Carol BovaMalatesta, Thin Zar2022-08-232022-08-232021-09-242021-10-1310.13028/31tt-qz33https://hdl.handle.net/20.500.14038/34417PURPOSE: The purpose of this qualitative descriptive study was to describe critical care nurses’ experiences of moral challenges, moral distress, and moral resilience during the COVID-19 pandemic. The specific aims of this study were to: 1. Describe the moral challenges experienced by ICU nurses. 2. Describe moral resilience in terms of integrity, buoyancy, moral efficacy, self-regulation, and self-stewardship among ICU nurses (from Rushton’s framework). 3. Explore the relationship between moral distress and moral resilience to advance the concept of moral resilience in the face of the COVID-19 pandemic. FRAMEWORK: This study was undergirded by an adaptation of Rushton’s conceptual framework of moral concepts. DESIGN: A qualitative descriptive design was used. Participants were recruited between January to May 2021, and a semi-structured interview guide was utilized to interview participants. RESULTS: 17 participants were interviewed for the study. Participants described the four themes of moral challenges: death and dying, pain and suffering, being alone, and being helpless and not in control. Moral resilience was described as: integrity, buoyancy, moral efficacy, self-regulation, self-stewardship, and self-perception. The relationship between moral distress and moral resilience was described as iterative and fluid. CONCLUSION: The findings of the study provided a new domain of moral resilience called self-perception and a revised adaptation of the conceptual framework for moral resilience.en-USCopyright © 2021 Malatestahttp://creativecommons.org/licenses/by/4.0/moral challengesmoral distressmoral resiliencecritical care nursescovid-19 pandemicICUNursingDoctoral Dissertationhttps://escholarship.umassmed.edu/cgi/viewcontent.cgi?article=1081&context=gsn_diss&unstamped=1https://escholarship.umassmed.edu/gsn_diss/6825403224gsn_diss/680000-0002-5223-4293