Concept synthesis of ethical resilience in nurses

'Moral resilience' is a concept whereby individuals sustain and restore their integrity in the face of moral distress. While the key aspect of this concept is the individual's integrity, some indicate that personal and professional integrity differ. In clinical practice, a phenomenon is observed where nurses demonstrate resilience and behave ethically in accordance with their professional values. However, this phenomenon cannot be fully explained by moral resilience. This study proposes the concept of ethical resilience, a phenomenon in which resilience and ethical behaviour are demonstrated towards ethical issues, by undertaking concept synthesis. Articles that mention ethical resilience were selected from among those released on PubMed and CINAHL and Web of Science and Eric (up to 20 January 2024). Walker and Avant's method was used for the concept synthesis. Four attributes were extracted for ethical resilience: (1) grasping ethical issues, (2) integrity as a nurse, (3) flexible and tenacious approach, and (4) collaboration to resolve ethical issues. Based on the results of concept synthesis, nurses' ethical resilience was defined as the ability to sustain or restore professional competence when facing ethical issues while assessing the situation and collaborating with others. This concept describes a positive approach to ethical issues oriented towards professional ethical behaviour. The concept of ethical resilience was derived from previous studies accumulated to this date. Research on resilience to ethical issues and moral distress is still in its infancy, and thus it must be examined further. It is expected that discussion on these matters will advance further along with the concept of ethical resilience.