Health inequities and moral distress among community health nurses during the COVID-19 pandemic
This research inquiry explores the experiences of moral distress among community health nurses (CHNs) during the COVID-19 pandemic, particularly relating to health inequities experienced by community members. Using a snowball sampling approach, 245 CHNs working in a community setting during the COVID-19 pandemic across Canada were surveyed about their experiences of moral distress.
Moral distress was understood to be present when CHNs were unable to act in accordance with their moral judgement. This distress prevented them from following the “right” course of action in providing necessary health-promoting interventions to populations living in conditions of marginalization.
The researchers found that the majority of participants experienced moral distress during the pandemic, and 75% identified the source being rooted in existing health inequities.
Four key constraints identified by participants were:
- limited availability of resources
- reactive pandemic responses
- heavy workloads
- abrupt and repeated redeployments
The main sources of moral distress identified by participants were organized into seven categories:
- unmet needs
- negative impact of public health measures
- do no harm
- one size doesn’t fit all
- queue jumping and vaccine prioritization
- threats to quality care
- constantly changing and uncertain landscape
The researchers also explored compounding factors such as pre-pandemic health system constraints; leadership, management and communication; hearing anger, denial, criticism and distress; personal and family lives; and safety of the work environment. A better understanding of the experiences of CHNs during the COVID-19 pandemic can strengthen advocacy for equity-focused pandemic planning, response and recovery.
Use this resource to:
- better understand the experiences of community health nurses; and
- advocate for equity-focused pandemic planning, response and recovery.
Baxter, C., Schofield, R., Betker, C., Currie, G., Filion, F., Gauley, P., Tao, M., & Taylor, M.-A. (2022). Health inequities and moral distress among community health nurses during the COVID-19 pandemic. Witness: The Canadian Journal of Critical Nursing Discourse, 4(2), 42–55. https://doi.org/10.25071/2291-5796.137