Background: Caring for patients with brain death diagnosis is the heaviest of duties for nurses, and, due to the complexities and stressors, it is the biggest challenge of nursing in an intensive care unit. 
Objective: This qualitative research aimed to disclose the nurses' experience of caring for brain-dead patients.
Methods: The present study was a qualitative research using a content analysis, where the data collection process included 21 semi-structured and in-depth interviews with intensive care nurses, physicians, head nurses, a transplantation committee coordinator, and the authority of the organ procurement unit. Adequate data were collected from March 2014 until the saturation point was reached in June 2016. Data were analyzed simultaneously with data collection using qualitative content analysis with a conventional approach.
Results: Qualitative content analysis of data resulted in two themes and eight subthemes, reflecting the analysis of nurses' experiences of caring for brain-dead patients. The themes included "Challenges of right and duty requirement,” and "turbulent confrontation with successive chains of tension". Finally, the main themes of "resonance of stress and internal conflict in care" were abstracted.
Conclusion: The findings deepened our understanding and knowledge of the issue. Despite all the stress, nurses care for potential organ donors, and this results in preserving the organs’ viability for donation. Nurses' problems and challenges in this caring process should be considered by policymakers of health and treatment systems and a supportive model be designed for nurses in the intensive care unit.


Keywords: Brain dead; End of life care; Qualitative research


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