برنامه رهبری اخلاقی برای مدیران واحد پرستاری An ethical leadership program for nursing unit managers

1. Introduction Health care ethics is a globally shared concern. Traditionally, healthcare ethics focused on individual healthcare professionals, particularly patient relationships. However, the 21st-century healthcare delivery system requires ethics at all healthcare leadership levels from staff to clinicians, administrators, executives, and even policymakers (Ho and Pinney, 2016). Inducing business and market-oriented values such as efficiency and cost-effectiveness in healthcare presented modern healthcare delivery system leaders with different ethical challenges from those in the traditional system (Makaroff et al., 2014). Unethical leadership may negatively impact followers’ work performance and, consequently, cause problems in patient outcomes and organizational effectiveness (Keselman, 2012). Ethical leadership (EL) is understood with various questions rather than one definition, e.g., “What should ethical leaders do?”, “What impact do ethical leaders have?”, and “How can EL be taught?” Brown et al. (2005) present a popular definition of EL as leaders showing “normatively appropriate conduct” and promoting followers’ conduct such as honesty, trustworthiness, fairness, care, two-way communication, discipline, and decision-making. Kalshoven et al. (2011) extended this with various behavioral dimensions such as fairness, powersharing, role clarification, people orientation, integrity, ethical guidance, and concern for sustainability. Nursing scholars have visualized EL among nurses through analyzing several studies (Makaroff et al., 2014). They reported that ethical leaders should not only be responsive and supportive to nurse staff and contextual system but also receive support from superiors. Furthermore, these scholars identified critical nurse leadership roles as building nurse staff ethical competencies and creating an ethical climate (Makaroff et al., 2014). Thornton (2013) explained EL with complexity including not only a people-oriented view, including personal ethical traits and organizational responsibilities, but also an environment-oriented view, including interpersonal behaviors and community, society, and future generation responsibilities. She defined EL with seven views (profit, law, character, people, communities, planet, and greater good) and 14 principles.