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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]

Aim: To understand the experience of critical care nurses during the COVID‐19 pandemic, through the application of the Job‐Demand‐Resource model of occupational stress. Design: Qualitative interview study. Methods: Twenty‐eight critical care nurses (CCN) working in ICU in the UK NHS during the COVID‐19 pandemic took part in semi‐structured interviews between May 2021 and May 2022. Interviews were guided by the constructs of the Job‐Demand Resource model. Data were analysed using framework analysis. Results: The most difficult job demands were the pace and amount, complexity, physical and emotional effort of their work. Prolonged high demands led to CCN experiencing emotional and physical exhaustion, burnout, post‐traumatic stress symptoms and impaired sleep. Support from colleagues and supervisors was a core job resource. Sustained demands and impaired physical and psychological well‐being had negative organizational consequences with CCN expressing increased intention to leave their role. Conclusions: The combination of high demands and reduced resources had negative impacts on the psychological well‐being of nurses which is translating into increased consideration of leaving their profession. Implications for the Profession and/or Patient Care: The full impacts of the pandemic on the mental health of CCN are unlikely to resolve without appropriate interventions. Impact: Managers of healthcare systems should use these findings to inform: (i) the structure and organization of critical care workplaces so that they support staff to be well, and (ii) supportive interventions for staff who are carrying significant psychological distress as a result of working during and after the pandemic. These changes are required to improve staff recruitment and retention. Reporting Method: We used the COREQ guidelines for reporting qualitative studies. Patient and Public Contribution: Six CCN provided input to survey content and interview schedule. Two authors and members of the study team (T.S. and S.C.) worked in critical care during the pandemic. [ABSTRACT FROM AUTHOR]

Background: Since the start of the global COVID‐19 pandemic in 2019, critical care nurses across the world have been working under extreme levels of pressure. Aim: To understand critical care nurses' experiences of and satisfaction with their role in the pandemic response across the United Kingdom (UK). Study Design: A cross‐sectional electronic survey of critical care nurses (n = 339) registered as members of the British Association of Critical Care Nurses. Anonymous quantitative and open‐ended question data were collected in March and April 2021 during the height of the second surge of COVID‐19 in the UK via an online questionnaire. Quantitative data were analysed using descriptive statistics and free text responses were collated and analysed thematically. Results: There was a response rate of 17.5%. Critical care nurses derived great satisfaction from making a difference during this global crisis and greatly valued teamwork and support from senior nurses. However, nurses consistently expressed concern over the quality of safe patient care, which they perceived to be suboptimal due to staff shortages and a dilution of the specialist skill mix. Together with the high volume of patient deaths, critical care nurses reported that these stressors influenced their personalwell‐being. Conclusions: This study provides insights into the key lessons health care leaders must consider when managing the response to the demands and challenges of the ongoing COVID‐19 pandemic. COVID‐19 is unpredictable in its course, and what future variants might mean in terms of transmissibility, severity and resultant pressures to critical care remains unknown. Relevance to Clinical Practice: Future responses to the challenges that critical care faces must consider nurses' experiences and create an environment that engenders supportive teamwork, facilitates excellent nursing practice and effective safe patient care where critical care nursing may thrive. [ABSTRACT FROM AUTHOR]