Good quality of care is dependent on nurses’ strong clinical skills and moral competencies, as well. While most nurses work with high moral standards, the moral performance of some nurses in some organizations shows a deterioration in their moral sensitivity and actions. The study reported in this paper aimed to explore the experiences of nurses regarding negative changes in their moral practice. This was a qualitative study utilizing an inductive thematic analysis approach, which was conducted from February 2017 to September 2019. Twenty-five nurses participated in semi-structured interviews. The main theme that emerged from our analysis was one of moral neutralization in the context of an unethical moral climate. We found five sub-themes, including: (1) feeling discouraged; (2) normalization; (3) giving up; (4) becoming a justifier; and (5) moral indifference. Unethical moral climates in health organizations can result in deterioration of morality in nurses which can harm both patients and health systems. Some unethical behaviors in nurses can be explained by this process.

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道德中和：护士在不道德的气候工作场所中的发展

良好的护理质量还取决于护士的强大临床技能和道德能力。尽管大多数护士以较高的道德标准工作，但某些组织中某些护士的道德表现表明其道德敏感性和行为有所下降。本文报道的研究旨在探讨护士在道德实践中的消极变化方面的经验。这是一项采用归纳主题分析方法的定性研究，于2017年2月至2019年9月进行。25名护士参加了半结构化访谈。我们的分析提出的主要主题是在不道德的道德氛围下的道德中和。我们发现了五个子主题，包括：（1）灰心丧气；（2）规范化；（3）放弃；（四）成为辩护人；（5）道德上的冷漠。卫生组织中不道德的道德氛围会导致护士的道德恶化，从而损害患者和卫生系统。护士的一些不道德行为可以用这个过程来解释。