The Role of Leadership in Supporting and Mitigating Moral Distress in Nursing: A Scoping Review

Introduction: Moral distress is a phenomenon that is increasing in nursing practice. Many factors can contribute to moral distress such as the quality of leadership, the rationing of care, the skill mix assigned to the unit or failure of leadership to respond to the nurse’s patient advocacy. While there is a significant amount of research on moral distress in nurses’ fewer studies have focused on the role of leadership in managing the moral distress experienced by Registered Nurses. 

Objective: To explore the relationship between leadership and moral distress in nursing, to identify the role of leadership in supporting and mitigating moral distress. 

Inclusion Criteria: Studies published from 2022–November 2024 were included. The populations were Registered Nurses, and the phenomenon of interest is the role of leaders in supporting nurses and mitigating moral distress. 

Methods: A scoping review using Arksey and O’Malley five-stage framework. 

Results: From the 2892 records retrieved, 20 met the inclusion criteria. Three themes were identified: (1) Qualities of the manager, (2) Workload and resource management, and (3) Culture and values. 

Conclusion: Nurse leaders play an important role in supporting nursing staff through distressing events and situations. Nurse managers must display qualities of a good leader, including being authentic and ethical in decision-making. Nurse leaders must work between policy and procedure requirements and the needs of individual staff to support a wider culture of safety and advocacy.