Background Moral distress, the phenomenon in which an agent is constrained in acting on their ethical choice, is a reoccurring theme in the literature on nurses' experiences of end-of-life care (EOLC). Understanding moral engagement solely through a lens of moral distress can be limiting—as such, we sought to explore the diverse experiences nurses consider ethically meaningful in their palliative and EOLC practice. Purpose and Methods This article presents an exploration and analysis of stories told to us, within an interpretive description study, by five nurses practicing in EOLC in diverse settings across Canada. Although these stories were told to us in a research context, the purpose of this theory article is to explore what these stories demonstrate about the moral engagement of nurses caring for dying patients. Findings Our analysis suggests that while moral distress is a feature of nursing stories, so too are many other dimensions of moral experience, including resilience, responsibility, and care. Implications for Practice Expanding how we understand nurses' moral engagement in the care of dying patients has implications for how we account for the many responsibilities that nurses shoulder in striving to provide “good” care to people at the end of life.

中文翻译：

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护士对具有伦理意义的临终关怀的道德体验：痛苦、复原力、责任和关怀。

背景 道德困扰，即代理人在其伦理选择上受到限制的现象，是护士临终关怀 (EOLC) 体验文献中反复出现的主题。仅仅通过道德困境的视角来理解道德参与可能是有限的——因此，我们试图探索护士认为在姑息治疗和 EOLC 实践中具有伦理意义的各种体验。目的和方法 本文在解释性描述研究中，对加拿大不同环境中在 EOLC 中执业的五名护士向我们讲述的故事进行了探索和分析。尽管这些故事是在研究背景下向我们讲述的，但这篇理论文章的目的是探讨这些故事所展示的关于护理垂死患者的护士的道德参与。结果 我们的分析表明，虽然道德困扰是护理故事的一个特征，但道德体验的许多其他方面也是如此，包括韧性、责任感和关怀。实践意义 扩展我们如何理解护士在护理临终病人时的道德参与，对我们如何解释护士在努力为临终病人提供“良好”护理时所肩负的许多责任具有重要意义。