This paper discusses the occupational health nurse's dilemmas by illustrating two cases faced by nurses in occupational health practice and setting out their analysis according to a decision-making model. The counter-interests, which may offend the principles of conserving professional occupational ethics among service consumers and employers as well as fellow professionals, are emphasized. This paper also describes the complex problems involved in the worker's safety and the safeguarding of their autonomy, while preserving interpersonal relations among the various people concerned.