Answer The Questions At The End Of Each Case ✓ Solved

In Each Case Answer The Questions At The End Of The Case And Give Res

Case One Summary: Mrs. Lewis, a head nurse at a community hospital, notices signs of patient abuse at Shady Rest Nursing Home. She reports this to the Department of Welfare, which investigates and finds proof of abuse. The hospital administrator, who has personal ties to Shady Rest, threatens Mrs. Lewis with termination if she reports further abuse, creating a conflict between legal/ethical obligations and workplace relationships. Mrs. Lewis seeks legal counsel, highlighting a dilemma involving moral integrity, legal compliance, and workplace loyalty.

Case Two Summary: Mrs. Allesfertig, the hospital nursing supervisor, identifies severe understaffing in the ICU and responds by reallocating experienced nurses to maintain patient care quality. Dr. Bestknabe, who oversees the ICU, then temporarily closes the unit until staffing can be stabilized. The case raises questions about whether nurses should have the authority to refuse patient admissions when staffing levels are insufficient and whether policies can or should override professional judgment in critical care settings.

Research and Ethical Analysis

Mrs. Lewis’s Actions and Ethical Considerations

Mrs. Lewis's decision to report abuse aligns with fundamental nursing ethical principles such as beneficence (doing good), nonmaleficence (avoiding harm), and justice (protecting vulnerable populations). Legally, mandatory reporting laws require health professionals to report suspected abuse, as Mrs. Lewis did, to safeguard patients and uphold societal obligations (American Nurses Association, 2015). Her subsequent opposition from hospital administration exemplifies the tension between ethical duty and institutional pressures, often encountered in healthcare (Siegel, 2016).

The ethical course of action for Mrs. Lewis was to adhere to her professional responsibilities despite administrative pressure. By reporting the abuse, she prioritized patient safety and legal obligations over internal workplace loyalties—an act of professional integrity. Consulting a lawyer was an appropriate step; if she could not afford legal counsel, she might have sought assistance from professional nursing associations or state boards that often offer legal guidance to members (Fletcher & DeNisco, 2018). Whistleblowers can protect themselves by understanding their legal rights under whistleblower protection statutes, documenting all relevant communications, and seeking support from professional organizations (Near & Miceli, 2016).

Distinguishing Ethical Actions from Workplace Retaliation

Healthcare professionals must recognize that patient safety and legal compliance should not be compromised by threats or intimidation. Ethical practice requires standing firm on moral obligations, even in hostile environments. Power, when misused to silence whistleblowing, undermines ethical standards and jeopardizes patient safety. Power dynamics are central to healthcare ethics, especially concerning vulnerable populations; exercising moral courage can challenge unjust hierarchies and foster organizational accountability (Boat & Yingling, 2017).

Case Two: ICU Staffing and Ethics of Admission

The decision by Mrs. Allesfertig to reallocate experienced nurses demonstrates proactive leadership aimed at safeguarding patient care. The ICU's decision of whether to refuse admissions when staffing is insufficient hinges on the principles of beneficence, nonmaleficence, and justice. Nurses and facilities have an ethical obligation to ensure safe patient care, which might sometimes mean refusing or delaying admissions if staffing levels jeopardize patient safety (Benner et al., 2010).

In some hospitals, nurses are empowered with the authority to refuse patient admissions under unsafe conditions. This aligns with the ethical principle that patient care must not be compromised due to staffing deficits. Policies that recognize nurse autonomy foster accountability and uphold quality standards (ANA, 2015). Conversely, policies must also respect institutional needs and overall care priorities; thus, clear guidelines should be developed to balance patient access with safety considerations.

Ultimately, policies should not supersede the professional judgment of ICU nurses. Nurses possess specialized knowledge and clinical judgment essential to patient safety (Benner, 2001). Policies that restrict nurses from making critical decisions conflict with core ethical principles of professional autonomy and responsibility. Protecting nurses’ ability to exercise clinical judgment promotes ethical practice and patient safety (ANA, 2015). Therefore, hospital governance must ensure that policies empower nurses to act according to their professional standards in complex situations.

Conclusion

Both cases illustrate the importance of ethical principles and professional responsibility in healthcare. Mrs. Lewis acted ethically in reporting abuse despite institutional opposition, emphasizing the duty to prioritize patient safety and legal compliance. Healthcare staff must be equipped to protect themselves and advocate for their patients, utilizing legal protections and organizational support. Meanwhile, staffing policies in the ICU should support nurses’ professional judgment, ensuring patient safety remains the priority. Ethical healthcare practice requires balancing individual moral obligations, legal mandates, and organizational policies, fostering a culture of integrity and accountability.

References

• American Nurses Association. (2015). Code of Ethics for Nurses with Interpretive Statements. ANA.
• Benner, P. (2001). From Novice to Expert: Excellence and Power in Clinical Nursing Practice. Prentice Hall.
• Benner, P., Tanner, C., & Chesla, C. (2010). Expertise in Nursing Practice: Caring, Clinical Judgment, and Ethics. Springer Publishing Company.
• Fletcher, K., & DeNisco, S. (2018). Advanced Practice Nursing: An Integrative Approach. Jones & Bartlett Learning.
• Near, J. P., & Miceli, M. P. (2016). Whistle-blowing and organizational ethics. Journal of Business Ethics, 25(1), 53-62.
• Siegel, B. (2016). Ethical dilemmas and nursing: Principles, practice, and challenges. Nursing Ethics, 23(3), 260-270.
• Boat, T. F., & Yingling, D. (2017). Power and Ethics in Healthcare: Navigating Organizational Conflicts. Journal of Healthcare Management, 62(1), 39-46.