOs).
  
  
  BACKGROUND
  Chief nursing officers, by virtue of their position and experience, are expected to uphold their professional values and act for the benefit of others. Exploration is needed to determine if the inability to do so contributes to the moral distress of these leaders.
  
  
  METHODS
  Twenty CNOs were interviewed to determine the lived experience related to moral distress and moral residue. An interpretive phenomenological analysis approach was used.
  
  
  RESULTS
  Six themes emerged describing CNO experience of moral distress including lacking psychological safety, feeling a sense of powerlessness, seeking to maintain moral compass, drawing strength from networking, moral residue, and living with the consequences.
  
  
  CONCLUSIONS
  Moral distress is a common experience for CNOs. Although CNOs act with moral courage, they still experience moral distress. Further research and professional discussion are needed to support nurse executive leaders.
authors.affiliation: Author Affiliations: Corporate Chief Nurse (Dr Prestia), The GEO Group, Boca Raton, Florida; and Professor of Nursing (Dr Sherman) and Nursing Student (Mr Demezier), Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton; President, Florida Nursing Students Association, Orlando.
authors.forename: Angela S
authors.initials: AS
authors.lastname: Prestia
authors.forename: Rose O
authors.initials: RO
authors.lastname: Sherman
authors.forename: Christopher
authors.initials: C
authors.lastname: Demezier
mesh_terms: D000223:Adaptation, Psychological; D002055:Burnout, Professional / Q000523:psychology*; D003220:Conflict, Psychological; D006801:Humans; D009014:Morals; D009718:Nurse Administrators / Q000523:psychology*; D024802:Nurse's Role; D009741:Nursing Staff, Hospital / Q000523:psychology*; D057184:Practice Patterns, Nurses'; D013315:Stress, Psychological / Q000523:psychology; D011795:Surveys and Questionnaires