Instinct, Ethics, Action: Understanding Nurses' Responses in Forensic Contexts

Nurses caring for patients who have committed morally reprehensible acts face complex emotional and ethical challenges that can impact care delivery and professional well-being. There is limited research examining how nurses navigate these situations, particularly in forensic contexts. The aim of this study was to explore how nurses manage their emotional responses and professional responsibilities when caring for patients whose actions provoke deep moral dissonance. A qualitative descriptive design using focus groups was employed, with 10 nurses participating across two groups. Progressive case vignettes were used to facilitate discussion about caring for patients involved in child harm. Focus group data were analyzed using thematic analysis to identify patterns in nurses' experiences and coping strategies. Three interconnected themes emerged, conceptualized as compasses: Instinctual (emotional reactions), Ethical (reconciliation with professional values), and Action (translation into practice). The findings highlight the need for structured support mechanisms and organizational resources to help nurses maintain professional standards while managing personal emotional responses in ethically challenging situations. This study contributes to understanding how nurses balance professional obligations with personal moral responses when caring for patients who have committed harmful acts.