Commentary: The silent epidemic – rethinking moral distress as a systems failure in critical care nursing
Year: 2026
Type: editorial
Abstract: Commentary to: Consequences of moral distress among critical care nursing: an integrative review (Ananzeh and Miller, 2025).Critical care nursing shortage has become a crisis worldwide due to rising turnover and prevalence of burnout.Although there is plenty of literature on the issues including workload, staffing ratio and pandemic-related challenges in relation to critical care nurses, another factor which still needs considerable attention is moral distress.An integrative review published by Ananzeh and Miller (2025) entitled 'Consequences of moral distress among critical care nursing: an integrative review' comes at an ideal time, as it presents a comprehensive evaluation of the existing research on this widespread problem.As this systematic integration of nine empirical papers conducted within various geographical settings and using different research methods reveals, the key point of this review is not just listing adverse consequences of moral distress but, more importantly, transforming the concept into a predictable outcome of systemic and organisational failures.It is only through understanding moral distress as a system-based preventable problem that effective interventions may be developed. Summary of the paperThis systematically executed integrative review conducted according to the Whittemore and Knafl (2005) model involved the analysis of data from nine papers that were published within the period of 2010 to 2024, comprising six cross-sectional, two qualitative and one mixed-methods designs.The search process employed the three main online databases, namely PubMed, CINAHL and PsycINFO, which provided a total of 366 papers at the outset; however, nine fulfilled strict selection criteria and were rated as Level III (good quality).The findings from the content analysis of the review's literature pointed to three main themes that have far-reaching implications.The first one pertained to the influence of moral distress on the
Source: Journal of research in nursing
Author: Ibrahim Aqtam
Language: English
Topic: Ethics in medical practice
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W7166553951