title: Nurses' moral strength: a hermeneutic inquiry in nursing practice.
abstract: 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.
authors.affiliation: Department of Health Studies, Faculty of Social Sciences, University of Stavanger, Norway. inga-britt.lindh@hkr.se
authors.forename: Inga-Britt
authors.initials: IB
authors.lastname: Lindh
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Severinsson
authors.forename: Agneta
authors.initials: A
authors.lastname: Berg
mesh_terms: 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