In nursing practice we find different kinds of difficult situations. What is the difference between such kinds of situations? It is important to know what kind of situation one is confronting because the answer and solution depend on it. In the literature the term ‘dilemma’ has different meanings. I am therefore interested in what constitutes a dilemma, and have conducted a concept analysis. The defining attributes were engagement, equally unattractive alternatives, awareness of alternatives, need for a choice and uncertainty of action.