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Moral Distress, Professional Burnout, and Potential Staff Turnover in Intensive Care Nursing Practice in Latvia—Phase 1

Author

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  • Olga Cerela-Boltunova

    (Department of Nursing and Midwifery, Riga Stradiņš University, LV-1067 Rīga, Latvia)

  • Inga Millere

    (Department of Nursing and Midwifery, Faculty of Health and Sports Sciences, Riga Stradiņš University, LV-1067 Rīga, Latvia)

  • Evija Nagle

    (Department of Health Psychology and Pedagogy, Rīga Stradiņš University, LV-1009 Rīga, Latvia)

Abstract

Burnout and moral distress are increasingly recognized as critical challenges within healthcare systems, particularly in high-stress environments such as intensive care units (ICUs). This cross-sectional study investigates the prevalence and interrelationships of moral distress, burnout, and turnover intentions among ICU nurses in Latvia, a country facing significant nursing shortages and structural workforce challenges. A total of 155 ICU nurses completed validated instruments assessing moral distress, the three subscales of burnout (personal, work-related, and client-related), and intentions to leave the profession. The results indicate that 68.2% of respondents experienced moderate to high levels of moral distress, especially related to providing aggressive treatment contrary to clinical judgment. Burnout scores were highest in the personal and work-related dimensions, with emotional exhaustion strongly correlated with moral distress. Approximately 30% of participants reported active intentions to leave their positions. Regression and mediation analyses confirmed that moral distress significantly predicted both burnout and turnover intentions, with burnout partially mediating this relationship. These findings highlight urgent risks not only to nurse well-being but also to healthcare quality and sustainability. This study underscores the importance of systemic interventions, including structured workload assessment tools, psychological support, and ethical consultation services. The results contribute to the international literature and offer context-specific insights for workforce resilience in Eastern European health systems.

Suggested Citation

  • Olga Cerela-Boltunova & Inga Millere & Evija Nagle, 2025. "Moral Distress, Professional Burnout, and Potential Staff Turnover in Intensive Care Nursing Practice in Latvia—Phase 1," IJERPH, MDPI, vol. 22(8), pages 1-25, August.
    • Handle: RePEc:gam:jijerp:v:22:y:2025:i:8:p:1261-:d:1722686
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    References listed on IDEAS

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    1. Noemi Giannetta & Giulia Villa & Loris Bonetti & Sara Dionisi & Andrea Pozza & Stefano Rolandi & Debora Rosa & Duilio Fiorenzo Manara, 2022. "Moral Distress Scores of Nurses Working in Intensive Care Units for Adults Using Corley’s Scale: A Systematic Review," IJERPH, MDPI, vol. 19(17), pages 1-13, August.
    2. Anna Maria Cybulska & Monika Anna Żołnowska & Daria Schneider-Matyka & Marta Nowak & Małgorzata Starczewska & Szymon Grochans & Aneta Cymbaluk-Płoska, 2022. "Analysis of Nurses’ Attitudes toward Patient Death," IJERPH, MDPI, vol. 19(20), pages 1-16, October.
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    1. Olga Cerela-Boltunova & Inga Millere, 2025. "Exploring the Relation Between Nursing Workload and Moral Distress, Burnout, and Turnover in Latvian Intensive Care Units: An Ecological Analysis of Parallel Data," IJERPH, MDPI, vol. 22(9), pages 1-19, September.

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