Nancy K. Dunn

Date of Award


Degree Name

Educational Leadership


College of Education

Type of Degree


Document Type


First Advisor

Dennis P. Prisk

Second Advisor

Laurie Badzek

Third Advisor

Robert Bickel

Fourth Advisor

Barbara Nicholson

Fifth Advisor

Linda Spatig


Technological changes, interpersonal relationships, and scarce resources have created a complex environment for health professionals. Nurses, as the largest group of health care providers, are confronted with moral issues when dealing with managed care policies, end-of-life care and workplace or institutional issues. Moral issues are expressed as moral distress, which has been linked to decreased satisfaction, termination of employment and leaving the profession of nursing altogether. Moral distress, therefore, decreases the number of nurses and contributes to the critical nursing shortage. The purpose of this study was to examine the relationships, if any, among the types, frequency and resolution of moral issues perceived by nurses in West Virginia and their educational preparation, educational needs, and selected demographics. Nurses from West Virginia reported staffing patterns that limited patient access to the nurse as the most disturbing moral issues in the workplace. Significant relationships (p < .05) were found among independent variables of interest and end-of-life, direct care, and human rights conflicts. Nurses who worked closest to the patient (staff nurses) were more likely to express moral distress than those with advanced practice status. Nurses with higher degrees and those who worked part-time experienced less distress. Nurses in this West Virginia sample recommended ethics components for all educational programs.


Nursing ethics - West Virginia.