In the current health system conditions, the strategies adopted by nursing managers in their ethical decision-making can lead to different results for patients, nurses, and health systems. Therefore, the present study aimed to explain ethical decision-making strategies implemented by nursing managers. The present study was conducted using qualitative content analysis in 2022 at Shahrekord University of Medical Sciences. A total of 18 nursing managers were selected through purposive sampling and were interviewed using in-depth unstructured individual interviews. Data were analyzed using the method proposed by Graneheim and Lundman. The results revealed one main category (human-centeredness) and three subcategories (customer-centeredness, valuing employees’ dignity, and the conflict between respecting the rights of patients and employees and adhering to organizational policies). Nursing managers attempted to make their ethical decisions based on the principle of humanism by using customer-centeredness strategies, valuing employees’ dignity, and prioritizing the rights of individuals and employees over organizational rules. The results of the present study showed nursing managers make decisions in line with respecting the rights of patients and employees. However, sometimes these decisions conflict with the interests of organizations. In this regard, the existing obstacles that create the conditions for such conflicts should be identified. Increasing organizational commitment in managers can also be effective in decisions that benefit different groups of customers, personnel, and health organizations.
