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Moral Distress in Nurses Caring for Undocumented Immigrants: A Concept Analysis
Rachael Salguero1, Lisa Cross2
1MGH Institute of Health Professions, Boston, MA, USA rhylersalguero@mghihp.edu.
Research and Theory for Nursing Practice
|June 3, 2026
Summary
Moral distress significantly impacts nurses caring for undocumented immigrants (UIs). Systemic barriers and ethical conflicts lead to burnout and affect patient care, highlighting the need for targeted interventions.
Area of Science:
- Nursing Ethics
- Healthcare Disparities
- Concept Analysis
Background:
- Moral distress is a critical issue for nurses.
- Caring for undocumented immigrants presents unique ethical challenges.
Purpose of the Study:
- To analyze the concept of moral distress in nurses caring for undocumented immigrants.
- To define attributes, antecedents, and consequences of this phenomenon.
Main Methods:
- Concept analysis using Walker and Avant's method.
- Literature search of nursing and healthcare databases (2015-2025).
- Identification and analysis of eight relevant articles.
Main Results:
- Key attributes include moral awareness, constraints, distress, and role conflict.
- Antecedents involve ethical obligations and barriers faced by undocumented immigrants.
- Consequences encompass emotional distress, burnout, compromised care, and identity questioning.
Conclusions:
- Moral distress is prevalent and understudied in nurses caring for undocumented immigrants.
- Systemic constraints and ethical conflicts have profound personal and professional impacts.
- Need for conceptual clarity and adapted empirical tools for interventions.
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