The process by which nurses make ethical decisions in clinical practice has significance for practitioners, educators, and administrators concerned with professional standards and the quality of care. This exploratory study attempted to ascertain the stages employed by psychiatric nurses when making ethical decisions in clinical practice. Based on the theory of symbolic interactionism, a semi-structured interview was developed. Twenty-four nurses participated in interviews during which they discussed ethical problems which occur in clinical practice. Content analysis of interview transcripts revealed a ten stage process used in ethical decision making. The process begins with an emotional response upon hearing of an event which affects clinical practice and ends in an aftermath which includes feelings, talking with others, reconsiderations, and change or vows to change. The study identifies both affective and cognitive components of the decision making process. The importance of the emotional aspect of ethical decision making, absent from previous studies, is recognized and evaluated. Implications based on the study suggest that the problems of ethical decision making may be a significant part of the stress in nursing. In addition, there is evidence that the process of ethical decision making affects the nurse's view of self and the profession and may have direct bearing on her/his leaving nursing for another professional career.