Relationship Between Ethical Assessment Skill Knowledge and Moral Distress in the Certified Registered Nurse Anesthetist

Certified registered nurse anesthetists (CRNAs) experience moral distress within their practice. Researchers have not explored this experience among the different CRNA practice models. This study serves to close the gap in knowledge of the experience of moral distress and ethical assessment skill knowledge across 3 practice models. The purpose of this quantitative correlation study was to measure the relationship between perceived ethical assessment skill knowledge and moral distress and how this varies across the 3 CRNA practice models. Data were collected from a sample of 134 CRNAs using a demographic survey, the Ethical Stress Scale, and the Ethical Assessment Skill Survey. Multiple regression analyses indicated a statistically significant correlation between the perceived ethical assessment skill knowledge and moral distress, indicating higher levels of moral distress associated with less self-perceived ethical decision-making skills. Multivariate analysis of variance results did not indicate a significant association between moral distress and self-perceived ethical assessment skill knowledge in the 3 practice models. Three separate multiple regression results indicated gender was the only predictor of moral distress, with women experiencing more moral distress, which indicated women selected activities or skills as more ethically important to their decision making. Additional information obtained indicated physicians are the most difficult professional group to influence when handling ethical issues, and physicians are the individuals the CRNAs stopped working with due to ethical issues. Findings of this study indicated content-specific curricula for the CRNAs need to be assessed for ethical decision-making skill assessment content to minimize moral distress when making ethical decisions. This is especially important to maintain patient safety and retain the required number of CRNAs to meet rural health care needs. Further research on the curricular content for CRNA education and the exploration of the physician relationship issues identified would be valuable to add to the current knowledge.