Many of the activities of clinical practice happen to, with or upon vulnerable human beings. For this reason numerous nursing authors draw attention to or claim a significant moral domain in clinical practice. A number of nursing authors also discuss the emotional involvement and/or emotional labour which is often experienced in clinical practice. In this article I explore the importance of emotion for moral perception and moral agency. I suggest that an aspect of being a good nurse is having an emotional sensitivity to other human beings (patients), because this emotional sensitivity allows the nurse to perceive more accurately the context and perspective of the patient. It is thus important to the moral agency of the nurse and to morally sensitive clinical practice. As such education of the emotions should be a feature of the moral education of the nurse. A useful conception of the role of educated emotion in the moral life can be discovered in Aristotelian ethics.

Over the last 15-20 years we have witnessed a dramatic interest in the moral domain of clinical practice. There has also been a growing focus on the patient as an individual whose individuality and perspective must be respected. It is argued in this paper that a key to both these concerns is a consideration of the role of empathy in both perceiving the moral aspects and issues of practice, and in providing adequate support for patients. In this paper the meaning and components of empathy are discussed in the context of human receptivity and preconditions of moral performance. However, we also draw attention to empirical studies which suggest that even following adequate educational preparation, if the clinical environment and the structures within which care is delivered are not supportive, the practitioner's ability to perceive the moral is limited. In such circumstances, patients are in danger of receiving less than appropriate care - from both the moral and professional perspective.

In an effort to create a healthy nursing work environment in a military hospital Intermediate Care Unit (IMCU), a facility-level Evidence Based Practice working group composed of nursing.Stakeholders brainstormed and piloted several unit-level evidence-based leadership initiatives to improve the IMCU nursing work environment. These initiatives were guided by the American Association of Critical Care Nurses Standards for Establishing and Sustaining Healthy Work Environments which encompass: (1) skilled communication, (2) true collaboration, (3) effective decision making, (4) appropriate staffing, (5) meaningful recognition, and (6) authentic leadership. Interim findings suggest implementation of these six evidence-based, relationship-centered principals, when combined with IMCU nurses' clinical expertise, management experience, and personal values and preferences, improved staff morale, decreased staff absenteeism, promoted a healthy nursing work environment, and improved patient care.