Read the case and answer the question in your opinion and not google Case 2 Vanessa Hardgrove has four children ranging

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Read the case and answer the question in your opinion and not
google
Case 2
Vanessa Hardgrove has four children ranging in age from 3 to 14
years and a husband who is a successful but underpaid account
executive. Vanessa is a registered nurse and, in addition to her
duties as a mother, she works a full shift each day. Vanessa has
spoken with her husband on several occasions about how overwhelmed
she feels with the demands of the house, children, and work. She
has suggested a housekeeper once weekly and a babysitter one night
a week to give her some rest and relaxation time. He responds that
he feels certain he will receive a substantial raise in the near
future, but now they simply do not have enough money. Vanessa's
work performance takes a slow but steady turn for the worst. Her
peers mention to each other that she looks exhausted all the time.
She has begun to forget commitments she makes to her children. She
has forgotten to give medications to patients. She has dull
migraine headaches. Out of desperation, she starts taking pain
medications intended for patients. She records the medications as
given to patients and then takes them herself or takes them home
for later use. Her work performance improves. She sleeps well at
night, and the migraines are under control. Her peers talk about
her improvement in attitude and patient care. Howard is the
physical therapist for the floor where Vanessa is a nurse. Some of
his patients do significantly better in their therapy if they get
mild pain medications prior to treatment. Some inevitably say they
have not received medications when in fact they have. The effects
of the hospital-unfamiliar faces and schedules, side effects of the
medications-often make patients unreliable. But even with these
allowances, Howard notices that the complaints of pain and the
denials that they have received their medications are significantly
higher on this floor, and almost all of the complaining patients
are under Vanessa' s care. Howard reports his suspicions to his
boss, Andreas, who talks with the nursing supervisor, Lynn. Lynn
responds that it is probably just a coincidence, but nonetheless
agrees to talk with Vanessa. Lynn calls Vanessa into her office and
tells her the observations that have been brought to her, including
the suspicions that she is taking patient's medications for her own
use. Vanessa immediately breaks down and cries. She says she knew
it was wrong but she was so desperate for something to make the
stress bearable that she made a terrible mistake. Lynn tells her
about the employee assistance program, which offers a drug
rehabilitation program, and asks her if she would like to enroll.
Vanessa agrees. Lynn goes on to explain that Vanessa will be
suspended without pay until she completes the program. The
following week Lynn talks with Andreas about what occurred and the
course of action she has taken. He seems to support her, but the
next day Andreas contacts the chief executive officer, the head of
human resources, and the head of the legal department to discuss
Lynn's decision. Andreas explains that what Vanessa did was illegal
and should result in permanent dismissal and that a report should
be made to the licensure board for nurses for additional remedy.
Lynn responds by saying that the policy manual makes the employee
assistance program available to all employees. Andreas responds
that the same policy clearly states, in compliance with state law,
that rehabilitation programs do not have to exclude other
disciplinary actions, including dismissal. Lynn says that she sees
this problem from the perspective of a disease. Vanessa should be
protected by the Health Insurance Portability and Accountability
Act as well as by state law, which binds an employer from giving
out confidential information. Andreas restates his position that
nothing in policy prevents dismissal and, at a minimum, dismissal
is the only defensible course of action. The hospital's primary
responsibility is to its patients, not its employees, and patients
either were or could have been seriously harmed. Lynn responds that
the hospital had dual commitments to patients and employees and
this requires a balanced course of action, which is what she
pursued.
Points to consider: [The content offered is not intended to be
complete. These are merely ideas to help stimulate options that are
more creative.]
1. Moral reasons: What are the obligations and virtues
applicable in this case? Vanessa's duties to her patients and their
reciprocal rights are critical. However, employers have duties to
employees as well as expectations for employees to honor their
rights as employees. An understanding of the nature of addiction as
a behavior choice or as something more complex with components that
make a person less than competent are at the core of this case.
2. Facts: What are the facts in this case? Who are the major
stakeholders? What are the applicable federal, state, or local
ordinances that apply? Vanessa admitted to taking drugs intended
for patients and using them for herself. The physical therapist
reported his suspicions because of poor patient performance
secondary to pain levels that could have been avoided with proper
medications. The head of physical therapy perceives this as a legal
violation justifying dismissal and a report to the licensure board.
The head of nursing sees this as a medical condition with
rehabilitation as the desired outcome.
3. What are the realistic options, and what are the likely
outcomes for each one? a. Report Vanessa to the licensure board and
to the police, and dismiss her from employment. (This will
certainly end her nursing career and may result in criminal charges
and civil charges if patients charge that they were harmed.) b. Let
Vanessa enroll in the employee assistance program and dismiss her
from employment. (Because her participation in drug rehabilitation
will be protected by most states' laws and as employers have duties
of confidentiality about employees, Vanessa will probably be free
to seek employment elsewhere without obstruction. The next hire to
replace her may be someone in an identical situation.) c. Enroll
Vanessa in the employee assistance program and suspend her without
pay until the program is completed; then reinstate her under
probationary conditions that include random drug testing. (This may
protect patients and salvage her professional career.) d. Enroll
Vanessa in the employee assistance program and keep her employed
with closer supervision. (This demands fewer organizational
resources, but it might not offer a completely safe environment for
patients.)
4. Deliberate and make a decision: On balance, which option will
most reasonably balance and integrate moral reasons?
5. Take action.
6. Review the process and outcomes and look for ways to improve
the process