Nurses’ Moral Competence in the Lens of Patients: A Qualitative Study

Abstract

Background: Most studies that examined nurses’ moral competence were focused on the nurses’ own perspectives. Limited research exists on how patients perceive their nurses’ moral competence. To address this gap, this study explored the nurses’ moral competence as perceived by patients. Methods: This study employed a qualitative descriptive design, conducting in-depth interviews with 23 purposively selected ward patients from two hospitals in Iligan City, Philippines. Data were gathered using a researcher-made guide with open-ended questions, then recorded, transcribed, and thematically analyzed. Results: The moral competence of nurses is strongly reflected in their ability to provide patient-centered care demonstrated through compassionate support and responsiveness to patients’ needs. This is supported by ethically grounded clinical proficiency, combining effective communication, skilled task execution, autonomy preservation, and fairness. However, nurses face significant challenges such as Workload-Induced Burnout, Overlooking Harm Prevention, Irritability, Care Delays, and Compassion Fatigue, which hinder consistent moral practice and impact patient experiences. Conclusion: Nurses’ moral competence plays a crucial role in patients’ healthcare satisfaction; therefore, it is imperative to address personal and systemic barriers like burnout and compassion fatigue through manageable workloads and support programs. Integrating moral competence frameworks into nursing education and continuous professional development enhances ethical decision-making, communication skills, holistic care delivery, moral resilience, and stress management, thereby better equipping nurses to confront clinical challenges.