Trust crisis: New frontline nurse managers' ethical experience in their units.

Purpose To explore the ethical experiences of new nurse managers when working at their units and propose response strategies accordingly. Design and methods A qualitative approach was taken at a Grade 3A hospital in Shandong, China. Data were collected via semi-structured long interviews and analyzed using interpretative phenomenological analysis. A total of 19 new frontline nurse managers participated in the study. Findings The sample consisted of 17 females and two males, with an age range of 40.11 ± 2.71 years and each worked in a variety of units. Trust crisis, tests on capability, and conflicts with the administration were the main ethical issues of new nurse managers, and trust crisis was the most common, especially with nurses in the unit. Eleven subthemes were also involved in these three themes. Conclusions New nurse managers encountered a variety of ethical conflicts and dilemmas in their first year. They should enhance their leadership to cope with the issues, and policy support at the hospital level is also needed. Clinical relevance Senior hospital managers could use these findings to design interventions that might solve new frontline nurse managers' ethical issues. And medical staff might understand the ethical experiences of new nurse managers and support them in the most critical period of role transition. Findings are conducted in the hope of facilitating new nurse managers to quickly settle into the new position, establishing a good relationship with physicians and patients and improving the quality of nursing services.