The manner in which nurses address and eventually solve ethical and moral questions and institutional problems is not yet well explained. This is a qualitative descriptive study examining the moral decision-making processes used by 24 nurses. The work of Carol Gilligan provides the framework for this study. The perspectives of the nurses was explored and a determination was made as to whether the justice or caring orientation prevailed in the situation. The method described by the Gilligan group is explained. Three stories are presented to serve as exemplars of the various orientations and of institutional forces that were active in the nurses' stories. The caring orientation was clearly present, as was the justice orientation to a lesser degree. Other issues such as power and financial security also were apparent.