Question

Analyze the case using the 8-Step Model for Ethical Analysis;

1. Gather the facts.
2. Define the ethical issues.
3. Identify the affected parties.
4. Identify the consequences.
5. Identify the obligations.
6. Consider your character and integrity.
7. Think creatively about potential actions.
8. Check your gut.

Case Information: Sarah O’Shaun was a supervisory nurse in the pediatric unit of Hope Children’s Hospital in Fairfield, Connecticut. This morning, her calendar included an observation of three probation nurses and an informal conference with each of them. As she turned the corner into the third floor unit, she saw Debbie Franz standing outside of a patient’s door and texting. Since this was not the first time that Debbie was cautioned about the no-texting policy, Sarah knew that she had to deal with this situation. Sarah, trying to remain patient, asked Debbie to follow her to her office. Because she did not want break continuity of care, she also asked another nurse to cover Debbie’s responsibilities for a few minutes. When they reached her office, Sarah asked Debbie to sit down. She reminded her that she attended an orientation session to review the

policy that prohibited texting while on duty. In addition, Debbie signed a document affirming that she understood this policy. However, she repeatedly violated the policy and today she did so right at the patient’s door. Sarah also reminded Debbie that she was in her probationary period and could be released from her job anytime during that period. Sarah waited for Debbie to speak, but she did not expect what happened next. Debbie said, “Who do you think you are? You do not have any right to embarrass me in front of the nurses and threaten me! I am a competent nurse who graduated from Fairfield University, one of the best nursing schools in Connecticut. My grades were excellent and I had no complaints from the faculty about my texting or any other behaviors.”

Debbie continued, “You are just an old, washed up nurse who cannot do real patient care. That is why they made you a supervisor. All you do is snoop and report. I’m sick of you and you need to retire. You know what, I’m going to go to HR and report you for discrimination against me because I’m a millennial!” Sarah, quite shocked by the vehemence of Debbie’s response, took a deep breath to control her emotions. She then responded, “Perhaps it is a good idea for you to discuss this with our HR department. I will have one of the nurses continue to cover your shift while you discuss your concerns with them.” Debbie stood up and said, “Fine! You’re going to be fired over this and I think that this will be the best thing HR ever did.” As soon as Debbie left the office, Sarah telephoned the human resources department director and told her to expect Debbie. She had documentation of Debbie’s infractions through the recent conversation and records of the violations placed in Debbie’s employee file. She hoped that human resources could resolve the situation without Debbie losing her job. But she also knew that while she might be a great technical nurse, Debbie needed more training in interpersonal communication and maybe a dose of humility. A few days later, Sarah received an email regarding the Debbie situation. Apparently, she calmed down on her way to HR and was able to give her side of the story. The reason that she was texting outside the patient’s door was that she was following up on a previous text (answered on her break). Her boyfriend was arrested for drunk driving and she was checking on the situation. Debbie felt that this was a good reason for an exemption to the no-texting policy. However, she did admit that she did not explain any of this to Sarah. The HR email stated that Debbie acknowledged her violation of the no-texting policy and realized that she should have handled the situation differently. She stated that she should have notified the supervisory nurse (Sarah) that there was a family emergency. Given adequate coverage, she could have been granted emergency leave to deal with the situation. Debbie also regretted her outburst against Sarah; she was just angry about everything. The email from HR informed Sarah that Debbie would receive a Step 3 notification on her employee record, which documented all of her violations of the no-texting policy. She was also required to attend training on effective interpersonal communication offered by Hope Hospital. In addition, she was required to apologize to Debbie for her insensitive and inaccurate statements. Sarah read the email with fixed emotions. Debbie clearly violated the policy in a most public way. However, she also understood that Debbie was still learning and was pleased that she was given another chance. Sarah hoped that the training and her supervision would be enough to influence Debbie to become an excellent nurse on all levels of nursing. Sarah waited for Debbie’s apology.

Answer 1

1.Fundamental response of nurse is to promote public health, prevent illness, to restore health through according to nursing principes and always obedient to the rules and regulations of health care intitutes. There are certain fundamental nursing ethical responsibilitiesincludes Nurses and people, Nurses and profession, Nurses and practice, Nurse and Co- Workers.all these four parts are practised in good manner. Respect patient preference, integration of total care,physical support, emotional support etc. Any kinds of inappropriate approach to these ethic's are basically turned be violation of profession dignity .Nurse discharge her duties legally. The hospital care procedure are should be carefully discharged by a nurse it not to be violated, and it should be always based on nursing ethics. The nurse uses judgement in relation to individual competence when accepting and delivering responsibilities and she should keep standards of personal conduct which credit upon the profession.

2.Keeping unethical conduct by a nurse affects dignity of profession as well patient and nurses.

Organizational precondition, individual charcter and responsibility, communication challenge, support sytem all will be affected by failures in practice of ethics.in above mentioned event both sarah's, debbie, patient involved normally are affected by this conduct.Rules not permit debbie to follow texting documents likewise which seems to an individual practice.

The consequence may be a unpleasant Co-working system where it lacks understanding manners each other.

As we know the Protection of public health, protection of institution, protection of client, protection of health team, keeping standards of nursing, Accountability for client care basic obligations of a staff nurse.

In this above mentioned case both the parties sarah and debbie failed to keep a better understanding system, they advocated for their own views in accordance with their practice they used to follow.