During their practice, nurses regularly encounter clinical ethical situations. As part of a graduate clinical ethics course, nurses had to write a narrative descriptions of a situation they experienced. Their descriptions seemed to include several considerations related to their occupational health and safety (OHS). This research aimed to highlight the sources of ethical situations and to explore these OHS considerations.

In all, 115 narrative descriptions, written by nurses during this course, were analyzed by using a continuous comparison technique (thematic analysis).

The sources of the situations are described using two components: substance and subject. The substance of the situation (dilemma, breach or disagreement) is defined along two continua: certainty/uncertainty and acceptability/unacceptability. The first continuum reflects the nurse's stance concerning the best option to choose in the situation. The second continuum relates to whether the options discussed in the situation are, in the nurse's opinion, acceptable or unacceptable. As for the subject of the situations, it relates to principles, rights or occupational safety and health determinants. This provides a much broader picture of the ethical situations faced by nurses. The majority of these described situations has underlying dynamics related to OSH.

In each situation described, the interplay between the substances and subject is promising because it allows to describe and distinguish what the situation was about and the way that subject led to the problem. This comprehension of the sources also emphasizes that OSH aspects could have a significant impact on ethical situations experienced by nurses. Consequently, developing ethical competency should take these aspects into account and not be focused solely on the patient and the care.