A cross-sectional study among operating room nurses in China (Chongqing, Beijing, Charbin, Sichuan Province) with 573 valid responses investigated the relationship between mental workload, moral sensitivity, and patient privacy. The mean scores were: patient privacy protection 82.384 ± 5.169, moral sensitivity 45.506775 ± 45.56075 and psychological burden 14.826. Psychological workload was negatively correlated with patient privacy protection (r = −0.655, p < 0.001) and moral sensitivity (r = −0.575, p < 0.001), while moral sensitivity was positively correlated with privacy protection (r = 0.506, p < 0.001). Moral sensitivity partially mediates the relationship between mental workload and privacy, accounting for 14.98% of the total effect. Higher mental workload is associated with lower moral sensitivity and lower protection of patients' privacy. The study highlights the need for interventions to alleviate burden and strengthen moral sensitivity.