Background: Moral distress is a common phenomenon in nursing profession and emergency nurses are constantly faced with moral distress in emergency situation. According to the kind of ward and the kind of the hospital, cause of its frequency, intensity and effect is different. This study was conducted to investigate the triple dimensions of moral distress and some related factors in nurses those working in emergency department.

Materials and methods: This cross- sectional study was carried out using census sampling on 125 nurses those working in 7 emergency department of non- teaching hospitals in Guilan province in 2015. Data were collected using the standard Hamric’s moral Distress Scale (2012) and have been analyzed by ANOVA, Pearson Correlation and T- test using SPSS 21 software.

Results: The mean score for the frequency of moral distress, the intensity of moral distress and the effect of moral distress were 1.4±0.58, 1.7±0.92 (of 4), and 3.4±2.8 (of 16), respectively. The results indicated that emergency nurses experienced a moderate level of distress. Based on Pearson correlation, there was a significant positive correlation between the number of nurses, the number of bed in emergency department and the triple dimensions of moral distress (P<0.01).

Conclusion: Moral distress in emergency department is accompanied by many disadvantages that have negative effects on nurses in various aspects, nurses’ profession and on hospital climate. Therefore, managers, the planners and the decision-makers in the field of health, should consider this ethical issue at the macro level and suggest appropriate programs to prevent of these issues.

Keywords: Moral distress, Emergency nurse, Non- teaching hospital.