Abstract
Background: Morals are norms of conduct, behaviour and guidelines that nurses must
uphold and observe in nursing. Moral codes require nurses and student nurses to respect
human rights and dignity, and act with sound ethical judgement. However, when student
nurses witness and fail to prevent acts that transgress their deeply held moral beliefs,
their moral code is damaged, and deep emotional wounds ensue, leading to moral injury.
Objectives: This study aimed to investigate the prevalence and effects of moral injury in
student nurses at a higher education institution in South Africa.
Method: A quantitative, non-experimental cross-sectional survey was relied upon. The total
population sampling method was applied, resulting in 124 respondents. Data were collected
among the undergraduate student nurses registered at a higher education institution in
Johannesburg from first to final year using a self-administered Moral Injury Symptom
Scale – Healthcare Professionals questionnaire. Data were analysed using IBM Statistical
Package for the Social Sciences (SPSS) Statistics version 28 software.
Results: The results indicated that more than a third (34%) of students experienced moral
injury. Furthermore, a positive significant relationship between the presence of moral injury
and academic performance among the students was noted (p = 0.029).
Conclusion: In this study, the prevalence of moral injury among student nurses was
investigated and its effects on academic performance were reported.
Contribution: The effects of moral injury among student nurses indicate a need for
higher education institutions to design and implement nursing curriculum that would assist
students to develop moral resilience and ethical behaviour.