Moral Courage Among Clinical Nurses: A Comparison of Government Hospital and Private Hospital


  • Indah Restika Nani Hasanuddin Health Institute
  • Yusran Haskas
  • Suarnianti



Moral Courage, Nurses, Private Hospital, Government Hospital


Strengthening moral courage is one of the effective ways to overcome moral distress that causes a lot of physical and emotional disturbance to a person, which affects their satisfaction with the profession. This study aimed to describe the moral courage in implementing the daily nursing practices of nurses in Indonesia. We applied the survey analytic research design in this. This research was conducted in 5 different locations, namely government and private hospitals in Makassar City, using multistage random sampling. The number of samples is 405 nurses. The results of the Moral courage nurses who work in Makassar city hospitals are at a moderate to the high level, and there is no difference in the level of moral courage nurses in government hospitals and private hospitals


Download data is not yet available.


(1) Silva. Moral Distress. Rhode Island College; 2015.

(2) Soeren, Miles. The role of teams in resolving moral distress in intensive care unit decision-making. Crit Care. 2003;7(3):217–8.

(3) Oberle, Hughes. Doctors ’ and nurses ’ perceptions of ethical problems in end-of-life decisions. J Adv Nurs. 2001;33(6):707–15.

(4) Harrowing, Mill. International Journal of Nursing Studies Moral distress among Ugandan nurses providing HIV care?: A critical ethnography. Int J Nurs Stud [Internet]. 2010;47(6):723–31. Available from:

(5) Bernhardt BA, Rushton CH, Carrese J. Distress and burnout among genetic service providers. Genet Med. 2009;11(7):5–7.

(6) Corley. Moral distress of critical care nurses. Am J Crit Care. 1995;24(4):285–9.

(7) Gutierrez. Moral distress of critical care nurses. Dimens Crit Care nurses. 2005;24(5):229–41.

(8) Iglesias, Becerro, Vallejo, Fuentes, Juan. Moral distress related to ethical dilemmas among Spanish podiatrists. J med Ethics. 2010;36:310–5.

(9) Numminen O, Katajisto J. Development and validation of Nurses ’ Moral Courage Scale Development and validation of Nurses ’ Moral Courage Scale. Nurs Ethics. 2018;1–18.

(10) Miller. The Mystery of Courage. Cambridge: Harvard University Press; 2002.

(11) Numminen O, Repo H, Leino-Kilpi H. Moral courage in nursing?: A concept analysis. Nurs Ethics. 2016;1–14.

(12) Gastmans. Nursing Ethics education A F Undamental E Thical A Pproach To Nursing?: Some Proposals For Ethics Education. 2002.

(13) Oh, Gastmans. Moral distress experienced by nurses?: A quantitative literature review. Nurs Ethics. 2015;22(1):15–31.

(14) Gallagher. Moral distress and moral courage in everyday nursing practice. J issues nurs. 2011;16(2):8.

(15) Iseminger. Overview and Summary: Moral Courage Amid Moral Distress: Strategies for Action. Online J Issues Nurs. 2010;15(3).

(16) Corley. Nurse M Oral D I stress?A Proposed Theory And Research Agenda. Nurs Ethics. 2002;9(6):636–50.

(17) Epstein, Delgado. Understanding and Addressing Moral Distress. Online J Issues Nurs. 2010;15(3).

(18) Hawkins SF, Morse J. The Praxis of Courage as a Foundation for Care. J Nurs Scholarsh. 2014;46(4):263–70.

(19) Bjarnason D, Lasala CA. Moral Leadership in Nursing. J Radiol Nurs [Internet]. 2011;30(1):18–24. Available from:

(20) Lindh, Severinsson, Berg. Nurses ’ moral strength?: a hermeneutic inquiry in nursing practice. J Adv Nurs. 2009;65(9):1882–90.

(21) Oktavia D. Gambaran Courage pada Perawat Rumah Sakit. (2013). Unpublished Thesis, Sumatera Utara University, Indonesia

(22) Taraz Z, Loghmani L, Abbaszadeh A, Ahmadi F, Safavibiat Z, Borhani F. The relationship between the ethical climate of hospital and moral courage of nursing staff. Electron J Gen Med. 2019;16(2):4–9.

(23) Stokes L. Learn How To Cultivate Moral Courage - Healthy Nurse, Healthy NationTM [Internet]. Healthy Nurse Healthy Nation. 2019. Available from:

(24) Ariawan IGN, Krisnayanti PM, Gede P, Suastrawan P, Emy NP, Yanti D, et al. Spirituality Relationship And Moral Sensitivity Of Nursing Students. Keperawatan Jiwa Vol [Internet]. 2019;7(2):153–8. Available from:

(25) Woods M, Rodgers V, Towers A. Researching moral distress among New Zealand nurses?: A national survey. Nurs Ethics. 2015;22(1):117–30.

(26) Sekerka LE, Bagozzi RP. Moral courage in the workplace?: moving to and from the desire and decision to act. J Comp. 2007;16(2):132–49.

(27) Kulju K, Stolt M, Suhonen R, Leino-Kilpi H. Ethical competence?: A concept analysis. Nurs Ethics. 2015;1–12.

(28) Sasongko, B., Bambang, S., Rosidi, Solimun. Searching For A Moral Character: The Genesis Of The Auditor's Duty. Journal of Economics, Business, and Accountancy Ventura. 2021; 16(3):503 – 514.

(29) Murray, J.S. Letter to the editor. Nursing Outlook. 2010; 58: 6 – 7.

(30) Connor, J. (2017). Psychometric Evaluation of the Professional Moral Courage ( PMC ) Scale in a Nurse Executive Population.