The nurse is working the 7p-7a shift as the night charge nurse. On the last evening she worked, one of her peers challenged the nursing assignment for the shift because the charge nurse did not assign her to care for client John Doe. The nurse specifically requested to care for Mr. Doe because she felt with the staffing shortage, he would not receive good care and she wanted to avoid problems for the institution from her family. The charge nurse noted that the client was the nurses’ brother-in-law.

QUESTION

Choose 1 question from Group 2: Nursing Ethics and Workforce Advocacy 

Group 2, Question 1: The Nurse Who Wants to Care for a Relative

The nurse is working the 7p-7a shift as the night charge nurse. On the last evening she worked, one of her peers challenged the nursing assignment for the shift because the charge nurse did not assign her to care for client John Doe. The nurse specifically requested to care for Mr. Doe because she felt with the staffing shortage, he would not receive good care and she wanted to avoid problems for the institution from her family. The charge nurse noted that the client was the nurses’ brother-in-law.

The charge nurse refused to change the assignment and cautioned the nurse not to review the client’s information nor ask to request confidential information from the care nurse as there were no signed documents giving her permission to access this information from the client. The nurse, after yelling and screaming in the report room at the charge nurse, then threatened to report the charge nurse to the nurse manager and to hospital administration for her “dumb decisions.”   Respond to the following questions about this situation.

1. Define the ethical theory which best defines the motives of the nurse who desires to care for her brother-in-law in this situation.
2. According to the nursing code of ethics, if the nurse had been allowed the assignment, what ethical violations would have occurred? Provide a brief explanation of why it was a violation.
3. What were the ethical responsibilities of the Charge Nurse according to the ANA Code of ethics? Provide a brief explanation of why this was a responsibility in this case.
4. How might the Charge Nurse address the repetitive staffing shortage issues?

ANSWER

 Ethical Dilemma: The Nurse Who Wants to Care for a Relative

Introduction

In this scenario, a nurse working the night shift desires to care for her brother-in-law, who is a patient in the hospital. However, the charge nurse refuses to assign her to the patient, leading to a heated exchange between the two. This situation raises ethical questions regarding the motives of the nurse, potential violations of the nursing code of ethics, and the responsibilities of the charge nurse. Additionally, addressing the repetitive staffing shortage issues becomes crucial for maintaining quality patient care.

Ethical Theory

The ethical theory that best defines the motives of the nurse who desires to care for her brother-in-law is “Familial Relationship Ethics.” This theory emphasizes the importance of family relationships and the natural inclination to protect and care for one’s relatives. The nurse’s desire to ensure good care for her brother-in-law is driven by her personal connection and concern for his well-being. However, it is essential to balance this ethical consideration with professional boundaries and ethical guidelines.

Ethical Violations

According to the nursing code of ethics, if the nurse had been allowed the assignment, several ethical violations would have occurred. These include:

Conflict of Interest: Caring for a family member can compromise objectivity and impartiality in decision-making, potentially affecting the quality of care provided.

 Breach of Confidentiality: Accessing confidential patient information without proper consent or authorization would violate patient privacy rights and the duty to maintain confidentiality.

 Ethical Responsibilities of the Charge Nurse

According to the ANA Code of Ethics, the charge nurse had the following ethical responsibilities:

Ensuring Patient Safety and Quality Care: The charge nurse has a duty to assign staff based on their qualifications and expertise, taking into consideration the best interests of the patients. This responsibility ensures that patients receive appropriate care from competent healthcare professionals.

Upholding Ethical Standards: The charge nurse must adhere to ethical guidelines, including maintaining patient confidentiality, respecting professional boundaries, and avoiding conflicts of interest. These standards protect the rights and well-being of patients and maintain trust in the healthcare system.

Addressing Staffing Shortage Issues

To address the repetitive staffing shortage issues, the charge nurse can consider the following strategies:

Advocating for Adequate Staffing: The charge nurse should communicate staffing concerns to the nurse manager and hospital administration, emphasizing the impact on patient safety and quality of care. This can help prioritize the allocation of resources and address the staffing shortage effectively.

Collaborating with Human Resources: Working with the human resources department, the charge nurse can explore options to attract and retain qualified nursing staff. This may involve revising recruitment strategies, offering incentives, and providing ongoing support and professional development opportunities.

Implementing Effective Workforce Management: The charge nurse can develop efficient scheduling practices, considering factors such as workload, staff preferences, and skill mix. This can help optimize staffing levels and ensure appropriate coverage during high-demand periods.

Conclusion

The ethical dilemma faced by the nurse who desires to care for her brother-in-law highlights the importance of maintaining professional boundaries, upholding ethical standards, and ensuring quality patient care. Adhering to the nursing code of ethics and addressing staffing shortage issues are crucial for maintaining the integrity of the profession and promoting the well-being of both patients and healthcare providers. By striking a balance between personal connections and professional responsibilities, nurses can navigate such ethical dilemmas while upholding the highest standards of ethical practice.