Linda Radzvin

Defense Date


Graduation Date

Summer 2008


Immediate Access

Submission Type


Degree Name





School of Nursing

Committee Chair

L. Kathleen Sekula

Committee Member

Gladys Husted

Committee Member

Alexander Tymchuk

Committee Member

John Kern


moral distress, nurses, CRNAs


Registered nurses are frequently confronted with ethical dilemmas in their nursing practice. As a consequence of their decisions regarding ethical challenges, nurses report experiencing moral distress. This experience is often manifested by such feelings as anger, guilt, sadness, fear, and frustration and has been identified as a contributing factor to burnout and turnover in nursing. A review of the literature has shown that the incidence of moral distress has been examined in various nursing settings. However, to date only one qualitative study has been conducted that examined the occurrence of moral distress in nurse anesthetists related to the delivery of anesthesia to older patients.

The purpose of this exploratory, descriptive study was to determine if Certified Registered Nurse Anesthetists (CRNAs) experience moral distress in their nursing practice. Demographic variables were also examined in relation to moral distress. A random sample of 800 Certified Registered Nurse Anesthetists from the registry of the American Association of Nurse Anesthetists was selected to participate in this study. Participating nurses were asked to complete a demographic data survey and the Ethics Stress Scale. Three hundred and two responses were received and 300 surveys were analyzed utilizing the Statistical Package for the Social Sciences 15.0 (SPSS).

The data supported the assumption that CRNAs do experience moral distress in their nursing practice. While a small number of nurse anesthetists experienced high levels of moral distress, as indicated by total Ethics Stress Scale Scores, CRNAs generally experienced moderate levels of moral distress. Moral distress was associated with situations in which they believed they were aware of the morally correct course of action but were unable to follow through with these behaviors. Nurse anesthetists reported physical and psychological manifestations in relation to moral distress and have considered changing positions or even leaving nursing as a result of ethical dilemmas. Also, CRNAs in the age group of 24-30 had higher levels of moral distress than anesthetists in any other age range. The results of this study supplement existing nursing knowledge, emphasizing the importance of the recognition and alleviation of the occurrence of moral distress in nurses.