This study examined the relationship between moral distress intensity, moral distress frequency and the ethical work environment, and explored the relationship of demographic characteristics to moral distress intensity and frequency. A group of 106 nurses from two large medical centers reported moderate levels of moral distress intensity, low levels of moral distress frequency, and a moderately positive ethical work environment. Moral distress intensity and ethical work environment were correlated with moral distress frequency. Age was negatively correlated with moral distress intensity, whereas being African American was related to higher levels of moral distress intensity. The ethical work environment predicted moral distress intensity. These results reveal a difference between moral distress intensity and frequency and the importance of the environment to moral distress intensity.

People with severe chronic obstructive pulmonary disease have had extensive experience of managing their disease and are familiar with techniques that have helped them integrate the illness and symptoms into their lives. Nurses can synthesize patient knowledge with nursing knowledge to assist patients with severe chronic obstructive pulmonary disease to achieve their maximum quality of life.

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This information will help to make a case for instituting or preserving those nursing processes that are effective and for identifying and working to change nursing processes that are not effective. Nurses will benefit by having a more collaborative work environment.