The Experience of Moral Distress From the Perspective of Emergency Medicine Physicians and Nurses in the Emergency Department: A Qualitative Study Publisher



Lm Yekta Leila MASOUDI ; Eh Pazevar Ehsan HASSANPOUR ; Ar Parsapoor Alireza R ; E Shamsigooshki EHSAN ; M Jalili MOHAMMAD ; A Shojaei AMIRAHMAD
Source: Iranian Journal of Medical Ethics and History of Medicine Published:2025

Abstract

Moral distress constitutes a significant challenge for healthcare professionals, arising when individuals find themselves unable to act in accordance with their personal and professional values due to both internal and external pressures. Healthcare professionals may face scenarios that prompt them to question the ethical acceptability of their decisions and treatment practices, often feeling powerless in the face of perceived unethical changes. This study sought to explore the experiences of moral distress encountered by emergency medicine physicians and nurses in the emergency department. This study was conducted using qualitative content analysis. Data were collected through semi-structured interviews with 25 healthcare providers selected via purposive sampling. Data analysis was conducted using MAXQDA 2018 software. The results indicated that the experiences of moral distress among emergency medicine physicians and nurses in the emergency department can be classified into four primary categories including those related to: 1. patient rights, 2. medical staff and colleagues, 3. management, and 4. professionals. Notably, factors such as overcrowding, inadequate staffing, discrepancies between salaries and workloads, and poor management of human and physical resources emerge as significant contributors to moral distress in the emergency department of Imam Khomeini Hospital. To improve patient care quality, it is essential to implement strategies that enhance triage processes, prioritize human resources, align resources with patient needs, monitor patient attendance, and develop a comprehensive protocol for staff. © 2025 Elsevier B.V., All rights reserved.