Health institutions can be considered as complex organizations because they need to be prepared to receive and satisfy patients. This clientele differs from other organizations because the use of hospital services is not a matter of choice. Another motive for this difference is that, most often, the patients do not determine what services and products they will use during their stay. Although they are the clients, usually, health professionals decide which service or product they will consume. Hence, nursing care delivery based on competence, efficiency and ethics represents a challenge.

This critical reflection is meant to draw attention to the relevance of the ethical aspects of nurses’ actions involving patients’ satisfaction with nursing care.

This paper highlights the responsibility of nurses to develop ethical actions in their commitment to manage and provide care with quality, commitment and efficiency. Findings and discussion: Possibilities of actions needed emerged from this discussion, such as the provision of reliable and updated information to clients, respect for standards, routines of care, exams and others, as well as clients’ education, in order to further their involvement and participation in decisions concerning the care planned for them.

The adoption of this paradigm entails a change in the performance of nurses’ management and care roles, which may have to observe attitudes previously disregarded in most services provided.