title: A theoretical argumentation on the consequences of moral stress.
abstract: BACKGROUND
  Intensive care units are characterized by heavy workloads, increasing work complexity and ethical concerns related to life-and-death decisions. In the present study, it is assumed that there is a relationship between moral stress, support and competence for nurses in intensive care units.
  
  
  OBJECTIVE
  To analyse and describe the theoretical relationship between moral stress and support on the one hand and competence on the other, in the context of intensive care.
  
  
  METHODS
  A form of qualitative secondary analysis based on the findings from three original studies. In the analytic process a theory on professional competence was used.
  
  
  RESULTS
  The findings suggest that imbalance due to moral stress between different competences hinders the development of collectively shared caring competence.
  
  
  CONCLUSIONS
  Moral stress cannot be totally eliminated in the intensive care unit. But moral stress is not only a problem. It can also become a driving force to stimulate competence.
authors: Department of Health Care Sciences, Ersta Sköndal University College, Stockholm, Sweden. agneta.cronqvist@esh.se
authors: Agneta
authors: A
authors: Cronqvist
authors: Maria
authors: M
authors: Nyström
mesh_terms: D000223:Adaptation, Psychological; D001291:Attitude of Health Personnel; D002055:Burnout, Professional / Q000209:etiology / Q000517:prevention & control / Q000523:psychology*; D002983:Clinical Competence; D003220:Conflict, Psychological; D003299:Cooperative Behavior; D003422:Critical Care / Q000941:ethics / Q000458:organization & administration / Q000523:psychology; D003657:Decision Making; D004645:Empathy; D028663:Ethical Theory; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007400:Interprofessional Relations; D009014:Morals; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000941:ethics / Q000523:psychology; D009742:Nursing Theory; D011582:Psychological Theory; D036301:Qualitative Research; D012307:Risk Factors; D020377:Self Efficacy; D012944:Social Support; D011795:Surveys and Questionnaires; D013548:Sweden