Nurses' Perceptions and Experiences of Unethical Pro-Organizational Behavior: A Descriptive Qualitative Study

Background: Unethical pro-organizational behavior (UPB) is detrimental to the organization's long-term growth and can even affect the health of the industry landscape. However, we know very little about the current UPB in nursing. Aim: This study aimed to explore nurses' perceptions and experiences of UPB using the theory of planned behavior (TPB). Methods: A descriptive qualitative study was employed. Fifteen nurses from four hospitals in Chengdu, China, were selected for semistructured interviews by purposive sampling from January 2024 to March 2024 to collect data. Directed content analysis was used for analysis. Results: One hundred and two codes were developed and organized into six themes and 14 subthemes. The themes of this study are nurses' ambivalent attitudes toward UPB (beliefs about the benefits of UPB and beliefs about the harms of UPB), multiple social pressures on UPB decision-making (influence of organization, influence of leadership, and influence of coworkers), factors influencing UPB implementation (facilitating factors for UPB implementation and barrier factors for UPB implementation), complexity of UPB's behavior intentions (stick to principles and resist UPB, obedience to rules and authority, consideration of interests, and flexible decision-making), UPB in clinical contexts (concealment of negative information and violation of behavioral norms), and nurses' recommendations for managing UPB (strengthening system construction, providing multifaceted support). Conclusions: While UPB does exist in nursing, it involves multiple influencing factors and motivations and can have complex consequences. To reduce the incidence of UPB, organizations should provide nurses with multifaceted support while strengthening UPB management.