Reliability and validity of the revised Rushton Moral Resilience Scale for healthcare workers

Moral Distress as Moral Heuristic Missing the Mark

I propose that moral distress may function as a moral heuristic, and one that misses its mark in signifying a fundamental source for nurses' moral suffering. Epistemic injustice is an insidious workplace wrongdoing that is glossed over or avoided in explicit explanations for nurse moral suffering and is substituted by an emphasis on the nurse's own wrongdoing. I discuss reasons and evidence for considering moral distress as a moral heuristic that obfuscates the role of epistemic injustice as a fundamental constraint on nurses' moral reasoning underlying moral suffering.

Moral Resilience Reduces Levels of Quiet Quitting, Job Burnout, and Turnover Intention among Nurses: Evidence in the Post COVID-19 Era

The aim of the study was to examine the impact of moral resilience on quiet quitting, job burnout, and turnover intention among nurses. A cross-sectional study was implemented in Greece in November 2023. The revised Rushton Moral Resilience Scale was used to measure moral resilience among nurses, the Quiet Quitting Scale to measure levels of quiet quitting, and the single-item burnout measure to measure job burnout. Moreover, a valid six-point Likert scale was used to measure turnover intention. All multivariable models were adjusted for the following confounders: gender, age, understaffed department, shift work, and work experience. The multivariable analysis identified a negative relationship between moral resilience and quiet quitting, job burnout, and turnover intention. In particular, we found that increased response to moral adversity and increased moral efficacy were associated with decreased detachment score, lack of initiative score, and lack of motivation score. Additionally, personal integrity was associated with reduced detachment score, while relational integrity was associated with reduced detachment score, and lack of initiative score. Moreover, response to moral adversity was associated with reduced job burnout. Also, increased levels of response to moral adversity were associated with lower probability of turnover intention. Moral resilience can be an essential protective factor against high levels of quiet quitting, job burnout, and turnover intention among nurses. This study was not registered.