Nurse leaders are required to make rapid, high-impact decisions that directly influence patient safety, team performance, and organizational outcomes. This e-learning module, Smart Decisions Under Pressure: Decision Making for Nurse Leaders, equips participants with structured frameworks to support effective judgment in complex and time-sensitive clinical environments. Learners will explore different decision-making styles and when to apply them, while developing a step-by-step approach to analyzing problems, evaluating options, and implementing solutions. The course also emphasizes the integration of ethical principles and professional standards to guide decision-making in moral and resource-related dilemmas. Designed for nurse leaders at all levels, this module strengthens the ability to make confident, collaborative, and patient-centered decisions under pressure. Vanderbilt University School of Nursing is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s (ANCC) Commission on Accreditation. To earn continuing education credit, participants must complete both the Nurse Leader pre-assessment and post-assessment. Upon successful completion, learners will be awarded 0.75 ANCC contact hours.