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  1. Sheppard, Katherine N. MSN, APRN, AGCNS-BC, CCRN
  2. Runk, Barbara G. MSN, RN, ACCNS-AG, CCRN
  3. Maduro, Ralitsa S. PhD
  4. Fancher, Monica MSN, RN, CPAN
  5. Mayo, Andrea N. BSN, RN-BC
  6. Wilmoth, Donna D. MSN, RN, NE-BC
  7. Morgan, Merri K. DNP, RN, CCRN
  8. Zimbro, Kathie S. PhD, RN


Background: Complexity in nursing practice creates an intense and stressful environment that may lead to moral distress (MD) and registered nurses (RNs) seeking other employment.


Local Problem: In 2020, the RN turnover rate was 8%, with postpandemic turnover projected to reach 13%.


Methods: The Measure of Moral Distress for Health Care Professionals (MMD-HP) was used to measure the frequency and level of RNs' MD.


Results: t tests showed significant differences for 16 of 27 MMD-HP items in RN intent to leave. RNs had 2.9 times the odds of intent to leave (P = .019) due to perceived issues with patient quality and safety and 9.1 times the odds of intent to leave (P < .001) due to perceived issues with the work environment. Results explained 40.3% of outcome variance.


Conclusions: MD related to work environment or patient quality and safety were significant factors in RN intent to leave their position.