This paper discusses a scenario in which a nurse-manager must deal with a nurse suspected of committing several petty thefts on the ward. The suspected nurse is popular and a friend and colleague of the nurse-manager. The paper reviews possible courses of action and the benefits and detriments of 1. doing nothing 2. confronting the nurse personally and 3. getting others involved.
Nursing Ethics
Ethical Dilemma
Ethics
Identify the potential ethical dilemma
A nurse accused of stealing. She is a good nurse but cannot be allowed to continue stealing and breaking the law while she is performing her duties.
Collect, analyze, and interpret data
Nurses must protect clients' well-being, even while they strive to support other nurses. The case study is presented in such a manner which suggests that the nurse manager is fairly certain, given the evidence she has observed, that this individual is the party responsible for the series of thefts.
State the dilemma
A nurse-manager has an unequivocal ethical responsibility to report any suspected crimes. However, this could destroy the goodwill on the ward and impede the community of nurses from working together and getting things done. Also, the crime may be difficult to prove and cause divisiveness on the ward.
Can the dilemma be resolved by the nurse?
The answer to this particular conundrum is 'yes and no.' No, in the sense that some outside investigation is required to prove the suspected nurse committed a crime. If the nurse loses her job without cause she could bring a suit against the hospital. However, the nurse-manager will have responsibilities in gathering evidence and dealing with the other nurses, once the crime has been revealed.
List the potential solutions
Potential solution 1: Do nothing.
The arguments for doing nothing are as follows -- the nurse is popular, and there are no apparent complaints from patients about her ability to provide healthcare. The nurse's crimes are relatively petty and not causing physical harm to patients. However, the nurse manager has a responsibility to prevent future crime, and if the crimes are discovered later, the consequences could be even graver, given the anger and bad publicity this could generate for the hospital.
Potential solution 2: Confront the nurse
Confronting the nurse is problematic if done in a face-to-face format, given that the evidence in support of the accusation is not necessarily strong enough to result in the nurse's automatic termination. If such a confrontation takes place, it should take place before the necessary HR personnel in charge of mediating disputes. Also, another supervisor should be present. Regardless of these precautions, if the nurse is not removed, the nurse-manager will have lost a valuable ally on her healthcare team.
Potential solution 3: Report the suspected crime to a higher-level supervisor in private
If this is the course of action undertaken, all evidence should be presented, along with a discussion of the nurse's strengths as well as her proposed crimes. The supervisor should be able to solicit legal guidance about how much proof is needed to move forward.
The potential problem with this solution may be that the supervisor does nothing, does not want to fire a good nurse in a short-staffed ward, or does not believe the accuser. Then, a great deal of damage has been done, given that the offending nurse still can continue stealing, but the nurse manager will lack support for her actions and may be questioned in any of the decisions she makes, because she has made what seems like a baseless accusation.
Acceptable consequences
None of the consequences are really 'acceptable' in the above-cited scenarios. However, clearly the least acceptable consequences are to do nothing. Patients should not have to come to the hospital and worry that their valuable possessions are being stolen. All nurses have an ethical obligation to put their patient's rights and needs first and foremost, and to promote a safe, healthy, and trusting environment. With a thief on the ward, this is impossible.
As the team gradually becomes aware of the fact that there is a thief in their midst, they will be unwilling to trust one another in the day-to-day duties they perform together on the ward. For nursing to be effective, it must take place in an environment of trust and support.
Thus, the most acceptable action seems to be to report the nurse, using the factual evidence at the nurse-manager's disposal. Confronting the nurse would put the hospital in legal jeopardy and would not give the nurse-manager adequate protections to deal with the personal fallout that would ensure, when the crime was revealed. Going through the necessary authorities makes the actions of the nurse-manager seem less personal, and more objective.
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