The unacknowledged challenge of moral distress for nurse academics

The pluralistic nature of healthcare presents nurses with situations challenging their moral values which nurses must navigate. Challenges to moral values can result in the experience of moral distress, a problem that is common within the clinical nursing context. Moral distress is a known and well-researched phenomenon within nursing and has long contributed to detrimental effects such as frustration, anger, anxiety, decreased job satisfaction, burnout and ultimately attrition. However, despite extensive research in clinical environments, minimal research exists detailing this concept within the context of nursing academics and educators. Nurses can experience moral distress if they are in or exposed to work situations that are at odds with their own ethical and moral values. We contend here that moral distress is experienced regardless of practice context, and therefore we discuss moral distress in the context of nursing academics who are impacted by moral distress. Nursing academics experience moral distress, and this distress emerges from a variety of sources including insufficient resourcing, interpersonal relationships, misalignment of values, and student attitudes to learning. The psychological impact is profound and contributes to interrupted career progression and attrition. Opportunity for improvement remains but ultimately relies upon systemic change. Moral distress emanating from student behaviours is a unique factor for the nursing academic workforce. The nursing academic workforce is experiencing increasing workplace stress, expanding expectations from consumers, and increasing fiscal constraints; a situation likely to exacerbate the occurrence and the experience of moral distress for this population. Nursing academics recognise the occurrence of moral distress and propose solutions to address this concern. However, very limited evidence supports this assertion. Further research is needed within this population to ascertain the scale and the nature of the challenges faced in higher education, and more importantly to develop, test and evaluate interventions to ameliorate moral distress.