Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Cynthia D. Connelly PhD, RN, FAAN, Chair; Jane M. Georges PhD, RN; Linda Urden DNSc, RN, CNA-BC, FAAN


compassion fatigue, critical care nurses, medication error, moral distress, nursing, qualitative, quantitative


A correlational embedded mixed method design was used for this study. A purposive sample of 205 critical care nurses (CCNs) provided quantitative data for the study. A focus group interview of five CCNs provided the qualitative data. The Moral Distress Scale (MDS), Professional Quality of Life Scale (ProQOL), and Medication Administration Error (MAE) Scale and demographics form were used to measure quantitative data. Quantitative findings included the majority of participants were female (91.7%); mean age 47 (SD = 7.91) years; mean years worked as a nurse was 23 (SD = 8.48); mean years worked on respective unit was 13.6 (SD = 8.45) and mean numbers of hours worked per week was 37 (SD = 8.45). Nineteen CCNs (9.5%) indicated they were considering leaving their current work position based on moral distress. Statistically significant positive relationships between moral distress, compassion fatigue, and perceived mediation error were found. Simultaneous multiple regression was conducted to determine the accuracy of the IVs; moral distress and compassion fatigue in predicting medication scores while controlling for gender, age, work status, marital status, resignation based on moral distress and others. Regression results indicate the overall model significantly predicted the Medication Administration Error Subscale of Nursing Staffing, R2 = .11; the subscale Disagree with Definition R2 = .13, and the subscale Fear, R 2 = .13. A summary of regression coefficients indicates only one (moral distress) of the 10 variables significantly contributed to the models predicting Medication Administration Error Subscale of Nursing Staffing, and Fear. For the Disagree with Definition subscale moral distress, compassion fatigue, and work status were the only variables that significantly contributed to the models. Focus group interview data revealed several themes including Process or Practice Issues, Staff Experience and Support, Negative Emotions and Other Nurses were identified as key in understanding medication error. Nurses did not relate moral distress or compassion fatigue to medication errors directly. This study contributed to the understanding of nurses' perceptions of medication error, moral distress, and compassion fatigue. Furthermore, an enhanced understanding of critical care nurses insight regarding medication error and power relations within the critical care environment was gained.

Document Type

Dissertation: Open Access



Included in

Nursing Commons