When caregivers are caught in the crossfire: A nursing commentary on structural violence, moral courage, and the urgent work of repair in an era of structural harm

Nurs Outlook. 2026 May 4;74(3):102793. doi: 10.1016/j.outlook.2026.102793. Online ahead of print.

ABSTRACT

The killing of ICU nurse Alex Jeffrey Pretti during a federal immigration enforcement operation in Minneapolis represents a sentinel event for the nursing profession, revealing how structural violence and contested political conditions increasingly intersect with nursing practice, education, and civic life. Situating this case within public health, critical nursing scholarship, and contemporary ethical frameworks, this commentary examines how nursing is practicing under conditions of structural harm and ethical strain that challenge traditional assumptions about professional neutrality, safety, and scope. We argue that this moment calls not for symbolic response alone, but for structurally grounded, ethically coherent action. We propose an agenda that articulates psychological safety as essential professional infrastructure; advances rights‑based, advocacy‑oriented nursing education aligned with competency‑based frameworks; emphasizes institutional protections and governance mechanisms that support ethical care; and recognizes the expanded moral, emotional, and relational labor borne by nurses and educators. These commitments are framed not as individual obligations, but as collective conditions necessary for ethical practice, professional sustainability, and the future of nursing.

PMID:42086023 | DOI:10.1016/j.outlook.2026.102793