Psychiatric nurses' experiences through the lens of moral reckoning theory: A qualitative study

Psychiatric nursing is a field in which moral distress is frequently encountered due to ethically complex care processes, institutional constraints, and structural challenges. This study aims to explore the experiences of psychiatric nurses within the framework of Nathaniel's Theory of Moral Reckoning.

This qualitative study was conducted using a directed content analysis approach. Data were collected through semi-structured interviews with 15 nurses working in psychiatric clinics. The analysis was structured according to the four stages of the theory: Ease, Situational Binds, Resolution, and Reflection.

Nurses were found to experience conflicts between institutional pressures and their ethical values, leading to diminished professional motivation in some cases. However, some nurses continued to strive to provide ethically appropriate care. During the reflection stage, participants questioned the emotional impact of their past decisions and reassessed their professional futures.

Moral reckoning plays a vital role in psychiatric nursing, shaping ethical integrity, professional identity, and emotional stability. Strengthening moral resilience and minimizing institutional barriers are crucial for sustaining ethically grounded, value-based nursing practice. This study enhances ethical awareness and promotes humane care by elucidating the experiences of moral conflict and ethical reckoning among psychiatric nurses.