Strategies of Iranian Psychiatric Nurses to Deal with Moral Distress.

Context: Moral distress is a common phenomenon in nurses that causes feelings of anger, fatigue, reduced quality of patient care, and leaving the nursing profession. To reduce the negative effects of this phenomenon, it is necessary to study the strategies and mechanisms to deal with it. Aims: It has been less studied in psychiatric nurses, so this study was conducted to investigate the mechanisms and strategies of psychiatric nurses in dealing with situations of moral distress. Settings and Design: This qualitative study was conducted based on a conventional content analysis of 12 psychiatric nurses selected by a purposive sampling method in the 2020 winter in Shiraz, Iran, considering the maximum diversity. Data were collected through semi-structured interviews with participants for an average of 40-60 minutes per interview until data saturation. Results: We obtained strategies for dealing with moral distress in psychiatric nurses in four categories. The categories included "Coping strategies," "Establish therapeutic and professional communication," "Managerial support for nurses," and "Commitment to religious beliefs." Conclusions: Psychiatric nurses use personal, team, and management strategies to reduce moral distress in themselves and their colleagues and reduce its adverse effects on patients. Management support and organizational cooperation are necessary for the better implementation of these strategies.