Burnout inpediatric nurses: Examining the relationship between moral distress and missed nursing care

Purpose

This study investigates the relationship between burnout levels of moral distress and missed nursing care in pediatric nurses.

Design and method

A cross-sectional study was conducted between November and December 2023. Pediatric nurses working in two hospitals and providing direct care to children (n = 140) completed the Moral Distress Scale-Revised Pediatric Nurses, MISSCARE Survey - Pediatric Version and Burnout Measure-Short Version questionnaire. Multivariate regression analysis modeling was applied to test the mediating effect on the relationship between burnout, moral distress, and missed nursing care.

Results

There was a significant positive correlation between the Moral Distress Scale-Revised Pediatric Nurses and its sub-dimensions and the Burnout Measure-Short Version (p < 0.05). There was a significant positive correlation between the mean MISSCARE- Survey-Ped score of the nurses participating in the study and its sub-dimensions and Burnout Measure-Short Version (p < 0.05). Providing Benefit-Do No Harm, one of the Moral Distress Scale-Revised Pediatric Nurses sub-dimensions, and Labour Resources, one of the MISSCARE sub-dimensions, were found to be predictors of burnout. The ethical principle of Providing Benefit-Do No Harm was found to mediate between moral distress and burnout and reduce burnout associated with missed care.

Conclusions

Accordingly, as the nurses' moral distress and inability to meet the necessary patient care increase, their burnout levels also increase. Providing Benefit-Do No Harm is an basic ethical principle that will positively affect the burnout level of pediatric nurses.

Practice implications

This study may provide insights into ethics training, communication improvement strategies, and individual support intervention programs aimed at reducing moral distress, and burnout and improving the coping mechanisms of nurses working in pediatric wards.