Document Type : Original Article
Authors
1 Tarbiat Modares University, Tehran, Iran/ Shahrekord University of Medical Sciences, Shahrehkord, Iran
2 Nursing Department, Faculty of Medical Sciences. Tarbiat Modares University, Tehran, Iran
3 Nursing Department. Faculty of Medical Sciences. Tarbiat Modares University, Tehran, Iran
4 Iranian Research Center on Healthy Aging, Sabzevar University of Medical Sciences, Sabzevar, Iran
Abstract
Introdiction: Making ethical decisions is significant in health systems committed to ethics. Meanwhile, determining how nursing managers incorporate ethical values in their decision-making processes is crucial in developing ethical decisions and achieving ethical goals of health care organizations. The aim of this study is to explore the ethical decision-making process in nursing managers.
Methods: This qualitative study was carried out in Tehran hospitals in 2020. Data was analyzed using Grounded Theory method according to Strauss and Corbin’s 2015 approach. 23 in-depth semi-structured interviews were taken from 20 nursing managers and 3 nurses. Purposeful and theoretical sampling continued until theoretical saturation was achieved.
Results: Conscientiousness was found to be a core variable in managers' ethical decision-making processes. Nursing managers working in unreliable organizational environments rely on 4 strategies (client orientation, cross-evaluation, contingency decision-making, and prioritizing individual rights over organizational regulations) in their decision-making to gain a comfort of conscience to overcome the anxiety that they experience when consciousness in not met at work.
Conclusion: Unreliable organizational environments should be taken seriously by senior managers as a cause of concern in nursing managers. Creating healthy interpersonal relationships within the organization and setting up a creative atmosphere are effective in improving the organizational environment. The sensitivity of managers towards teaching ethical and managerial principles and developing a positive attitude towards applying ethics can be facilitating in managers' ethical decision-making processes. Also, employing empowered managers in decision-making and giving them sufficient autonomy in describing their responsibilities can be effective in reducing their decision-making barriers
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