Cumulative disasters have been shown to influence mental and physical health in both responders and victims, with studies showing associations in rates of depression and Post Traumatic Stress Disorder. Systemic problems that impact patient care such as limited resources, overcrowding of emergency rooms, and staffing shortages can be morally challenging for healthcare workers. Andrew Jameton, in 1984 defined Moral Distress (MD) as the inability of a moral agent to act according to his or her core values and perceived obligations due to internal and external constraints. Unresolved MD can create significant long-term debilitating physical and mental damage. Emergency medical providers on the island of Grand Bahama had the unique experience of responding to both the aftermath of Hurricane Dorian and the Covid-19 Pandemic. The aim of this study is to determine the prevalence of Moral Distress (MD) in Accident & Emergency (A&E) Physicians, Nurses, and Emergency Medical Service (EMS) staff at the Rand Memorial Hospital (RMH) in the Bahamas.

This is a descriptive, qualitative, prospective cross-sectional study, utilizing a three-part survey sent to participants. Sociodemographic information, Hurricane Dorian & Covid-19 experiences, and responses to a validated modified Moral Distress Scale will be collected and uploaded to a secure, encrypted data management program. The data will be analyzed using the most current IBM SPSS statistical analysis package. Descriptive and Inferential statistics will be used to determine the impact of Hurricane Dorian & Covid-19 on MD and its associated sociodemographic factors.

Data collection and analysis are planned for completion by March 1, 2023.

Addressing the causes of Moral Distress early can help improve healthcare systems’ resiliency by ensuring a healthy and supported workforce equipped with the resources to respond to future disasters.