Alice K Maranga, Sylvia K Abunga, Catherine Syombua Mwenda, Vincent k Mukthar


Introduction: Ethics have been regarded as a vital part of nursing as a profession since the beginning of modern nursing, starting with the era of Florence Nightingale. Ethical distress occurs when ethical problems arise among nurses in different situations such as when they have to make decisions on life-sustaining treatment. Different factors such as hospital policies can give rise to ethical problems. These problems clearly lead to ethical distress among nurses who have to make different decisions with regard to patients’ care; ethical action can be described as listening to patients, putting their needs first and upholding confidentiality. The aim of this study was to describe ethical distress as perceived by nurses in Kenya.

Methods: The study was done at Kenyatta National Hospital, Machakos and Kisii County Referral Hospitals A qualitative phenomenological design was used. Convenience sampling was used to select the hospitals and informants from a population of registered nurses who had experienced situations in the clinical area believed to be causing ethical distress. Data was collected using in-depth interviews and Focus Group Discussions. Data was then subjected to thematic content analysis.

Results: The informants perceived ethical distress as moral uncertainty, ethical dilemmas and moral distress all of which explained their understanding of ethical distress.

Conclusion: Nurses in Kenya have experienced ethical distress regardless of their age, position, number of trainings attended or years of work experience. The two overarching causes of ethical distress among Kenyan nurses are the scarcity of resources and overwhelming workload.

Keywords: Ethical, Distress, Nurses, Kenya.


Ethical, Distress, Nurses, Kenya

Full Text:



Anderson, L. M., Scrimshaw, S. C., Fullilove, M. T., Fielding, J. E., & Normand, J. (2003). Culturally competent healthcare systems: A systematic review. American Journal of Preventive Medicine, 24(3), 68-79. Retrieved from

Corley, M. C. (2002). Nurse moral distress: A proposed theory and research agenda. Nursing Ethics, 9(6), 636-650.Retrieved from

Corley, M.C., Minick, P., Elswick, R. K., & Jacobs, M. (2005).Nurse moral distress and ethical work environment. Nursing Ethics, 12(4), 381-390.Retrieved from

Epstein, E. G., & Delgado, S. (2010). Understanding and addressing moral distress. Online Journal of Issues in Nursing, 15(3). DOI: 10.3912/OJIN.Vol15No03Man01

Fant, C., (2012). Major ethical dilemmas in nursing. Nurse Together. Retrieved from

Harrowing, J. N., & Mill, J. (2010). Moral distress among Ugandan nurses providing HIV care: a critical ethnography. International Journal of Nursing Studies, 47(6), 723-731. DOI:

Kafulafula, U. K., Hami, M., & Chodzaza, E. (2006). The challenges facing nurse midwives in working towards safe motherhood in Malawi. Malawi Medical Journal, 17(4), 125-127. Retrieved from

Kenya Nurse Workforce Report. (2012).The status of nursing in Kenya. Retrieved from:

Pauly, B., Varcoe, C., Storch, J., & Newton, L. (2009). Registered nurses’ perceptions of moral distress and ethical climate. Nursing Ethics, 16(5), 561-573. DOI: 10.1177/0969733009106649

Silén, M. (2011).Encountering ethical problems and moral distress as a nurse: Experiences, contributing factors and handling. Retrieved from

Shahriari, M., Mohammadi, E., Abbaszadeh, A., & Bahrami, M. (2013). Nursing ethical values and definitions: A literature review. Iranian Journal of Nursing and Midwifery Research, 18(1), 1. Retrieved from

Wadensten, B., Wenneberg, S., Silén, M., Tang, P. F., & Ahlström, G. (2008). A cross-cultural comparison of nurses' ethical concerns. Nursing Ethics, 15(6), 745-760.DOI: 10.1177/0969733008095385

West, J. (2007). Ethical issues and new nurses: preventing ethical distress in the work environment. The Kansas Nurse, 82(4), 5-8. Retrieved from

Woods, M. (2014).Beyond moral distress preserving the ethical integrity of nurses. Nursing Ethics, 21(2), 127-128.DOI: 10.1177/0969733013512741


  • There are currently no refbacks.

Copyright (c) 2017 Kenyan Journal of Nursing & Midwifery

© Numid Publishers        ISSN:  2518-8631