Investigation of moral distress in students and newlygraduated nurses: A model development study

The aim of the study was to examine the moral distress in senior nursing students and new graduate nurses. The study, which was conducted using the convergent parallel design approach, one of the mixed method research designs, was completed in two separate populations (senior nursing students and newly graduated nurses) and in two stages. The data were collected with the descriptive data form for senior nursing students and new graduate nurses, Moral Distress Scale for Nursing Students and Healthcare Workers, and semi-structured questionnaire for senior nursing students and new graduate nurses. SPSS 25.0 and MAXQDA programs were used for data analysis. The frequency of moral distress in senior nursing students was found to be below the medium value and the intensity was found to be above the medium value. It was determined that the type of school, taking courses on ethical issues, feeling ready to fulfill the role of caregiver, advocate and manager, self-confidence in solving ethical problems and the level of mastery of legal regulations for the profession significantly affected moral distress. In the qualitative study conducted in the context of moral distress experiences of senior nursing students, a total of four themes and 14 sub-themes emerged. Quantitative analyses showed that gender, type of hospital, length of service in the profession, fulfillment of caregiver role and fulfillment of manager role significantly affected moral distress in newly graduated nurses. The frequency of moral distress in newly graduated nurses was found to be below the medium value, while its intensity was found to be above the medium value. In the qualitative analysis conducted in the context of moral distress experiences of nurses, four themes and 16 sub-themes emerged.Based on the qualitative and quantitative data of the study, a model was developed to address the moral distress process experienced by new graduate nurses who transition from student to professional. As a result, it is recommended that supportive guidance mechanisms, practices and regulations at individual, institutional and system level should be implemented to reduce and cope with moral distress in nursing students and new graduate nurses.