to stress-related moral problems, described as moral distress or stress of conscience characterized by frustration and guilt with a risk of depersonalization, emotional exhaustion and burn-out. In some people, a troubled conscience may become destructive For others, it serves as a guardian, pointing up the ethical problem and calling for changes.' Childress writes that conscience indicates the meaning of the ethical conflict, by making us conscious that we act according to our moral convictions. Failing to follow our moral conviction can give us a troubled conscience followed by feelings of guilt shame and alienation. In contrast, acting in accordance with our conscience preserves a feeling of whole- ness and integrity ofself e Inthis context, we consider that a troubled conscience isthe result ofa merger f the life-world of the nurse with the life-world of the patient. By asking the professionals to narrate an ethically difficult situation that gave rise a troubled conscience, we may reveal the underlying barriers for communicating value conflicts among RNs and physicians and hopefully work out strategies to help professionals to improve care for this vulnerable group of patients. The aim of the study was therefore to illuminate RNs' experiences of being in ethically difficult situations in dialysis care, giving rise to troubled conscience.