What are the ethical responsibilities of nurse leaders and managers in making unit decisions?

  

Ethical Issue Clinical Judgment Case Scenario
Nurse leaders and managers are responsible for the units ethical and legal decisions.
Initial Post
Consider the examples provided below and describe how you would handle the experiences.

A manager is not granting pay to someone who worked overtime.
A nurse manager tolerating verbal abuse of another nurse.
Constantly short staffing the unit when there is high census.
A nurse not providing all of the patients information during shift report.
Favoring one staff over others.
Making a hiring or firing decision based on friendship.

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Reply Post
Respond to at least one of your peers about their example that illustrates their interpretation of DECIDE. Expand on your peers ideas.

Introduction:
In the healthcare field, ethical issues are an inevitable part of daily decision-making. As a nurse leader or manager, one is responsible for making ethical and legal decisions that may impact the lives of patients and staff. These decisions can be challenging, and the consequences of making the wrong choice can be severe. In this context, our discussion will revolve around some commonly occurring ethical issues and their possible solutions.

Description:
Nurse leaders and managers face complex ethical dilemmas when making decisions about patient care, staff management, and resource allocation. Clinical judgment, which involves making decisions based on available evidence and clinical expertise, is central to this process. In this discussion, we will explore some common ethical issues that nurse leaders encounter and discuss ways to handle them. These ethical issues include withholding overtime pay, verbal abuse, staff favoritism, information sharing, and hiring decisions. We will use the DECIDE framework to guide our analysis of these issues and discuss potential solutions.

Objectives:
1. To understand the ethical issues faced by nurse leaders and managers in making decisions
2. To learn strategies for handling ethical dilemmas in the workplace
3. To develop effective communication and decision-making skills in relation to ethical issues in nursing
4. To understand the importance of legal and ethical considerations in the nursing profession

Learning Outcomes:
1. Students will be able to identify ethical issues in nursing leadership and management
2. Students will be able to analyze different strategies for addressing ethical dilemmas in the workplace
3. Students will be able to apply ethical decision-making frameworks to real-life case scenarios
4. Students will be able to understand the legal and ethical responsibilities of nurse leaders and managers
5. Students will be able to communicate effectively and confidently about ethical issues in nursing

Note: The above objectives and learning outcomes are related to the content in the given scenario, which talks about various ethical issues that nurse leaders and managers may face, and how to handle them using the DECIDE framework.

Solution 1:

Ethical issues are common in nursing units. Nurse leaders and managers play a crucial role in ethical and legal decision-making to maintain the integrity of the unit. To handle the scenarios mentioned above, the DECIDE model can be used effectively. This model involves defining the problem, establishing the criteria, developing and evaluating alternatives, implementing the best course of action, deciding and taking action, and evaluating the outcome.

For the scenario of a manager not granting pay to someone who worked overtime, the nurse leader or manager should define the problem by reviewing the employee’s contract and overtime policies to understand the situation entirely. They need to establish the criteria for the review and evaluation process and determine whether there are any legal implications. If the manager is at fault, the nurse leader should develop alternatives such as speaking to HR about regularizing the employees’ overtime pay. They should then evaluate and implement the best course of action that adheres to ethical and legal principles before deciding on the most effective solution.

Solution 2:

For the scenario of a nurse manager tolerating verbal abuse of another nurse, the nurse leader or manager should define the problem by reviewing the evidence of the verbal abuse and how the nurse manager responds. The nurse leader should establish clear policies for appropriate workplace behavior and establish consequences for inappropriate actions. The nurse leader should work with the management team to develop and evaluate alternative solutions, such as a disciplinary process, mediation, or a clear code of conduct for the entire unit. After evaluating and implementing the best course of action, the nurse leader should decide and take action that adheres to ethical principles, such as the confidentiality of the nurse who complained of the abuse. Finally, they should evaluate the outcome and initiate follow-up measures to ensure their solution was effective.

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