Is the Theory of Moral Reckoning in Nursing Ready for Modification?

Article Sidebar

PDF
Published: Jun 28, 2025
Keywords:
classic grounded theory, modifiability, rigor, relevance

Main Article Content

Alvita Nathaniel
Grounded Theory Institute

Abstract

This paper is a personal reflection on the original theory of moral reckoning in nursing, which seeks to answer the question, “Is the Theory of Moral Reckoning in Nursing Ready for Modification?” I was reminded recently to pick up some data I had gathered and left dormant about nurses’ experiences with COVID-19. A question was posed to me about published modified grounded theories. This triggered me to think more about modifying my own theory of moral reckoning to make it more relevant, explanatory, and predictive in today’s healthcare environment. In this paper, I share snippets of data I gathered a couple of years ago and bits of popular, empirical, and theoretical literature which both impel me toward modifying the existing theory.  

Downloads

Download data is not yet available.

Article Details

How to Cite
Nathaniel, A. (2025). Is the Theory of Moral Reckoning in Nursing Ready for Modification?. Grounded Theory Review, 24(1), 69–79. Retrieved from https://groundedtheoryreview.org/index.php/gtr/article/view/306
Issue
Vol. 24 No. 1 (2025)
Section
Research Articles

The Grounded Theory Review is an open-access journal, which means that all content is freely available without charge to the user or his/her institution. Users are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles in this journal without asking prior permission from the publisher or the author. This is in accordance with the international Budapest Open Access Initiative (BOAI) definition of open access.

Author Biography

Alvita Nathaniel, Grounded Theory Institute

Alvita Nathaniel, PhD, is Professor Emerita and past department chair at West Virginia University School of Nursing. Mentored by Barney Glaser, Nathaniel continues to be involved with grounded theory initiatives.  In addition to her grounded theory publications, she co-authored the nursing textbook, Ethics & Issues in Contemporary Nursing, which is now in its 6th edition. Writing the ethics textbook led to her grounded theory research on moral reckoning, which she continues to pursue along with additional scholarship focusing on the two main foci of classic grounded theory and nursing ethics. She is a Fellow of the Grounded Theory Institute, a Fellow of the American Academy of Nurse Practitioners, a Fellow of the West Virginia University Academy of Excellence in Teaching and Learning, and a founding member of the International Grounded Theory Alliance. Dr. Nathaniel is past Editor of The Grounded Theory Review, an open access online journal focusing solely on classic grounded theory and is currently partnering with Tom Andrews and the Glaser family to edit a selection of Glaser’s seminal books for electronic dissemination.

References

American Nurses Assciation (ANA). (2015). Code of ethics for nurses with interpretive-statements. http://nursingworld.org/DocumentVault/Ethics-1/Code-of-Ethics-for-Nurses.html

… . (2025). Code of ethics for nurses with interpretive statements.

Antelo, P. U. (2020). Nurse quits in emotional video after being sent to an active coronavirus testing floor. Talentrecap. Retrieved from https://talentrecap.com/nurse-quits-in-emotional-video-after-being-sent-to-an-active-coronavirus-testing-floor/

Beck, C.T. (1993). Teetering on the edge: A substantive theory of postpartum depression. Nursing Research, 42(1), 42-48.

Beck, C.T. (2012). Exemplar: Teetering on the edge: A second grounded theory modification. In Munhall, P.I ed. Nursing Research: A Qualitative Perspective (5th ed.). Jones & Bartlett, 257–284.

Beck, C.T. (2022). Teetering on the edge: A third grounded theory modification of postpartum depression. Advances in Nursing Science, 46(1), 14–27.

Ariander, A., Olaison, A., Andersson, C., Sjodahl, R. N., & Kastbom, L. (2024). Etical challenges causing moral distress: Nursing home staff's experiences of working during the COVID-19 pandemic. Scandinavian Journal of Primary Health Care, 42(2), 266–275. https://doi.org/https://doi.org/10.1080/02813432.2024.2308573

Bow, S. M. A., Shroder-Back, P., Norcliffe-Brown, D., Wilson, J., & Tahizib, F. (2023). Moral distress and injury in the public health professional workforce during the COVID- 19 pandemic. Journal of Public Health, 45(3), 697–705. https://doi.org/https://doi.org/10.1093/pubmed/fdad010

Bustan, S., Nacoti, M., Botbol-Baum, M., Fischkoff, K., Charon, R., Made, L., . . . Kritzinger, M. (2020). COVID 19: Ethical dilemmas in human lives. Journal of Evaluation in Clinical Practice, 27(3), 716–732. doi:10.1111/jep.13453

Evans, M. (2020). 'It's killing us': Doctors, nurses resigned on Christmas morning as COVID cases continue to rise. Long Beach Post News. Retrieved from https://lbpost.com/news/covid-19-christmas-cases-deaths-hospitalizations

Glaser, B. G. (1978). Theoretical sensitivity: Advances in the methodology of grounded theory. Sociology Press.

International Counsil of Nurses (ICN). (2012). The ICN code of ethics for nurses. https://www.icn.ch/sites/default/files/inline-files/2012_ICN_Codeofethicsfornurses_%20eng.pdf

… . (2021). The ICN code of ethics for nusres. ICN_Code-of-Ethics_EN_Web.pdf.

Jetten, H., & Allard, E. (2025). The general experience and moral distress of nurses in the sociocultural context of the intensive care unit and the COVID-19 pandemic: A focused ethnography. The Canadian Journal of Critical Care Nursing, 36(1), 8–24. https://doi.org/DOI: 10.5737/23688653-3618

Jia, Y., Chen, O., Xiao, Z., Xiao, J., Bian, J., & Jia, H. (2021). Nurses' ethical challenges caring for people with COVID-19: A qualitative study. Nursing Ethics, 28(1), 33–45. doi:10.1177/0969733020944453

Lewis, S., Willis, K., & Smallwood, N. (2025). The collecdtive experience of moral distress: A qualitative analysis of perspectives of frontline health workers during COVID-19. Ethics, and Humanities in Medicine, 20(1). https://doi.org/https://doi.org/10.1186/s13010-024-00162-y

McKenna, H. (2020). Covid-19: Ethical issues for nurses. International Journal of Nursing Studies, 110, 1–2. doi:10.1016/j.ijnurstu.2020.103673

Morley, G., Grady, C., McCarthy, J., & Ulrich, C. M. (2020). Covid-19: Ethical challenges for nurses. Hastings Center Report, 50(3), 35-39. doi:10.1002/hast.1110

Nathaniel, A. K. (2004). A grounded theory of moral reckoning in nursing. Grounded Theory Review, 4(1).

Nathaniel, A. K. (2006). Moral reckoning in nursing. West J Nurs Res, 28(4), 419-438; discussion 439-448. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16672631

Swazo, N. K., Talukder, M. M. H., & Ahsan, M. K. (2020). A Duty to treat? A Right to refrain? Bangladeshi physicians in moral dilemma during COVID-19. Philosophy Ethics and Humanities in Medicine, 15(1), 23. doi:10.1186/s13010-020-00091-6