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"Teaching without time to think": An interpretive qualitative study of academic identity, moral distress, and
Sayed Ibrahim Ali1, Mostafa Shaban2
1Department of Family and Community Medicine, College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia.
Background:
Nursing and midwifery education is being reshaped by rapid higher education and health system reforms that prioritise teaching delivery, accountability, and performance reporting. While educator workforce concerns are often framed as workload and capacity problems, less is known about how reform pressures disrupt nurse educators' academic identity and moral integrity, with implications for long-term workforce sustainability.
Aim:
To explore how reform-related pressures influence academic identity, experiences of moral distress, and perceptions of sustainability among nurse educators.
Design:
Interpretive qualitative study.
Settings:
A public university nursing education context within a rapidly reforming health and higher education system.
Participants:
Nurse educators (n = 15) purposively sampled to reflect variation in academic role and experience.
Methods:
Semi-structured interviews were conducted, audio-recorded, and transcribed verbatim. Data were analysed using reflexive thematic analysis. Strategies to enhance trustworthiness included reflexive journaling, team discussion of theme development, and an audit trail.
Results:
Three interconnected themes were identified. Moral distress and compromised values captured ethical tension and emotional burden when educators felt constrained from providing the quality of teaching, assessment, and student support they considered professionally necessary. From scholar to service provider described erosion of academic identity under intensified teaching and administrative demands, reduced scholarly time, and diminished autonomy. Sustainability under strain reflected questioning of long-term academic careers, reduced mentoring capacity, and concerns about the future nurse educator workforce. Participants repeatedly characterised their work as "teaching without time to think."
Conclusions:
Reform-related pressures threaten nurse educator sustainability not only through workload but through identity disruption and moral distress. Workforce strategies should protect time for scholarly engagement, strengthen mentoring infrastructures, and create organisational conditions that support ethical teaching practice to sustain nursing education quality under reform.
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