Conscience is an important concept in in nursing and ethics, having various meanings in different cultures. In a multicultural society, people with different views on conscience have to cooperate, which demands understanding and respecting each other’s views while facing challenges. A growing number of healthcare professionals are of immigrant background, particularly within the care of older people. In Sweden, 18% of enrolled nurses and nursing assistants are foreign-born. Care for people with dementia who reside in residential care settings in Sweden is mainly provided by ENs. The care of people with dementia requires that care providers take many ethical positions. It is important to explore the meaning of conscience among care providers within different cultural contexts. Our study aimed to illuminate the meaning of conscience by enrolled nurses with an Iranian background working in residential care for Persian-speaking people with dementia. A phenomenological hermeneutical method guided the study. A total of 10 enrolled nurses with Iranian background, aged 33–46 years, participated in the study. All worked full-time in residential care settings for Persian-speaking people with dementia in a large city, in Sweden. The study was approved by the Regional Ethical Review Board for ethical vetting of research involving humans. Participants were given verbal and written study information and assured that their participation was voluntary and confidential. Three themes were constructed including perception of conscience, clear conscience grounded in relations, and striving to keep a clear conscience. The conscience was perceived as an inner guide grounded in feelings, which is dynamic and subject to changes throughout life. Having a clear conscience meant being able to form a bond with others, to respect them, and to get their confirmation that one does well. To have a clear conscience demanded listening to the voice of the conscience. The enrolled nurses strived to keep their conscience clear by being generous in helping others, accomplishing daily tasks well and behaving nicely in the hope of being treated the same way one day. Cultural frameworks and the context of practice needed to be considered in interpreting the meaning of conscience and clear conscience.

A feature of healthcare system, particularly in the care of older people, is its cultural diversity in terms of having considerable numbers of both caregivers and care recipients with an immigrant background. Considering the influence of culture in ethical decision-making processes, the idea of conscience, and the adverse effects of a troubled conscience, it is important to study these issues in culturally diverse populations. There are no published studies regarding troubled conscience among immigrant populations that include enrolled nurses. The aim of the study was to illuminate the meanings of troubled conscience and how to deal with it among enrolled nurses with Iranian backgrounds working in Swedish residential care settings. The study conducted with a phenomenological hermeneutical design. Ten nurses were interviewed. Analysis included noting a naive understanding of text as a whole followed by a structural analysis. Five subthemes and two themes were identified. The meanings of having a troubled conscience include not being a good person, being an uncaring person, not acting according to one’s values, and living in a state of unease. Dealing with a troubled conscience involves trying to compensate for the harm one has caused and trying to prevent similar situations in the future. The nurses understood themselves as caring people and not only caregivers. They knew that they should hear their conscience and respond to it by trying to be a caring person and acting according to their values.

This article explores the possibilities and limits of a hermeneutic way of being in the world, more specifically being a researcher as a part of human, embodied existence. Understanding existence as embodied highlights the subjectivity of a researcher. For a hermeneutic researcher this subjectivity is both a precondition for interpretation and something that might endanger the scientific endeavour. In this article, I examine the possibilities of combining Hans-Georg Gadamer’s empathetic hermeneutics with Paul Ricoeur’s critical hermeneutics as a means of both recognizing and, to some extent, controlling my subjectivity in the research process. With Gabriel Marcel I also argue for hermeneutics as an embodied experience. This is exemplified by my study with a focus on the existential dimensions of the nursing profession. The first part of the article introduces Marcel and his philosophical anthropology concerning our bodily existence as essential for shared lives with others. In the second part, this understanding of self and others is further developed by means of the hermeneutics of Gadamer and Ricoeur. In the third part, I present a way of applying hermeneutics in procedures for interviews, transcription, and analysis of data.