Nurse Managers’ Ethical Problems in Hospital Settings: An Analysis From the Macintyrian Perspective

Abstract

Objective: to understand hospital nurse managers’ ethical problems from the perspective of Macintyre’s virtue ethics. Method: qualitative research of the single case study type, encompassed by Alasdair Macintyre’s theoretical framework of virtue ethics. Sixteen nurses in management positions participated in the study for a minimum period of six months. The setting was a university hospital in Belo Horizonte, Brazil. Data were collected between August and October 2021, through individual interviews with a semi-structured script and document analysis, analyzed using Bardin’s content analysis. Two categories of ethical problems emerged from the thematic analysis linked to violations of care values: internal goods; and linked to breaking norms, patterns of behavior and interpersonal relationships: external goods. Results: the ethical problem is present in care, in relationships and in the institution. When referring to the profession’s internal assets, ethical problems are characterized as a violation of care values: denial of assistance, negligent and reckless actions or violation of the rights of professionals, patients, staff and institutions. When referring to external goods, such problems are linked to interruption of norms, inappropriate actions and behaviors or ethical conduct questioned and disrespected by professionals. Conclusion: nurse managers understand ethical problems as circumstances that generate opposition to actions considered correct and that go against what is proper to nurses and against their duty, negatively affecting professionals, patient care, the institution and the public service.