Research has shown that, when nurses feel they are being prevented from taking a morally justifiable action or achieving an ethical outcome, it contributes to poor mental health, burnout, and intent to leave one's job. Surveys from the COVID-19 pandemic found that a shortage of personal protective equipment (PPE) and lack of perceived support from hospital administrators were associated with higher levels of this moral distress. University of Pennsylvania School of Nursing researchers and their collaborators hypothesized that nurses working in hospitals where Black patients predominantly access care—which they call Black-serving hospitals, or BSHs—would suffer greater moral distress , since these hospitals were disproportionately affected by the pandemic and generally have fewer resources.
In a study published in the journal Nursing Outlook , they found that the percentage of nurses experiencing moral distress was twice as high in hospitals with the highest share of Black patients, and that poor leadership communication contributed to the greater moral distress. "The nurses had poorer support from their leaders and poorer access to personal protective equipment , they're caring more frequently for COVID patients, and they're reporting greater moral distress, all of which is an inequitable burden for the nurses in those hospitals," says lead author Eileen T. Lake, professor of nursing at Penn and associate director of the Center for Health Outcomes and Policy Research (CHO.