Explaining Courage in Ethical Decision-making by Nursing Managers: A Qualitative Content Analysis

Ethical decision-making by nursing managers is influenced by various essential factors, such as courage, without which it is impossible to act on them. Objective: This study aimed to explore the experiences of nursing managers about courage in ethical decision-making. Materials and Methods: The current study was conducted in Iran by a qualitative content analysis approach in 2018. Nineteen nurse managers were selected purposefully from hospitals in Tehran and Shahrekord cities. Data were collected using semi-structured, indepth, face-to-face interviews, and after transcription, they were analyzed according to the Graneheim and Lundman method. Results: Based on data analysis, we extracted 2 categories (obligation, decisiveness) and 8 subcategories (clearness in expressing decisions, the ability of the manager to make decisions in critical and complex situations, authority/decision-making as a religious responsibility, follow the decision process, being responsible, making compensatory decisions, making preventive decisions). Conclusion: The findings showed that managers who are committed to ethical decision-making have enough assertiveness to make the decisions. Educating, empowering, and sensitizing managers and enhancing their insight into ethical issues through problem-solving and roleplaying techniques can play an essential role in promoting their commitment and responsibility.