A key ethic in the nursing profession is serving as advocates for patients. At times, nurses may stand up for patients w
Posted: Sun May 08, 2022 4:29 pm
A key ethic in the nursing profession is serving as advocates
for patients. At times, nurses may stand up for patients when their
actions challenge authority. Included in Provision 3 of the
American Nurses Association’s Code of Ethics is a focus on the
patients’ rights to privacy, confidentiality, and patient safety
(Lachman 2009). The code directs nurses to report actions that may
harm the patient. That directive is clear, and it is taken
seriously by professional nurses. HR support for nurses when they
are advocating for their patients is important because the nurses
are fulfilling their ethical duty. Consider the following summary,
compiled from newspaper and blog accounts (see Elbein 2011; Lowes
2010; Sack 2010), of an incident that happened in Winkler County,
Texas. As you read this summary, consider the role and ethical
obligations of those involved to their patients and employees. What
should the hospital leaders have done at various times during the
two-year ordeal for the nurses as they served as patient
advocates
Two nurses had worked at the same Winkler County hospital for
more than 20 years. One of the nurses was in charge of quality
assessment, and her responsibility included au-diting hospital
records to ensure that quality of care was maintained. The other
nurse was the compliance officer, responsible for ensuring that
hospital physicians and pharmacists were following state
regulations. In 2007, the hospital hired a new administrator to
serve as an executive director and head manager; later, he was
described by the compliance of-ficer as not a listener, saying “He
didn’t want us looking at anything or making comments about
anything . . .” (Elbein 2011). In 2008, the hospital hired a new
physician, who became friends with the new administrator and the
town’s sheriff. As the compliance officer, the nurse reviewed
charts (medical records) of patients, including those under the new
physician’s care. She found the new physician’s treatments to be
highly unsafe and found evidence of a conflict of interest.
Specifically, he was giving patients samples of elixirs that were
not approved as medicine by the Federal Drug Adminis-tration. These
elixirs consisted of fruit juice and dietary supplements, and they
were sold only by the physician and through his website. Moreover,
she found that the physician prescribed thyroid medicine to
patients who did not have thyroid issues, failed to appropriately
treat a diabetic patient who should have been referred to another
hospital for skin grafting, and performed surgeries at the hospital
even though surgeries were not allowed at the hospital.She
expressed her concerns to the new administrator, but the
administrator’s response was minimal. He instructed her to write a
waiver for patients to sign; the waiver released the hospital from
liability resulting from the elixirs. Additionally, he told her to
write a letter to the physician to inform him about hospital
policies (such as physicians were prohibited from prescribing
medications that had not been approved by the FDA and from
performing surgeries on site). The administrator refused to take
further actions.Next, the compliance officer, the quality assurance
nurse, and a nurse who worked with the physician reported their
concerns to the hospital’s board of directors. One board member
interrupted them and shut down their attempt to inform. Frustrated,
the nurse who worked with the physician quit her job, but the
compliance officer and quality assurance nurse continued to voice
their concerns—but to no avail. In fact, the administrator issued
an order that no one employed in the hospital may report any
doctors without his permission; the board passed this order as
policy. In 2009, both nurses anonymously wrote a letter to the
Texas Medical Board detailing the physician’s unsafe clinical
practices.After the physician (who already had a restricted
license) was informed he was under review by the state board, the
sheriff launched an investigation and obtained a warrant to search
the nurses’ computers. A copy of the complaint letter was found on
the computer used by the quality assurance nurse. Both nurses were
fired, arrested, and then indicted for misuse of official
information, which carried a $10,000 fine and possible imprisonment
of up to ten years. The Texas Nurses Association established a
legal defense fund for the nurses, and other state nurse
associations as well as the national nurse association con-tributed
financial support. Letters and e-mails of support poured in for
both nurses before and during the trial.
n the end (between 2010 and 2011), •the charges were dropped
(before the trial) against the quality assurance nurse;•the
compliance officer was found not guilty after a jury deliberation
that lasted less than one hour; •the two nurses sued the hospital,
county, and the sheriff and prosecutor in civil court and received
damages of $750,000;•the administrator resigned from the hospital,
was charged with and pled guilty to a misdemeanor of abuse in an
official capacity, and turned over evidence against the
sheriff;•the sheriff was found guilty of retaliation, misuse of
official information, and two counts of official oppression and was
subsequently removed from office, sentenced to four years of
probation and 100 days in jail, and fined $6,000; and•the physician
pled guilty to two felony charges of retaliation and misuse of
official information, surrendered his medical license, was
sentenced to 60 days in jail and five years of probation, and was
fined $5,000
1. Review the events in this two-year conflict. What were the
unethical HR practices that took place?
2.If you worked in HR at the hospital, what were your ethical
obligations to prevent these unethical practices? Consider, for
example, the ethical standards of justice, beneficence,
nonmaleficence, and autonomy and the responsibility to patients,
employees, and physicians with practicing privileges.
