Nurses' moral strength: a hermeneutic inquiry in nursing practice.
OBJECTIVE
This paper is a report of a study to interpret nurses' experiences of moral strength in practice.


BACKGROUND
Moral strength is said to be beneficial in providing nursing care for patients, thereby contributing to high qualitative care. However, few studies focus on the meaning of nurses' moral strength.


METHODS
This study included eight Registered Nurses working in different aspects of health care in southern Sweden. Individual interviews were conducted in 2006 and 2007. We recorded, transcribed verbatim, and interpreted the interviews by a method grounded in hermeneutics.


RESULTS
Three themes were interpreted on three different levels: the action level as 'having courage to act on one's convictions', the relational level as 'being attentive and recognizing vulnerability', and the existential level as 'facing the unpredictable'. Overall, moral strength was understood as a driving force to be someone special in the care of patients, i.e. someone who makes a difference.


CONCLUSIONS
The value of nurses' moral strength in patient care should be recognized. Attention must be given to aspects outside the individual, e.g. professional and institutional processes that influence the work environment. Clinical team supervision can help make such processes visible and supportive.
Lindh
Inga-Britt
IB
Department of Health Studies, Faculty of Social Sciences, University of Stavanger, Norway. inga-britt.lindh@hkr.se
Severinsson
Elisabeth
E
Berg
Agneta
A
D001291:Attitude of Health Personnel; D004993:Ethics, Nursing; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009014:Morals; D009723:Nurse-Patient Relations / Q000941:ethics; D009732:Nursing Care; D009741:Nursing Staff, Hospital / Q000941:ethics / Q000523:psychology*; D017009:Professional Autonomy