Abstract
Background: Nurse managers have responsibilities relating to the quality of care, the welfare of the staff
and running of the organization. Ethics plays significant role in these responsibilities. Ethical problems are
part of daily management, but research in this area is limited.
Objective: The aim of this study was to identify and describe ethical problems nurse managers encounter
in their work to get more detailed and extensive view of these problems.
Methods: The data consisted of nine interviews with nurse managers at different management levels in
primary healthcare and specialized healthcare organizations, and it was analysed by inductive content
analysis.
Ethical considerations: Permission to conduct the interviews including ethical approval was given at all
participating organizations according to national standards. The respondents were informed about the aim
of the study, and voluntary participation, anonymous response and confidentiality were explained to them.
Findings: Four main categories were found: conflicts in practical situations, lack of appreciation, disregard
of problems and experienced inadequacy. Problems could also be divided to patient-related, staff-related,
organization-related and other problems.
Discussion: The findings correspond with results from earlier studies but add knowledge of the nature and
details of nurse managers’ ethical problems. New information is produced related to the ethical problems
with nurse managers’ own courage, motivation and values.
Conclusion: Nurse managers identified a variety of different ethical problems in their work. This
information is useful in the development of ethics in nursing management. Further research about the
frequency and intensity of nurse managers’ ethical problems is needed as well as possible differences in
different levels of management.