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Nurse Practitioners' Experiences of Moral Distress in the Continuing Care Setting Open Access


Other title
Continuing Care
Moral Distress
Nurse Practitioner
Type of item
Degree grantor
University of Alberta
Author or creator
Ritchie,Vanessa S
Supervisor and department
Tammy O'Rourke (Nursing)
Sarah Stahlke (Nursing)
Examining committee member and department
Sherry Dahlke (Nursing)
Diane Kunyk (Nursing)
Faculty of Nursing

Date accepted
Graduation date
2017-11:Fall 2017
Master of Nursing
Degree level
Objective: To increase our understanding of moral distress experienced by nurse practitioners in the continuing care setting Design: This qualitative study employed an interpretive description approach in which participants in a major urban center in Western Canada were interviewed about their experiences of moral distress. Participants: The study consisted of a small sample of six nurse practitioners that practiced in the continuing care setting during the time of recruitment. Inclusion criteria ensured potential participants had practiced as a nurse practitioner for a minimum of one year, had practiced in the continuing care setting for a minimum of six months, and were able to speak English. Methods: Semi-structured face-to-face interviews were conducted and recorded with each of the participants. Transcriptions were imported into QSR International NVivo Version 11 for thematic analysis of the participants’ experiences of moral distress, including contributing factors, and methods to address these experiences. Ethical Considerations: Ethical approval was obtained from the Research Ethics Board at the University of Alberta prior to commencement of the study. Findings: This study provided confirmation that nurse practitioners in continuing care experience moral distress. The data presented five themes related to the tensions they identified in their descriptions of their experience. The themes were patients, perceptions, physicians, palliation, and policies. It was found that nurse practitioner experience of moral distress was similar to that of the registered nursing population, although the contributing factors had perhaps a more pronounced impact because of the advanced level of independence and the persistent role issues in advanced practice. Conclusion: Moral distress is a substantial issue for nurse practitioner practice in the continuing care setting. Further research is required in the continuing care setting in addition to other settings, to determine as to whether the experience of moral distress is limited to the profession, practice setting, both, or neither. It is imperative that the experience and contributing factors of moral distress be addressed, and that strategies for cohesiveness among key stakeholders in continuing care be developed in order to decrease the negative experiences of nurse practitioners, and prevent them from leaving the profession.
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