Practice has embedded within it a morality which is derived from the very activity of that practice. This study illustrates an actual morality of nursing practice across the three domains of ethical experience; virtue, duty, and cultural ethos. Stories of the concerns experienced in their practice were elicited from 9 psychiatric and 10 home care nurses. Each nurse was interviewed twice for an approximate total of three hours. Philosophically, these stories were considered to exhibit narrative rationality and they were analyzed by using techniques of narrative analysis.

In this research, nursing ethics is seen as comprised of the four aspects which constitute the moral work of practice: having a life, acting for, relationship, and testimony. For these nurses, helping patients to have a life lay at the moral heart of their practice. To have a life is to have a sense of agency, to occupy social and political space, to live a temporally structured existence, and to die. The work of nursing inevitably necessitated that these nurses act for their patients in several domains; physical, psychological, and integrity of the self. The potential for the abuse of power in such situations was offset by knowing the patient. This was made possible through the relationship between nurse and patient, specifically by listening and entering the patient's world. The significance of having a life lay in the distinction between the knowing of the person in her world and the knowing of the patient as an object of biomedical science. These epistemologies and the values which underlie them frequently collided head on in the everyday realities of health care. When this happened, nurses questioned the ends and means of medicine. Such challenges were always raised against the background of what a given intervention would mean for the patient in their world. Speaking morally, these nurses bear witness to lives and give testimony. This study goes beyond principles and care to suggest a content for nursing ethics.