ABSTRACT Background: Moral distress is a critical challenge in psychiatric nursing education, yet its experiential dimensions among undergraduate students remain insufficiently understood. Psychiatric placements expose learners to ethically charged situations that test their values and professional identity. Aim: The aim of this study was to explore how undergraduate nursing students at Helwan University, Egypt, to experience and navigate moral distress, and to examine how these experiences shape moral resilience. Methods: A qualitative descriptive design grounded in a constructivist paradigm was used with 12 final-year nursing students. Data from semi-structured interviews and structured reflective journals were analyzed using reflexive thematic analysis. Results: Four themes captured the developmental trajectory of moral distress: (1) negotiating autonomy and authority, (2) ethical paralysis and silencing, (3) emotional disengagement as coping, and (4) reconstructing moral resilience through reflection. Moral distress evolved from initial tension toward reflective empowerment when supported by structured mentorship. Conclusion: Moral distress functions as a formative catalyst for ethical growth. Embedding structured reflective mentorship within psychiatric curricula is essential for transforming moral suffering into professional development.
Essam Eltantawy Elsayed (Thu,) studied this question.