Exploring the dimensions of moral character among operating room nurses in Iran: a qualitative descriptive study

Background Moral character is important in guiding operating room nurses’ responsibilities toward patients who may be unable to protect their own interests. However, little is known about how nurses understand moral character in perioperative practice. This study explored the dimensions of moral character among operating room nurses in Iran. Methods A qualitative descriptive design was used, with conventional content analysis. Twenty-two operating room nurses from eight Iranian teaching hospitals were recruited through purposive maximum-variation sampling between October 2025 and February 2026. Data were collected through in-depth, semi-structured interviews and analyzed inductively using Graneheim and Lundman’s approach. Trustworthiness was assessed using Lincoln and Guba’s criteria, and reporting followed COREQ. Results Five interconnected dimensions were identified: Inner Ethical Orientation, Emotional Regulation in Ethical Practice, Ethical Practice in Action, Ethical Communication and Advocacy, and Personal and Professional Capacities for Ethical Practice. Participants described moral character in relation to ethical commitments, emotional regulation, patient protection, professional responsibility, communication, and competence. Hierarchical pressure, fear of professional consequences, team conformity, and negative labeling could make it difficult for nurses to act according to their ethical obligations. Conclusion Moral character in perioperative nursing involves ethical commitments, professional capacities, and everyday practices. The findings also show that interpersonal and organizational factors may prevent nurses from acting on their ethical responsibilities. Educational and organizational approaches may help support ethical practice among operating room nurses. Clinical trial number Not applicable.