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Nurses' experiences of moral suffering: A qualitative interview study
Anna-Henrikje Seidlein1, Michael Schilder2, Radia Miskine2
1Institute of Ethics and History of Medicine, University Medicine Greifswald, Greifswald, Germany.
Nursing Ethics
|November 24, 2025
Summary
Nurses experience moral suffering, encompassing moral distress and injury, due to complex triggers and personal factors. Understanding its multidimensional essence is key for effective healthcare interventions and promoting workplace well-being.
Area of Science:
- Nursing Ethics
- Healthcare Professional Well-being
- Qualitative Research Methods
Background:
- Moral suffering, including moral distress and injury, significantly impacts nurses' professional integrity and health.
- Lack of consensus on definitions and causes of moral suffering hinders effective interventions.
- Joint consideration of overlapping concepts may refine understanding and inform practice.
Purpose of the Study:
- To explore nurses' perceptions of moral suffering in clinical practice.
- To analyze the essential nature of nurses' experiences with moral suffering.
Main Methods:
- Qualitative, semi-structured online interviews were conducted.
- Data from 47 registered nurses in German hospitals were analyzed using qualitative content analysis.
Main Results:
- Moral suffering was defined by five categories: trigger situation, moral disposition, moral meaningfulness assessment, experience dimensions (characteristics, integrity, action), and consequences.
- Key characteristics include dynamism, context-dependence, temporality, and ambiguity.
- Experience dimensions encompass rational/emotional integrity and handling/coping/prevention strategies.
Conclusions:
- Moral suffering in nursing is a complex, multidimensional phenomenon influenced by personal and professional factors.
- A systemic approach is needed, emphasizing ethical leadership and workplace health promotion.
- Fostering shared values within healthcare teams is crucial for addressing moral suffering.
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