Discussion – Ethical Issue Clinical Judgment Case Scenario

Discussion – Ethical Issue Clinical Judgment Case Scenario

Numerous ethical and legal issues arise in clinical practice, and nurse leaders/managers are expected to satisfactorily address these challenges to uphold the unit’s integrity and deliver quality healthcare services. Below are examples of typical ethical dilemmas and how applying the DECIDE model for ethical clinical reasoning would look.

Overtime Pay

Not paying a nurse for extra hours worked is immoral and unlawful. Tackling the problem starts with ensuring that all information regarding the issue is compiled, including the timesheets and the policy about overtime premiums (Determine). Subsequently, the effects of non-payment should be further discussed, as well as possible legal implications and the morale of the staff (Evaluate) (El-Gazar & Zoromba, 2021). Possible solutions include talking to the payroll department about the problem or taking the matter to the next level of management (Consider). The proposed solution is achieved by ensuring the nurse is paid the right amount. (Specify). Lastly, the event is recorded, and the result is shared with all the stakeholders. (Evaluate). This approach prevents any bias and upholds the testing ethical principle of fairness.

Verbal Abuse

Tolerating verbal abuse creates a toxic environment. First, assess the situation by gathering accounts from both parties (Determine). Next, evaluate the effects of abuse on staff morale and patient care (Evaluate). Solutions could involve mediation or disciplinary action against the abuser (Consider). Follow-up is necessary to ensure the abuse ceases (Implement and Evaluate). Additionally, maintaining a respectful workplace is crucial for team cohesion and patient care (Storaker et al., 2022).

Short Staffing

Regular shortages of staff are also a major factor that hinders or lowers the quality of care delivered to patients. Short staffing is defined (Define), its consequences are assessed (Assess), and its implications for patient safety are assessed (Analyze). Possible interventions may include modifying the staffing pattern or resources (Consider ), with follow-up examinations to ascertain whether the issue is being addressed (Implement and Evaluate).

Incomplete Shift Report

The omission of all patient information is prejudicial to patient safety. The cause for exclusion should be found or determined (Determine), and procedures like retraining or the use of a checklist should be employed (Consider and Implement) (Aitamaa et al., 2019).

Favoritism and Hiring Based on Friendship

Favoritism and friendship-based hiring/firing decisions create inequality. These behaviors are identified (Determine), and fair, merit-based practices are implemented to restore equity (Consider, Implement, and Evaluate).

References

Aitamaa, E., Suhonen, R., Puukka, P., & Leino-Kilpi, H. (2019). Ethical problems in nursing management – A cross-sectional survey about solving problems. BMC Health Services Research, 19(1), 1–11. https://doi.org/10.1186/s12913-019-4245-4

El-Gazar, H. E., & Zoromba, M. A. (2021). Ethical Leadership, Flourishing, and Extra-Role Behavior Among Nurses. SAGE Open Nursing, 7(6). https://doi.org/10.1177/23779608211062669

Storaker, A., Heggestad, A. K. T., & Sæteren, B. (2022). Ethical challenges and lack of ethical language in nurse leadership. Nursing Ethics, 29(6). https://doi.org/10.1177/09697330211022415

Ethical Issue Clinical Judgment Case Scenario
Nurse leaders and managers are responsible for the unit’s ethical and legal decisions.

Discussion – Ethical Issue Clinical Judgment Case Scenario

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 yo
ur 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.