Professional identity and moral distress in nursing and midwifery leadership

Background: Nursing and midwifery leaders are faced with decisions on a daily basis that require them to uphold their professional values and act for the benefit of others as well as meeting performance indicators and upholding organisational reputation. Moral distress is defined as the disequilibrium that can result when leaders recognise that they are unable to balance these competing priorities ethically. This study explores the perspectives of senior healthcare leadership in undertaking their role; the moral distress they encounter and the ways in which they balance the needs of the service, the wellbeing of staff and their own professional values.

Methods: A qualitative interview study of 19 senior leaders working in the National Health Service. Using Grounded Theory, the interviews have been conducted and analysed with the themes generated providing a unique perspective of the challenges faced by nursing and midwifery leadership.

Findings to date: The themes constructed demonstrate that leaders navigate decision making in alignment with their personal and professional values. Where this is challenged, moral distress occurs. The participants discuss the tactics they deploy to navigate these complex situations and the toll this can take on their own well-being as well as the impact on teams and patient safety.