Date of Completion

Spring 4-10-2022

Thesis Advisor(s)

Dr. Valarie A. Artigas, DNP, APRN, NNP-BC, Assistant Clinical Professor

Honors Major



Maternal, Child Health and Neonatal Nursing


Background: Opioid Use Disorder (OUD) is both a physical and psychological dependence on opioids. When a woman with OUD becomes pregnant, Neonatal Abstinence Syndrome (NAS) can occur in her child. NAS occurs when the infant shows manifestations of withdrawal, due to the exposure to opioids in the womb being abruptly discontinued once born. Nurses that care for mothers with OUD and their infants with NAS report varying degrees of moral distress related to preexisting stigmas, a lack of education on the chronic disease of addiction, and the multitude of ethical dilemmas experienced while caring for this vulnerable population of mothers and infants.

Purpose: To explore the frequency and intensity of moral distress among neonatal intensive care unit (NICU) nurses when caring for infants with NAS.

Methods: A mixed-methods study was conducted by administering a survey consisting of multiple-choice questions, open-ended questions, and the Moral Distress Scale (MDS-R) pediatric version to a group of Neonatal Intensive Care (NICU) nurses. The survey consisted of 10 multiple choice questions that were followed by open-ended responses where participants were asked to explain the reasoning for their answers to the multiple-choice questions. The Moral Distress Scale instrument was used to quantify the frequency and intensity of moral distress experienced by the nurses.

Results: Findings illustrate that NICU nurses that care for infants with NAS whose mothers utilized illicit drugs during pregnancy experience varying levels of moral distress.