AIM: To investigate Swedish and Chinese nurses' conceptions of ethical problems and workplace stress and ascertain whether there are differences between the nurses in the two countries and between types of clinics.

BACKGROUND: Nursing can be regarded as an ethical practice and ethical problems are one type of problems nurses have to deal with.

DESIGN: The research design was comparative and quantitative.

METHODS: A questionnaire was used. The study was carried out at one hospital in China and two hospitals in Sweden. One hundred and thirty-six Chinese nurses and 137 Swedish nurses participated.

RESULTS: There was a statistical difference between nurses working in the different countries regarding commonest stated ethical problem. The Swedish nurses indicated a greater number of ethical problems than the Chinese nurses. The latter felt irritated, dissatisfied or sad at work or after work more often than the Swedish nurses. Forty-one per cent of the nurses in both countries thought there was a modest or rather big difference between the current and the desired quality of nursing.

CONCLUSIONS: The findings were partially the same in the two countries and this underlines the importance of looking at ethical problems from an organisational perspective.

RELEVANCE TO CLINICAL PRACTICE: The findings also show the need for a reduction of nurses' workload as well as the importance of assuring that nurses have the knowledge they need to carry out their work. The communication between nurses and other members of the health-care team, patients and relatives also needs to be improved.