Objectives: Nurses, as the largest group providing health care services, play a critical role in the continuity of care and respond to services commensurate with their competence. Professional competence in nursing is a complex and ambiguous concept and needs the redefinition of competence and development of its definition and concept. In this study, we aimed to conceptually analyze professional competence in nursing. Methods: In this study, a hybrid concept analysis was used. In the literature review phase, the concept of 'competence' was investigated through valid databases limited to 2000-2018 and the participants' experiences also appeared in the fieldwork phase. In the fieldwork phase, the participants revealed some aspects of professional competence in nursing, which were not well-addressed in the literature. Finally, the comprehensive definition of professional competence in nursing was presented after integrating the findings obtained in these two phases. Results: According to the findings, professional competence in nursing is a combined, complex, multidimensional, and contextdependent concept, and consists of different domains. Based on the analysis results of the fieldwork phase, this concept was classified into 16 domains and the participants largely contributed to the provision of a comprehensive definition based on the definitions of professional competence presented in the literature. Conclusions: Based on the domains of professional competence in nursing obtained from this study, an appropriate instrument can be developed to assess professional competence in nursing for students and nurses.

Introduction:Moral distress is a serious problem for health care professionals all over the world; it has detrimental effects for patients, nurses and organizations. Nurses in ICUs experience more moral distress due to their daily dealing with ethical problems and the stressful atmosphere. The purpose of this study was to conduct an integrated review and a combination of existing studies on moral distress in Intensive Care Unit nurses. Methods & Materials:In the literature review from 2000 to 2019, various databases including SID, Irandoc, Google Scholar, PubMed, Medline, Scopus, Cochrane Library, and Science Direct were searched with keywords of moral distress, nursing, Intensive Care Units. The modified version of Cooper's five-stage integrated review by Whittemore and Knalf was used for this purpose. Results:Results were presented in four sections on the effects and sources of moral distress on nurses in Intensive Care Units, their psychological reactions, and how they deal with moral distress. Conclusion:Based on a review of the literature, we can say that moral distress can never be completely eliminated, but its causes and effects can be mitigated. As this phenomenon is more common among nurses in intensive care units due to its challenging environment, ethical distress should be identified in nurses and prevention or treatment strategies should be considered.