Objective To explore nurses′ feelings and needs regarding ethical decision-making in clinical practice, so as to provide a reference for implementing targeted measures to enhance their ethical decision-making competence. Methods A phenomenological study was designed. Fourteen nurses were selected through purposive sampling and underwent semi-structured interviews. Data were analyzed using Colaizzi′s seven-step analysis method to identify, condense, and extract themes. Results Three main themes and nine sub-themes were identified: emotional experiences in ethical decision-making (responsibility, pressure, sense of achievement), ethical dilemmas (confusion, helplessness, psychological burden) and perceived needs (ethical awareness, communication skills, organizational support). Conclusion Nurses frequently encounter ethical dilemmas and express diverse needs for support in ethical decision-making during clinical practice. It is recommended that managers provide systematic support to enhance nurses′ ethical decision-making competence.