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Abstract

In Long-Term Care (LTC) regulated nurses are exposed to many workplace stressors, placing them at a heightened risk for experiencing moral distress. Regulated nurses working in LTC are reported to be leaving the profession at alarming rates due to increased moral distress, creating concerns for the LTC sector. The purpose of this research study was to synthesize the existing research literature on contributing factors and mitigating strategies related to moral distress experienced by regulated nurses in LTC. This scoping review was conducted using databases (i.e., CINAHL and Medline) between December 2015 and December 2025. The findings showed five organizational and one individual level contributing factors: (1) organizational constraints and resource limitations, (2) efficiency-driven organizational culture, (3) hierarchical power structures and lack of autonomy, (4) ethical conflict in clinical decision-making, (5) family influence and competing obligations, and (6) individual moral awareness and self-reflection. There was limited research on mitigating strategies for reducing moral distress experienced by LTC regulated nurses. Further research is needed to identify and evaluate effective mitigation strategies that support the psychological wellbeing of the nursing workforce in LTC, thereby enhancing the quality and safety of care provided to residents.