Between meaning and duty - leaders' uses and misuses of ethical arguments in generating engagement.

AIM

To identify, record and determine from the perspective of an argumentation theory whether and how nurse leaders use or possibly misuse ethical arguments to motivate and engage their staff when daily practice is affected by reforms.

BACKGROUND

In some cases, health reforms based on New Public Management theories have met resistance, especially when perceived as contrary to nurses' professional and personal ethical values, creating a motivational challenge for nurse leaders.

METHODS

Qualitative thematic analysis and argumentation analysis based on personal interviews, focus group interviews and observations of nurse leaders and nurses in two different wards in a Danish hospital that has undergone structural and management reforms.

CONCLUSION

Nurse leaders use ethical arguments to engage their staff, either by trying to make the reforms ethically meaningful or by appealing to duty when no meaning can be found. Occasionally, these ethical arguments are fallacious and inconclusive from an argumentation theory perspective.

IMPLICATIONS FOR NURSING MANAGEMENT

Using ethical arguments can motivate and engage staff, but it may also escalate conflicts. Managers and leaders must be aware that, if the argument is flawed, appealing to higher ethical values is not always beneficial.