3.Are you concerned by the administrator’s actions (or lack of)
that led up to one nurse leaving and two nurses getting fired? Why
or why not
for patients. At times, nurses may stand up for patients when their
actions challenge authority. Included in Provision 3 of the
American Nurses Association’s Code of Ethics is a focus on the
patients’ rights to privacy, confidentiality, and patient safety
(Lachman 2009). The code directs nurses to report actions that may
harm the patient. That directive is clear, and it is taken
seriously by professional nurses. HR support for nurses when they
are advocating for their patients is important because the nurses
are fulfilling their ethical duty. Consider the following summary,
compiled from newspaper and blog accounts (see Elbein 2011; Lowes
2010; Sack 2010), of an incident that happened in Winkler County,
Texas. As you read this summary, consider the role and ethical
obligations of those involved to their patients and employees. What
should the hospital leaders have done at various times during the
two-year ordeal for the nurses as they served as patient
advocates
Two nurses had worked at the same Winkler County hospital for
more than 20 years. One of the nurses was in charge of quality
assessment, and her responsibility included au-diting hospital
records to ensure that quality of care was maintained. The other
nurse was the compliance officer, responsible for ensuring that
hospital physicians and pharmacists were following state
regulations. In 2007, the hospital hired a new administrator to
serve as an executive director and head manager; later, he was
described by the compliance of-ficer as not a listener, saying “He
didn’t want us looking at anything or making comments about
anything . . .” (Elbein 2011). In 2008, the hospital hired a new
physician, who became friends with the new administrator and the
town’s sheriff. As the compliance officer, the nurse reviewed
charts (medical records) of patients, including those under the new
physician’s care. She found the new physician’s treatments to be
highly unsafe and found evidence of a conflict of interest.
Specifically, he was giving patients samples of elixirs that were
not approved as medicine by the Federal Drug Adminis-tration. These
elixirs consisted of fruit juice and dietary supplements, and they
were sold only by the physician and through his website. Moreover,
she found that the physician prescribed thyroid medicine to
patients who did not have thyroid issues, failed to appropriately
treat a diabetic patient who should have been referred to another
hospital for skin grafting, and performed surgeries at the hospital
even though surgeries were not allowed at the hospital.She
expressed her concerns to the new administrator, but the
administrator’s response was minimal. He instructed her to write a
waiver for patients to sign; the waiver released the hospital from
liability resulting from the elixirs. Additionally, he told her to
write a letter to the physician to inform him about hospital
policies (such as physicians were prohibited from prescribing
medications that had not been approved by the FDA and from
performing surgeries on site). The administrator refused to take
further actions.Next, the compliance officer, the quality assurance
nurse, and a nurse who worked with the physician reported their
concerns to the hospital’s board of directors. One board member
interrupted them and shut down their attempt to inform. Frustrated,
the nurse who worked with the physician quit her job, but the
compliance officer and quality assurance nurse continued to voice
their concerns—but to no avail. In fact, the administrator issued
an order that no one employed in the hospital may report any
doctors without his permission; the board passed this order as
policy. In 2009, both nurses anonymously wrote a letter to the
Texas Medical Board detailing the physician’s unsafe clinical
practices.After the physician (who already had a restricted
license) was informed he was under review by the state board, the
sheriff launched an investigation and obtained a warrant to search
the nurses’ computers. A copy of the complaint letter was found on
the computer used by the quality assurance nurse. Both nurses were
fired, arrested, and then indicted for misuse of official
information, which carried a $10,000 fine and possible imprisonment
of up to ten years. The Texas Nurses Association established a
legal defense fund for the nurses, and other state nurse
associations as well as the national nurse association con-tributed
financial support. Letters and e-mails of support poured in for
both nurses before and during the trial.
n the end (between 2010 and 2011), •the charges were dropped
(before the trial) against the quality assurance nurse;•the
compliance officer was found not guilty after a jury deliberation
that lasted less than one hour; •the two nurses sued the hospital,
county, and the sheriff and prosecutor in civil court and received
damages of $750,000;•the administrator resigned from the hospital,
was charged with and pled guilty to a misdemeanor of abuse in an
official capacity, and turned over evidence against the
sheriff;•the sheriff was found guilty of retaliation, misuse of
official information, and two counts of official oppression and was
subsequently removed from office, sentenced to four years of
probation and 100 days in jail, and fined $6,000; and•the physician
pled guilty to two felony charges of retaliation and misuse of
official information, surrendered his medical license, was
sentenced to 60 days in jail and five years of probation, and was
fined $5,000
1. Review the events in this two-year conflict. What were the
unethical HR practices that took place?
2.If you worked in HR at the hospital, what were your ethical
obligations to prevent these unethical practices? Consider, for
example, the ethical standards of justice, beneficence,
nonmaleficence, and autonomy and the responsibility to patients,
employees, and physicians with practicing privileges.
3.Are you concerned by the administrator’s actions (or lack of)
that led up to one nurse leaving and two nurses getting fired? Why
or why not