Defense Date


Graduation Date

Spring 5-8-2020


One-year Embargo

Submission Type


Degree Name





School of Nursing

Committee Chair

Alison Colbert

Committee Member

Eric Vogelstein

Committee Member

Rachel Berger

Committee Member

Diane Hupp


Child maltreatment, pediatric nurses, moral distress


Background: Moral distress is a significant concern for nurses as it can lead to burnout and intentions to leaving the profession. Pediatric nurses encounter stressful and ethically challenging situations when they care for victims of suspected child maltreatment. Data on pediatric nurses’ moral distress in this situation are lacking, as most research in this field has been done in adult inpatient and intensive care units.

Aims: The purpose of this study was to describe pediatric nurses’ moral distress and determine the impact of caring for victims of suspected child maltreatment on nurses’ moral distress, burnout, and intention to leave.

Design and Method: This descriptive cross-sectional correlational study was conducted in a mid-Atlantic, urban area magnet pediatric level I trauma center hospital that cares for over 1,800 cases of suspected maltreatment annually. An electronic survey was sent to all the nurses working the hospital. Study participation was voluntary and anonymous.

Findings: Overall, nurses (N = 146) reported low levels of moral distress with a mean score of 59.54 ± 49.22 and a range of 0-300 on the Moral Distress Scale Neonatal-Pediatric version (MDSNPV). Although the frequency of caring for victims suspected of child maltreatment did not affect nurses’ moral distress, caring for victims with severe injuries due to abuse contributed to nurses’ intention to leave, X2 (1) = 5.35, p = 0.02.

Conclusions: The results of this study add to the understanding of moral distress in pediatric nursing. Caring for victims of severe injuries impacts pediatric nurses’ intention to leave.



Additional Citations

Karakachian, A., & Colbert, A. (2019). Nurses' Moral Distress, Burnout, and Intentions to Leave: An Integrative Review. Journal of Forensic Nursing, 15(3), 133-142