Running head: ETHICAL AND LEGAL DILEMMAS 1

Ethical and Legal Dilemmas

Deepa Magar

3151082

Athabasca University

Case Study-C (NURS 250)

Adrienne Weare

9 August, 2017
Ethical and Legal Dilemmas 2

Ethical and Legal Dilemmas

Nurses must attend to the ethical dilemmas and responsibilities during their career due to

unique relationships in the professional practice (Blais & Hayes, 2011). Nurses need to able to

apply the ethical principle during decision making and also consider the own values and beliefs

and the values and beliefs of others (Blais & Hayes, 2011). In this paper, I have presented the

case-c from the assignment 3 and used Catalanos algorithm made for nurses for decision-making

to identify the ethical issues and interventions from the nursing perspective.

A nurse manager of the 25-bed medical-surgical unit has a responsibility of 26 staffs. It

came to her knowledge that one of the senior nurse clinicians is stealing money and other

miscellaneous objects from the patients and staffs. This senior nurse clinician has very well

reputation due to her expertise in the field and very supportive to staffs, and she supported the

manager whenever she needed help. The senior nurse is popular among the peers and patients and

earns huge respect among all of the staffs. Now, the nurse manager knows that she's stealing, and

she knows what is the right thing to do but afraid that no one will believe what her. Being quite

and doing nothing is making her morally distressed.

Catalanos decision-making algorithm is specifically designed to help nurses choose what

to do when they find themselves in an ethical dilemma (Blais & Hayes, 2011). In this case, the

nurse manager is in moral distress, she knows what is the right thing to do but unable to take the

right action due to the fear that no one will believe her. Moral distress is experienced when the

decision makers ability to carry out the moral action decision is thwarted by some barrier (Blais

& Hayes, 2011). Moral distress can result in different emotion and physiological response; it can

evoke the frustration, anger, and guilt (Blais &Hayes, 2011). The charge nurse is already feeling
Ethical and Legal Dilemmas 3

stressed. As per the algorithm, making a moral decision and rational thinking involves five steps,

starting with identifying the potential ethical dilemma and ending with either making decision or

not taking action to resolve the ethical dilemma (Blais & Hayes, 2011).

Ethical Decision-Making Algorithm

(Blais & Hayes, 2011)

The charge nurse fears that if she speaks out the truth, others might not believe her and if

she decides to stay quiet; shes going against the moral values that she holds. In this case, the

potential ethical dilemma is whether to keep quiet or to speak the truth. As per algorithm, first the

charge nurse should collect, analyze and interpret data; she has to find out if there are any

complaints filed from the patients or staffs about their missing items/cash. Does she have any

proof that the senior nurse stole the item/cash? After collecting the necessary data, the next step is

if she can solve the dilemma. Being the charge nurse of the unit, it is her responsibility to protect

the patients and the staffs from any harm. If she plans to speak out, she has to list the potential
Ethical and Legal Dilemmas 4

solutions for the dilemma. The first solution is to talk to the senior nurse in private about her

stealing behavior. If she accepts it, charge nurse can offer her help to try to find the resources

where she can get help to change the behavior or consultation programs. She also has to speak to

her manager and make plans accordingly. Senior nurse clinicians behavior might lead to

disciplinary action, and she might lose the job and license. Secondly, the senior nurse might deny

stealing; in that case, she has to inform the senior nurse that she will be reporting her and present

all the facts that she has collected against her. In this case, whether the senior nurse accepts or

denies of stealing, it has to be reported to the higher management level. If the charge nurse

decides to report to the management, other staffs and patients might not believe her. However, if

the charge nurse thinks that these consequences are unacceptable, then she will have to keep quiet

and take no action which is what she is doing right now and her action is causing her moral

distress. So, the ethical dilemma identified is whether the charge nurse should remain quiet or

speak the truth.

Stealing is never right morally and illegal, and especially the nurses those who are meant

to take care of the patients. It is against the code of ethics of the nursing profession. Nurses have

the responsibility to protect the rights of the patients (Blais & Hayes, 2011). Likewise, it is

illegal to steal, and nursing code of ethics is usually higher than legal standards (Blais & Hayes,

2011). The nurse knows that it is right to speak out against the senior nurse's behavior. Several

factors should be considered while making an ethical decision like the facts of the particular

situation, ethical theories, and principles, nursing code of ethics, clients right and personal values

(Blais & Hayes, 2011). No moral principles support the act of stealing from the co-workers and

the patients. From, deontology viewpoint, the person has to act on the right action without

worrying about the consequences (Blais &Hayes, 2011). In this case, the charge nurse should do
Ethical and Legal Dilemmas 5

the right thing by reporting the senior nurse without fearing of consequences. Similarly, Canadian

Nurse Association, 2017 states, Nurses uphold the principles of justice by safeguarding the

human rights, equity, and fairness and promoting the public good. The nurses should promote

justice; it should guard the patient's trust and their safety; it should never exploit the trust and

safeguard the therapeutic relationship with the patients (CNA, 2017). The senior nurse is

violating the relationship of trust with the patients and the co-workers. The charge nurse knows

that it is wrong to stay quiet knowing that the senior nurse is stealing from the patients and co-

workers. It is her major responsibility to create the safe environment for the patients and staffs of

the unit. The senior nurse clinician is betraying the patients and the coworkers' trust which is not

a moral act and also against the code of ethics of nursing. The only potential solution for the

charge nurse is to accept the consequences and make the decision to report the senior charge

nurse.

The main task of nurses, when confronted with the ethical dilemmas, is to maintain moral

integrity, defined by living up to the personal and professional ethical beliefs by acting honestly,

being trustworthy and consistently supporting and doing what is right (Lachman, 2016). In this

case study, moral agent recognizes the ethical dilemma. She fears that no one will believe her if

she speaks out about the senior clinician stealing habit who is also well known for her expertise

in the field and honored by the staffs and patient. The willingness to speak the truth requires

courage, but it will also foster the patient trust in nurses (Lachman, 2016). If she knows that her

action is morally correct, then she has to prioritize what is morally right instead of what is

personally valuable and act on the morally correct plan (Lachman, 2016). Even though the senior

nurse has supported the charge nurse every time she needed help, she has to keep aside those

personal relationships and act on what is morally right and required by the standard of practice.
Ethical and Legal Dilemmas 6

References:

Blais, K. K., & Hayes, J. S. (2011). Professional Nursing Practice, 6/e Vital Source ebook

Hondros College. [Vital Source Bookshelf version]. Retrieved from

http://online.vitalsource.com/books/9781256519355/id/ch04lev2sec14

Code of Ethics, 2017, Canadian Nurses Association. P.10-20. Retrieved from https://www.cna-

aiic.ca/html/en/Code-of-Ethics-2017-Edition/index.html#20/z

Lachman, V.D. (2016). Ethics, Law, and Policy. Ethical Concerns in Medical-Surgical Nursing.

MEDSURG Nursing,25(6) p. 429-432. Retrieved from http://0-

eds.a.ebscohost.com.aupac.lib.athabascau.ca/eds/detail/detail?vid=3&sid=ef20ede4-9fe7-

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