Moral distress in clinical research nurses

Clinical research nursing is the nursing specialty that focuses on the care of research participants and the management of clinical trials. Clinical research nurses (CRN) experience unique challenges in the context of their role related to informed consent, dual obligations, and organizational support. These ethical challenges can lead to conflict, which may lead to moral distress. While moral distress has been examined in many areas of nursing and non-nursing healthcare specialties, it has not been studied in clinical research nursing. A descriptive, quantitative design was used to examine moral distress experienced by CRNs and explore the relationship between moral distress scores and demographic characteristics of CRNs. CRNs (N=322) were recruited using digital flyers, emails through professional organizations, social media, and snowball recruitment. The Measure for Moral Distress – Health Care Professionals (MMD-HP) was administered electronically to measure moral distress in CRNs. Sample characteristics were recorded using a nine-item demographic form. Mean scores were calculated to obtain the overall moral distress score, as well as individual item scores. Pearson’s product-moment correlations, independent t-test, and one-way ANOVA were performed to explore differences among the demographic variables. The analysis demonstrated that CRNs experience moral distress (M = 79.58, SD = 64.27) and that moral distress scores varied by participant demographics. Levels of moral distress were negatively correlated with CRN age (r = -.156, p < .05). CRNs who had previously left a job or considered leaving a job due to moral distress had significantly higher levels of moral distress than those who had not (F2,239 = 14.26, p = .000). Further, the moral distress scores for CRNs currently considering leaving their position due to moral distress were significantly higher than CRNs not considering leaving(t = 6.42, p = .00). Good reliability of the MMD-HP and four subscales with the sample was demonstrated.