• Kathleen A DiGangi Condon, Jeffrey T Berger, and Kathleen M Shurpin.
• Kathleen A. DiGangi Condon is a nurse practitioner, Division of Palliative Medicine and Bioethics, Department of Medicine, NYU Langone Health-Long Island, Mineola, New York.
• Am. J. Crit. Care. 2021 Nov 1; 30 (6): 461-465.

BackgroundNurses experience moral distress when they feel disempowered or impeded in taking the ethically right course of action. Research suggests an inverse relationship between moral distress and empowerment. In the intensive care unit, providing palliative care services may reduce moral distress because palliative care is often provided in situations that give rise to moral distress.ObjectiveTo evaluate the effect of nurses' use of a palliative care screening tool on their moral distress and perceptions of empowerment.MethodsA pretest-posttest pilot study was conducted involving day-shift medical intensive care unit nurses. The nurses administered a palliative care screening tool to their assigned patients daily for 8 weeks and communicated the results to an attending physician or fellow. Demographic information was collected, along with data on nurses' moral distress and perceptions of structural and workplace empowerment before and after the intervention. Moral distress was evaluated using the Moral Distress Scale-Revised. Perceptions of structural and workplace empowerment were quantified using the Conditions for Work Effectiveness Questionnaire-II and the Global Empowerment Scale, respectively.ResultsPreintervention and postintervention surveys were completed by 17 nurses. Paired-sample t tests revealed a significant decrease in the frequency of moral distress (t16 = -2.22, P = .04) and a significant increase in workplace empowerment (t16 = -2.75, P = .01). No significant changes in moral distress intensity or structural empowerment were found.ConclusionNurses' sense of empowerment and the frequency of moral distress are favorably affected by active participation in assessing and communicating patients' palliative care needs.©2021 American Association of Critical-Care Nurses.

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