Silent struggles: Nurses experience of moral distress
| Thursday, May 21, 2026 |
| 4:40 PM - 4:41 PM |
Speaker
Ms Andrea Grimes
Lecturer
James Cook University
Silent struggles: Nurses experience of moral distress
Abstract Document
Emergency departments (ED) serve as the primary entry point for individuals requiring urgent medical care. However, for patients experiencing a mental health crisis, the fast-paced, high-turnover nature of the ED is often ill-suited to provide safe, therapeutic support. Over half (52%) of mental health-related ED presentations arrive via emergency services, compared to 26% of general ED presentations. Extended waiting times for admission or discharge are distressing not only for patients and their families but also for ED staff, who often lack the resources and support to manage complex mental health needs. Chronic underinvestment in mental health services has left EDs as the only accessible option for many in crisis.
Moral distress is a common experience in complex healthcare environments. Nurses working in emergency departments (EDs) are increasingly vulnerable due to systemic pressures such as the need to do more with fewer resources. With these demands is the unknown effect of emotional, psychological, ethical and moral labour toll that can be associated with nursing in this environment.
Moral injury can result from sustained or repeated moral distress. The recent redefinition by VanderWeele et al. expands moral injury to include distress arising from threats to one’s sense of goodness—of self, others, institutions, or higher powers—and from violations of deeply held moral beliefs. This broader framework may offer nurses a more resonant lens through which to understand their experiences.
Despite the prevalence of these challenges, limited data exists on nurses’ experiences when caring for patients in mental health crises. Understanding these experiences is essential to addressing the emotional and ethical toll they face.
This presentation will discuss a research project exploring moral injury among ED nurses caring for patients in mental health crisis. By amplifying nurses’ voices, we aim to illuminate the hidden emotional labour of emergency care—and advocate for systemic change that honours both patient and provider wellbeing.
Moral distress is a common experience in complex healthcare environments. Nurses working in emergency departments (EDs) are increasingly vulnerable due to systemic pressures such as the need to do more with fewer resources. With these demands is the unknown effect of emotional, psychological, ethical and moral labour toll that can be associated with nursing in this environment.
Moral injury can result from sustained or repeated moral distress. The recent redefinition by VanderWeele et al. expands moral injury to include distress arising from threats to one’s sense of goodness—of self, others, institutions, or higher powers—and from violations of deeply held moral beliefs. This broader framework may offer nurses a more resonant lens through which to understand their experiences.
Despite the prevalence of these challenges, limited data exists on nurses’ experiences when caring for patients in mental health crises. Understanding these experiences is essential to addressing the emotional and ethical toll they face.
This presentation will discuss a research project exploring moral injury among ED nurses caring for patients in mental health crisis. By amplifying nurses’ voices, we aim to illuminate the hidden emotional labour of emergency care—and advocate for systemic change that honours both patient and provider wellbeing.
Biography
Andrea Grimes is a Registered Nurse and Lecturer in Nursing and Midwifery at James Cook University, based in Cairns. She holds a Master of Public Health and Tropical Medicine. Andrea’s teaching and research focus on mental health nursing in regional, rural, and remote contexts. She has recently commenced her PhD, which explores the concept of moral injury among emergency department nurses caring for patients in mental health crisis. She is passionate about supporting the wellbeing of frontline healthcare workers and advancing compassionate, evidence-based mental health care.
