title: Ethical problems in nursing management: The views of nurse managers.
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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: University of Turku, Finland; Satakunta Hospital District, Finland elina.aitamaa@utu.fi.
authors.forename: Elina
authors.initials: E
authors.lastname: Aitamaa
authors.affiliation: University of Turku, Finland; Turku University Hospital, Finland.
authors.forename: Helena
authors.initials: H
authors.lastname: Leino-Kilpi
authors.forename: Silja
authors.initials: S
authors.lastname: Iltanen
authors.affiliation: University of Turku, Finland; Satakunta Hospital District, Finland.
authors.forename: Riitta
authors.initials: R
authors.lastname: Suhonen
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003657:Decision Making / Q000941:ethics; D004991:Ethics, Institutional; D004993:Ethics, Nursing; D006801:Humans; D008875:Middle Aged; D009718:Nurse Administrators / Q000941:ethics* / Q000523:psychology; D015279:Organizational Culture; D036301:Qualitative Research
keywords: Ethical problem; ethics; interview; nurse manager; nursing management