["I am in conflict with myself every day"-Moral distress among geriatric nurses during the COVID-19 pandemic].

Background: Due to the COVID-19 pandemic-related changes and guidelines, nurses in the setting of inpatient geriatric care are exposed to specific burdens and may experience dilemmas with respect to their moral responsibility.

Aim: The aim of this study was to explicate the effects and perceptions regarding the development of moral distress of nurses in the setting of geriatric care during the SARS-CoV‑2 pandemic in Germany and to draw conclusions for the design of care in residential care settings.

Methods: Based on a subgroup analysis (n = 510) of the qualitative survey of the COVID-19 Nursing Study, perceptions of nurses working in residential care settings during the pandemic are presented and evaluated with respect to the development of moral distress.

Results: The results show five categories ("That we have no time to care properly", "Loneliness", "Conflicts with relatives and residents", "Constant fear for patient safety but also for one's own safety" and "Grief, stress and anger"), which represent differentiated criteria for the development of moral distress among nurses as well as its effects.

Conclusion: It can be concluded that structural and professional solutions must be developed that enable nurses to shape their own working environment and to undertake professional nursing decision-making competence.