Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Chief Nursing Officers’ Experiences With Moral Distress

Prestia, Angela S. PhD, RN, NE-BC; Sherman, Rose O. EdD, RN, NEA-BC, FAAN; Demezier, Christopher

JONA: The Journal of Nursing Administration: February 2017 - Volume 47 - Issue 2 - p 101–107
doi: 10.1097/NNA.0000000000000447

OBJECTIVE This study explores if moral distress and its lingering residue were experienced by chief nursing officers (CNOs).

BACKGROUND Chief nursing officers, by virtue of their position and experience, are expected to uphold their professional values and act for the benefit of others. Exploration is needed to determine if the inability to do so contributes to the moral distress of these leaders.

METHODS Twenty CNOs were interviewed to determine the lived experience related to moral distress and moral residue. An interpretive phenomenological analysis approach was used.

RESULTS Six themes emerged describing CNO experience of moral distress including lacking psychological safety, feeling a sense of powerlessness, seeking to maintain moral compass, drawing strength from networking, moral residue, and living with the consequences.

CONCLUSION Moral distress is a common experience for CNOs. Although CNOs act with moral courage, they still experience moral distress. Further research and professional discussion are needed to support nurse executive leaders.

Author Affiliations: Corporate Chief Nurse (Dr Prestia), The GEO Group, Boca Raton, Florida; and Professor of Nursing (Dr Sherman) and Nursing Student (Mr Demezier), Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton; President, Florida Nursing Students Association, Orlando.

The authors declare no conflicts of interest.

Correspondence: Dr Prestia, The GEO Group, One Park Place, Suite 700, 621 SW 53 St, Boca Raton, FL 33487 (;

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.