This learning activity examines ethical decision-making in nursing leadership, covering foundational principles, contemporary healthcare dilemmas, and systematic frameworks for moral reasoning. The content addresses current challenges including AI integration, health equity, technology ethics, and moral distress management while providing practical strategies for creating ethical practice environments. Participants will learn evidence-based decision-making models to navigate complex situations involving patient care quality, organizational constraints, and team well-being, emphasizing the development of moral courage and psychologically safe environments that support compassionate, patient-centered care.