Abstract: Objective: To investigate the working environment and moral distress of emergency and critical care nurses, and to analyze the relationship of working environment and moral distress. Methods: A convenience sample of 457 emergency and critical care nurses from 4 tertiary hospitals in Changsha were investigated by Practice Environment Scale and Moral Distress Scale. Results: The total score of working environment was 90.95±13.24, and the total score of moral distress was 53.98±35.89. Working environment was significantly negatively correlated with moral distress (P<0.01). Nurses' participation in hospital affairs and sufficient manpower and material resources in nursing work environment can independently explain 29.1% variation of moral distress after controlling demographic variables. Conclusion: The moral distress of emergency and critical care nurses is not optimistic, the working environment can predict moral distress partially, and the moral distress level could be relieved by improving the working environment.

Key words: emergency and critical care nurses; working environment; moral distress; relationship