Saturday, May 7, 2011

Ethical Encounter

  1. Describe an ethical situation you have encountered:  This situation occurred in the nursing home I use to work at.
Situation: The nursing home I use to work for always has a high enough census where most rooms are filled with residents approximately 117 with a capacity of 152 beds.  During my time working at this nursing home the turn-over rate for CNA’s was always high.  This had partly to do with CNA’s not wanting to work and also because of the scheduling supervisor mandating CNA’s to work overtime or pick up extra shifts.  One evening I was scheduled to work an overnight shift and this was my first time working overnight.  There was supposed to be three CNA’s and one nurse on the hall I was scheduled to work.  As it turned out, the two other CNA’s didn’t show up for work and the nurse refused to help me throughout the night catching call lights and repositioning patients.

The dilemma:  As much as I loved my job as a CNA and felt my comfort level was pretty high with patient care.  There was no way I was capable to take care of as many patients as I did that night, with no help from the nurse.  It was hard to go home that night with a good conscience knowing that the patients who I was responsible for were well taken care of.  I know this isn’t uncommon for the particular nursing home and I wonder if the patients really are getting the proper care they deserve and are paying for.
  1. Apply one of the ethical principles to the situation.
Nonmaleficence:  “the duty to do no harm.”  The nurse must not act in a manner that would intentionally harm the patient.
  1. Utilizing an ethical decision model describe how you came to the conclusion you acted upon.
Step 1:  Clarify the dilemma:  There wasn’t proper care given to the residents at this nursing home.  Who owns the problem?  The nurse who didn’t help me pick up the slack and for not contacting back-up help.

Step 2:  Gather additional data:  In times prior to this instance if a CNA doesn’t report to work the nurse should be calling in reinforcements and that didn’t happen.  This nurse felt we could get the job done together, but he didn’t help and I was forced to do all the work.

Step 3:  Identify options:  A. Demand the Nurse help me or call someone else to help me (even if from another unit).  B. I could call the DON myself and ask for help.  C. Continue working the best I could even though my unit was short staffed.  D.  I could have just walked out and quit. 

Step 4:  Decision:  I decided to continue working the best I could even though my unit was short staffed.  I did ask the nurse to help me and he said he would, but never did anything to help me.  The nurse also expected my help to change bandages for residents with pressure sores.

Step 5:  Act:  I worked 150% that night and went home completely drained and upset.  Shortly thereafter I gave my notice.


  1. Oh, sweetie! This sounds horribly draining for you and unsafe for the patients! I hate confrontation, but I would probably still said/have said something to the DON. That's just unacceptable.

    And also, I feel for you. My brother-in-law just finished his BSN and also worked his way through, by picking up CNA shifts at a nursing home. It was hard work for not very much pay! He used to reference his paycheck by what scut work he had to do that night. Like, "Do you know how many butts I had to clean to make this $20?!" :)

  2. This was a discussion question I had to post for school but it was a true story.
    From my clinical experience so far on the Cardiac floor I haven't seen much butt wiping done by the nurses, so that will be nice when the time comes to switch roles.
    I was more upset with the nurse that promised he'd help me and then didn't. Unfortunately broken promises run rampant in this profession.