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NU420 Leadership and Management in the Changing Health care Environment

NU420: Unit 7 Discussion

As a nurse leader, you are sometimes confronted with ethical and legal dilemmas. Fortunately, multiple laws and professional standards are available to guide you in the best direction for the patient, the organization and yourself. (Your state’s Nurse Practice Act, the ANA Code of Ethics are great places to start)

For this discussion board assignment, please select one of the two scenarios below and answer the discussion questions related to the cases.

Scenario 1: Catching up on work

You are the new nurse manager of a busy medical office and you are asked to come to the corporate office because of an incident that occurred after hours yesterday.

A local citizen brought a shopping bag of patient charts to the area hospital. The charts were found at a car wash. They appear to be the charts of patients seen over the past few days in your office. An investigation revealed that a nurse who works in the office has been bringing charts home to complete documentation in the evenings and then bringing them back the next day. On this occasion, the nurse washed their car and removed the bag of charts to vacuum. The charts were then inadvertently left at the car wash, where the local citizen discovered them.

The nurse admitted that she took the charts home even though it is clearly prohibited by policy. She stated that she has been struggling to keep up with her workload because of frequent staffing issues in the office.

Scenario 2: False intentions

You are the nurse manager of a small pediatrics unit. When you arrive to work one morning, night Nurse A asks to speak with you. The nurse reports that a patient appears to have a serious infection in a wound on her face. The wound dressing on her face was identified by date and initials as the same one that Nurse A applied the night before. Nurse A reviewed the charting from the off-going Nurse B. Nurse B’s documentation indicated that the dressing was changed and the shift assessment revealed no signs of infection.

Upon the attending physician’s examination, the wound had spread and was presumptive for osteomyelitis. The patient was transported to a larger medical center for treatment. An interview with Nurse B revealed that the nurse had been “busy” and forgot dressing supplies when the shift assessment and medications were administered. Nurse B stated that the patient’s family was difficult to deal with and often scrutinized the nurse’s care. While charting at the end of the shift, Nurse B falsified documentation rather than face the family and have them question the nursing care.

Discussion Questions

  1. Please explain what violations of ethical standards or laws have occurred in the selected case. Include the specific language from the legal or professional entity.
  2. Determine whether the occurrence needs to be reported to a legal entity such as your state’s board of nursing or any federal agency. Include supporting rationale and the reporting process if applicable.
  3. Are there any legal or financial ramifications of the event in terms of fines, lawsuits or additional agency oversight? If so, what are they?
  4. What is your evaluation of the scenario? What could you do as a nurse leader to prevent a similar event from happening in the future?

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