Canadian Forces Military Nursing Officers And Moral Distress: A Grounded Theory Approach

Abstract

Background: Deployed military nurses frequently experience moral dilemmas in their delivery of care, putting them at risk to suffer moral distress. Purpose: The purpose of this study was to understand the experience of deployed Canadian Forces nurses and moral distress. Methods: A grounded theory approach provided the framework for the study's design and data analysis. Semi-structured interviews were conducted with ten nurses previously deployed on combat or humanitarian missions. Findings: A new Moral Distress Model was developed reflecting four contributing factors to the development of moral distress: patient care delivery, chain-of-command, lack of moral preparation and training, and lack of professionalism. The central category -- "unique environment" -- suggests that moral distress is a two-part process: moral deliberation, and moral impact, influenced by the unique environment. Conclusion: Moral distress was a prominent phenomenon affecting deployed CF nurses. Pre-deployment training and on-going educational and supportive strategies are suggested to mitigate the significant impact of moral distress. Keywords: ethics, morals, nurses, military nurses, military personnel, decision making