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AIM To explore the factors affecting the emergence of diplomacy in Iranian nurse managers. BACKGROUND Today, with the development of complex health systems, diplomacy in health care can take place at organizational, national and international levels. INTRODUCTION Diplomacy\'s role is to convince others peacefully to achieve goals. Diplomacy in nursing can facilitate professional development and direct policy and decision-making process towards the development of a healthcare system. METHODS The study used a qualitative descriptive approach. The sampling method was purposeful, and data were collected via in-depth, unstructured and face-to-face interviews with 16 participants. The interviews were digitally recorded, transcribed verbatim and analysed through conventional content analysis based on Graneheim and Lundman\'s work. RESULTS In total, 212 codes were generated, which were grouped into three main categories, namely paradigmatic socio-political changes (two subcategories), nurses\' dissatisfaction with their status in healthcare system (two subcategories) and multidimensional development of the nursing profession (four subcategories). DISCUSSION/CONCLUSIONS Socio-political changes, development of the nursing profession and nurses\' dissatisfaction with the health system have led to the emergence of diplomacy roles in nurse managers, the recognition and development of which can improve the effectiveness of nurse managers in policymaking. IMPLICATIONS FOR NURSING & HEALTH POLICY The recent COVID-19 pandemic outbreak has demonstrated the urgent need to use diplomacy to solve health problems and adjust or develop policymaking at the national and international levels. Strengthening their role in diplomacy, nurse managers can play an important role as diplomats at various levels of policymaking and in health crisis management.
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