Published by the Healthcare Ethics Committee Forum, the author reviews research efforts to date exploring cultural differences in nursing roles. The aim is to understand actions that represent threats to moral integrity in an overall effort to build a cohesive research-based understanding of the concept. The author also examines the importance of capturing root causes of moral distress in instruments to allow for interventions to be appropriately targeted. In addition, the issue of studying moral distress and interaction over time with moral residue is discussed. Through this review of contemporary research, the author highlights potential for interventions to decrease moral distress.