Nearly half of the New Zealand nurses surveyed in a Massey University study have considered quitting the profession because of "moral distress", and Palmerston North nurses are no exception.

Of the 412 hospital-based New Zealand nurses who took part in the survey, the first of its kind in New Zealand, 48 per cent had considered leaving their jobs because their ethical judgments were often tested at work.

"It's very disturbing," said Dr Martin Woods, a nursing ethics and education expert at Massey's Palmerston North campus.

"Half the nursing workforce at some stage have had such moral disquiet that they wanted to leave. It shows moral distress is a reality nurses are struggling with and they are really struggling. Stories of burnout and leaving not just a given position but nursing itself must be taken seriously."

Dr Woods said moral distress in nurses included being unprepared for the complexities of an ethical dilemma, such as prioritising a patient's needs, lack of peer or managerial support and difficult working conditions.

He said moral or ethical distress could lead to depression, burning out and stress.

"However, the research findings showed that in nearly all cases it is the institutional constraints, and not personal factors, that cause distress for nurses when they confront moral issues in the workplace."

Palmerston North nurses were "frustrated" and over-worked, New Zealand Nurses' Organisation organiser Donna Ryan said.

"We've got the hospital consistently at full capacity and our nurses are being asked to do double shifts all the time to keep up with the demand and it leads to tiredness and resulting in issues for the individual," she said.

"They're consistently not being able to do their best. This really adds to their frustration."

There are 1069 nurses working for the MidCentral District Health Board.

She said the Government's target of getting as many patients off waiting lists as soon as possible was causing headaches for staff.

"No nurses want to say no, because they'll be letting down their team.

"The retention rate in Palmerston North is not too bad, but I think the economic recession has meant a lot of people have chosen to stay in employment. They're front-line staff and they're being worked to the max."

Mrs Ryan said nurses' biggest fear was making a mistake, because of exhaustion.

A MidCentral Health spokesman said he was unable to provide comment on the survey.

The survey suggested New Zealand nurses faced five major issues. The most frequent was having to deliver less-than-optimal care because of cost-cutting and pressure from management. Others included having to watch patients suffer because of a lack of provider continuity or competence, and having to carry out orders they thought were unnecessary or prolonged the dying process.

It also found 16 per cent of those nurses were thinking about leaving their clinical positions. Dr Woods said it was the first time a survey of this nature had been conducted in New Zealand. The results of the survey will be used by researchers to develop guidelines.

- © Fairfax NZ News