This cross-sectional, correlational study’s purpose was to evaluate the effects of resilience and moral distress on workplace engagement in emergency department nurses providing direct patient care. Data were collected from 175 emergency department nurses using a Web-based survey. The higher the nurses’ resilience and the lower their moral distress, the greater their workplace engagement. Resilience and moral distress were not correlated; furthermore, moral distress did not mediate a relationship between resilience and workplace engagement. Resilience was higher with greater job satisfaction, increased age, and longer tenure as a nurse. Workplace engagement increased with higher job satisfaction and less time seeking other employment. Moral distress scores were higher in nurses reporting lower job satisfaction. Multiple regression analysis revealed that resilience, job satisfaction, and moral distress were independent predictors of workplace engagement. Interventions that improve resilience and job satisfaction and/or lower moral distress may improve workplace engagement of emergency department nurses.

The aim of this study was to explore how resilience, job satisfaction, and moral distress affect emergency department (ED) nurses' workplace engagement. BACKGROUND: Stressful nursing workplace conditions increase moral distress. Lowering moral distress and improving resilience can increase workplace engagement. METHOD: Semistructured qualitative interviews were conducted with 15 ED nurses. RESULTS: Participants indicated that greater nursing experience, increased confidence in skills, ability to overcome emotional stressors, and more satisfaction with patient care all improved resilience and workplace engagement. Morally distressed, disengaged nurses reportedly lacked workplace autonomy and/or ability to make workplace changes or worked in hostile and/ or unsafe workplaces. Engaged nurses invested more time in their job and were more willing to remain in their workplace.