Date of Award


Document Type


Degree Name

Master of Science (MS)




Nurses may experience distress as they perceive the inability to advocate for their patients as they feel ethically bound to do. due to external factors. Labeled in literature as moral distress, these feelings have been shown to result in significant emotional stress and dissatisfaction with the work environment. This study was designed to explore the relationship between moral distress in North Dakota (ND) registered nurses (RN), and the choice to leave a position of employment. Relationships between moral distress and demographic and workplace variables were also explored.

The basis for this study was the Model for a Theory of Moral Distress. A systematic sample of the RNs licensed to practice in ND was surveyed by mail using the revised Moral Distress Scale.

Of the respondents (N=207), 26.6% reported having changed positions of employment as a result of moral distress. Of those employed in patient care settings, 37.4% (n= 165) reported experiencing moderate or high levels of moral distress. No demographic variables were found to have statistically significant relationships to moral distress.