Razi Journal of Medical Sciences

    Background & Aim: Factors such as improved medical technology, resource allocation, increasing costs, individual rights, and the changing role of a nurse can result in ethical conflicts that require the nurse’s abilities to recognize moral dilemmas and conflicts and make appropriate ethical decisions. The goal of this article is describing stress as the major reaction of nurses to the context of ethical decision making in taking care of patients. Patients & Method: The present study was conducted by using grounded theory method. The participants were 17 Iranian nurses working in medical and educational hospitals. Semi-structured, unstructured and in-depth interviews were used for data gathering. All interviews were transcribed verbatim and simultaneously and coded according to Strauss and Corbin method (open, axial and selective coding). Results: Job stress and moral distress were identified as the major reaction of nurses to the context of ethical decision making. The participants believed that decision making context consisting of individual and job characteristics, patient and patient's family features, physician’s traits, and structural and management conditions plays an important role in nurses' stress and their inability to respond morally to patient and patient's family needs and optimal caring for patients. Conclusion: Because of the negative effects of stress on physical and mental health of nurses, it is necessary that they consider the context in their own decisions. Also, the agents who are involved in structural conditions and nursing management should attempt to reform and improve the circumstances so that nurses can make better decisions without stress or moral distress.