Directions:
Ethical Issue Clinical Judgment Case Scenario

Nurse leaders and managers are responsible for the unit’s ethical and legal decisions.

Initial Post

Consider the examples provided below and describe how you would handle the experiences.

A manager is not granting pay to someone who worked overtime.
A nurse manager tolerating verbal abuse of another nurse.
Constantly short staffing the unit when there is high census.
A nurse not providing all of the patients information during shift report.
Favoring one staff over others.
Making a hiring or firing decision based on friendship.
Reply Post

Respond to at least one of your peers about their example that illustrates their interpretation of DECIDE. Expand on your peer’s ideas.

Note:

“Expand on your peer’s ideas” needs more than 1 – 2 sentences for an acceptable reply.
If you refer to a website or article, be sure to cite it in APA format. This prevents plagiarism and allows your fellow students to review the cites and increase the class knowledge base.
Please make your initial post by midweek, and respond to at least one other student’s post by the end of the week. Please check the Course Calendar for specific due dates.

___________________________

A manager is not granting pay to someone who worked overtime. This is a clear violation of the employee’s rights and should be addressed immediately. I would first speak to the manager directly to try to resolve the issue. If that is not successful, I would escalate the issue to the human resources department.
A nurse manager tolerating verbal abuse of another nurse. This is also a serious issue that should not be tolerated. I would first speak to the nurse manager directly to express my concerns. If the behavior does not stop, I would escalate the issue to the human resources department.
Constantly short staffing the unit when there is high census. This is a dangerous situation that puts both patients and staff at risk. I would first speak to the nurse manager to try to understand why the unit is consistently short-staffed. If the staffing issue is not resolved, I would escalate the issue to the hospital administration.
A nurse not providing all of the patients information during shift report. This is a serious breach of patient confidentiality and could have serious consequences for the patient. I would first speak to the nurse directly to express my concerns. If the behavior does not stop, I would escalate the issue to the nurse manager.
Favoring one staff over others. This is unfair to the staff who are not being favored and could create a hostile work environment. I would first speak to the nurse manager to express my concerns. If the behavior does not stop, I would escalate the issue to the human resources department.
Making a hiring or firing decision based on friendship. This is a conflict of interest and could lead to unfair decisions being made. I would first speak to the nurse manager to express my concerns. If the behavior does not stop, I would escalate the issue to the human resources department.
I agree with your interpretation of DECIDE. I think it is an important tool for nurse leaders and managers to use when making ethical decisions. By following the DECIDE process, nurse leaders and managers can ensure that they are making decisions that are in the best interests of their patients, their staff, and their organization.

Here are some additional thoughts on how to expand on the ideas of your peers:

A peer suggests that a manager should first try to resolve an ethical issue informally. I agree with this suggestion. In many cases, informal discussions can be an effective way to resolve ethical issues. However, it is important to be prepared to escalate the issue to a more formal level if necessary.
Another peer suggests that a nurse leader should document all ethical issues. I also agree with this suggestion. It is important to document all ethical issues, including the steps that were taken to resolve them. This documentation can be helpful if the issue ever needs to be revisited.
A third peer suggests that a nurse leader should seek advice from other nurse leaders and managers. I think this is a great idea. It can be helpful to get advice from others who have experience in dealing with ethical issues

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