ArticleNursing ethics2023
Meanings of troubled conscience in nursing homes: nurses' lived experience.
Article in Nursing ethics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 16 citations in OpenAlex.
- Changes in nurses' quality of work life prior to and during COVID: A repeated cross-sectional analysis.International journal of nursing studies advances · 2026Article
- Nursing care and moral distress among nordic nurses: a scoping review of ethical challenges in contemporary clinical practice.BMC nursing · 2026Article
- Professionals' ideals of care in the context of technological innovation in healthcare, a focus group study.BMC nursing · 2025Article
- Nurses' perception of troubled conscience in intensive care units: a qualitative study.BMC nursing · 2024Article
- "Just pee in the diaper" - a constructivist grounded theory study of moral distress enabling neglect in nursing homes.BMC geriatrics · 2024Article
- Psychometric evaluation of the Persian version of the perception of conscience questionnaire in Iranian nurses.Journal of medical ethics and history of medicine · 2023Article
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTroubled conscience among nurses and other healthcare workers represents a significant contributor to healthcare worker moral distress, burnout and attrition. While research in this area has examined critical care in hospitals, less knowledge has been obtained from long-term care contexts such as nursing homes, despite widely recognised challenges with regard to vulnerable patients, increasing workload and maintaining workforce sustainability among nurses.
objectiveThe aim of this study was to illuminate and interpret the meaning of the lived experience of troubled conscience among registered nurses (RNs) working in nursing homes. RESEARCH
designThis qualitative research employed narrative interviews with eight nurses to obtain essential meanings of their lived experiences of troubled conscience. The interview texts were analysed using a phenomenological hermeneutic approach. ETHICAL CONSIDERATIONS: Participation was voluntary, informed and was conducted with written consent. The Norwegian Centre for Research Data approved the data processing of personal data.
findingsThe analysis uncovered two themes: (1) troubled conscience means abandoning ideals, with the subthemes: failing dependent patients; being disloyal to colleagues; being inadequate in the performance of work tasks and (2) troubled conscience means facing realities, with the subthemes: accepting being part of the system; responding to barriers. DISCUSSION: Troubled conscience meant experiencing continuous and simmering tension between one's ideals and realities and feeling a drive to preserve accountability and one's moral integrity. Endangered ideals were often under cross-pressure and included humanistic values, professional values, working life values and the values of the organisation.
conclusionNurses' troubled conscience refers to a struggle, but also a force that plays out at various levels and arenas in long-term care. Openness and dialogue about how professional values and the welfare state's intentions can be realised within the given framework are important for individual nurses' occupational health as well as the quality of care provided to patients.
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