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Background: Moral distress is recognized as an international problem that contributes to decreased work productivity, job dissatisfaction and intent to leave for adult Critical Care nurses. Aim: To explore Critical Care nurses moral distress levels using the Moral Distress Scale Revised (MDS‐R) and its relationship with intention to stay. The study reported in this paper was part of a larger study that also investigated Critical Care nurses' work environment in Canada and the Midlands region of the UK. Study design: During January to August 2017 a cross‐sectional survey was distributed to adult Critical Care nurses in the Midlands region of the UK. Methods: Surveys were distributed to adult Critical Care Registered Nurses in the Midlands region of the UK examining moral distress levels and intention to stay in Critical Care, the organization (NHS Trust) and in the nursing profession. Results: Two hundred sixty‐six number of a potential sample of 1066 Critical Care nurses completed the survey (25% response rate). Age and moral distress were significantly positively correlated with intention to stay on their current unit (r = 0.16, P =.05), indicating older nurses were more likely to stay in the critical care unit. Moral distress was negatively correlated with intent to stay scores, showing critical care nurses with higher levels of moral distress were less likely to stay on their unit (r = −0.20, P =.02). Moral distress was also significantly negatively correlated with intention to stay with their current employer (r = −0.28, P <.001). Nurses that stated they had high rates of moral distress were more likely to consider leaving their current employer. Conclusion: Moral distress appears to be an issue among adult Critical Care nurses requiring further exploration and development of effective strategies to reduce this phenomenon and stabilize the workforce by reducing turnover. Relevance to clinical practice: By identifying the top causes of moral distress, tools and strategies can be developed to allow the Critical Care nurse to work within an ethically safe clinical environment and reduce the turnover of experienced adult Critical Care nurses. [ABSTRACT FROM AUTHOR]

ABSTRACT Background The first independent paediatric retrieval nurse practitioners ( RNP) in the UK and Europe were appointed in 2006 in one hospital Trust. Since then, many have been appointed around the UK but the range of responsibility and scope of the role is unknown as well as possible geographical variability. Aim The aim of this paper is to explore the role and scope of paediatric retrieval nurse practitioners in the United Kingdom ( UK). Method A two part questionnaire was sent to all RNPs identified by the regional retrieval/transport centres. Information was sought about the role and scope of RNPs and how the role may have changed since appointment. RNPs were asked to self-assess their own ability in a variety of technical and leadership skills. Conclusion The majority of respondents felt their role had expanded since appointment. RNPs reported that they would now lead the team for any critically ill infant or child where previously they were retrieving stable or high dependency patients. Other expansions of their role included being on a middle grade tier of the medical rota, asked to undertake aeromedical transfers, providing the withdrawal of care at referring centres and non-medical independent prescribing. Relevance to Practice This survey has revealed the changing role and scope of RNPs in the UK but most importantly, the increased responsibility of the roles. Over 80% of RNPs rated their leadership skills between proficient and expert on Benner's Novice to Expert Continuum (Benner, 1984). [ABSTRACT FROM AUTHOR]