Emergency nurses' ethical challenges with psychiatric patients: A qualitative study.

= 15) from three tertiary general hospitals in Northeast China with experience treating patients with severe mental disorders. Data were collected through interviews lasting 29-54 min.Ethical considerationsEthical principles were observed throughout the research process, including informed consent and participant anonymity.FindingsNurses experienced a pervasive climate of structural violence manifesting through institutional oppression (structural violence reproduction in EDs), technological usurpation (digital ethical collapse in decision-making), and subjective disintegration (traumatic reconstruction of nursing relationships). These conditions were systematically produced through institutional structures, technological mediations, and identity fragmentations rather than individual moral failings. Emergency nurses navigated paradoxical spaces where institutional structures and a violent care climate rendered ethical nursing care structurally impossible rather than merely difficult.ConclusionEmergency nurses face fundamental crises in practice that cannot be addressed through conventional ethics consultations or resilience strategies. Findings indicate needs for specialized psychiatric emergency services within general EDs, revised nursing curricula, and policy reforms addressing staffing requirements to create environments where ethical care for patients with severe mental disorders becomes possible rather than exceptional.