This article provides a critical review of the literature about moral injury observed in nurses after a patient safety incident. The authors describe ‘moral injury’ as an experience violating deeply held moral values and beliefs, which can place and individual at risk for burnout and post-traumatic stress disorder. Moral injury symptoms identified in this review included guilt, shame, spiritual-existential crisis, and loss of trust. The authors posit that moral injury may be a more appropriate term for what has been historically referred to as the ‘second victim’ phenomenon.