The Consequences of Moral Courage in Nursing: A Narrative Inquiry

To holistically illustrate the consequences of nurses' morally courageous acts for patients, nurses, and work communities.

Narrative inquiry was used to explore the topic in the context of encountering ethical conflicts in nursing care. Consequences of nurses' morally courageous acts were illustrated to understand the significance of the acts for the good of patients, nurses, and work communities.

Ethical approval was received from the University's ethical committee. The participants were registered nurses who gave their informed consent to participate voluntarily.

Individual in-depth interviews with fourteen registered nurses of varying working experience were conducted in January-February 2023. Data were analysed inductively with holistic content analysis. This report follows the Consolidated criteria for reporting qualitative research (COREQ).

Nurses demonstrated moral courage in ethical conflicts such as disrespectful behaviour, collaboration issues, missed care, and privacy violations. In doing so, they initiated discussions, completed written reports, admitted mistakes, and provided attentive patient care. Morally courageous acts helped mitigate the ethical conflicts, although some remained unresolved. The direct and indirect consequences were positive and negative for nurses who acted, and positive for patients and the work community.

The nurses considered the consequences of morally courageous acts for themselves and others, expressing their experiences, which excluded other people's perspectives. The complexity of the topic posed challenges in reporting the findings coherently, with only a few concepts.

Nurses act morally courageously in varying ethical conflicts, indicating that they can defend morally responsible conduct. The consequences identified in this study highlight the potential for nurses who act morally courageously to promote well-being among patients and professionals. However, complex ethical conflicts cannot always be resolved with one courageous act. Thus, healthcare organisations can aim to develop processes that facilitate nurses acting morally courageously and that enhance multi-professional collaboration in ethical conflicts.