Table 2.

Sources of moral distress with median score greater than zero

Experience	Median*	Mean
Experience compromised patient care due to lack of resources/equipment/bed capacity.	3	4.2
Witness low quality of patient care due to poor team communication.	3	3.8
Follow the family’s insistence to continue aggressive treatment even though I believe it is not in the best interest of the patient.	3	3.7
Be required to care for more patients than I can safely care for.	2	3.8
Watch patient care suffer because of a lack of provider continuity.	2	3.4
Have excessive documentation requirements that compromise patient care.	1	3.7
Experience lack of administrative action or support for a problem that is compromising patient care.	1	3.3
Fear retribution if I speak up.	1	3.2
Feel pressured to order or carry out orders for what I consider to be unnecessary or inappropriate tests and treatments.	1	2.8
Participate on a team that gives inconsistent messages to a patient/family.	1	2.8
Be unable to provide optimal care due to pressures from administrators or insurers to reduce costs.	1	2.8
Be required to care for patients who have unclear or inconsistent treatment plans or who lack goals of care.	1	2.8
Be required to work with abusive patients/family members who are compromising quality of care.	1	2.8
Be required to work with other healthcare team members who are not as competent as patient care requires.	1	2.4
Witness healthcare providers giving “false hope” to a patient or family.	1	2.2

* Median and mean of item scores on Measure of Moral Distress for Healthcare Providers. Possible item scores range from 0 to 16