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Date of Award

Spring 5-30-2019

Author Requested Restriction

Restrict to UW for 5 years - then make Open Access

Work Type

Dissertation in Practice

Degree Name

Doctor of Educational Leadership (EdD)



First Advisor

Susan Johnson

Second Advisor

Patsy Maloney

Third Advisor

Minerva Holk



Background: Evidence suggests that one in three nurses will experience moral distress, which has been associated with intent to leave, depersonalization of the patient and disengagement with work at some point in their career.

Purpose: The purpose of this narrative inquiry was to identify nurses that have experienced a morally distressing experience in practice and give them the opportunity to share their lived experience and share the impact of their experience. This study provided a better understanding of the complexities of moral distress.

Method: Convenience sampling was used to select the female registered nurse participants. Narrative inquiry was used to collect the experiences of moral distress.

Results: Twelve nurses wrote narratives for this study. Two themes (the voices behind the experience and outcomes of moral distress) and five subthemes were identified. All the participants mentioned that not being heard and silencing of self, contributed to moral distress. Participants also discussed strategies for growth after a morally distressing incident.

Implications for practice: Nurses in many different settings have the potential to experience moral distress. This finding suggests that interventions for moral distress should be considered in any setting. This study also identified the potential to learn and grow from morally distressing experiences.

Conclusions: The impact of self-silencing and the practice of being dismissed should be further explored to truly identify stronger and more effective interventions.