Ethical dilemmas frequently occur in the practice of orthopaedic nursing. Nurses, however, are often unsure about how to resolve these dilemmas. The language of ethics remains elusive. Yet, because nurses have a central role in patient care, they need to become more comfortable making ethical decisions related to their practice. This article briefly describes the dialectical process of ethical decision making and demonstrates this process by using a case presentation. Readers are encouraged to put themselves into the role of the bedside nurse in the case, determine what they believe to be the right action, and provide a well-grounded rationale for that decision.