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Reflection On A Significant Incident From Practice

2160 words - 9 pages

Ethics can be defined as a system of moral conduct and principles that guide a person’s actions in regard to what are considered to be right and wrong (Marquis & Huston, 2012). Nurse managers make decisions each day about their patients, their employees and their organization. According to Marquis & Huston (2012), management is a discipline not a profession and because of that management lacks the set of norms to guide ethical decision making. Therefore managers’ decisions are made based upon the organization’s values and ethical principles. The American Nurse Association (ANA) code of ethics is a set of principles that help both nurses and nurse managers to solve ethical problems. This paper will discuss a case study involving the unsafe practice of a student nurse in clinical and the professional responsibility of the hospital and the nursing school. In addition, the Moral Decision Making Model will be applied to the ethical scenario and two ethical principles that are appropriate for this scenario will be identified.
This is a case study of a student nurse whose performance in clinical is unsafe. According to Killam, Montgomery, Luhanga, Adamic, & Carter (2010), an unsafe student is defined as a student who performances in clinical place the client or staff in either physical or emotional jeopardy. From the case study from NetCE (2014), JC is a senior nursing student who chose the intensive care unit (ICU) to complete her university nursing program requirement of a 200 hour practicum. Within the first week of the 6 week practicum, JC’s preceptor reported to the ICU nurse manager that JC dresses inappropriately for work, has an arrogant attitude towards staff members, and is always discussing the amount of money she will make as a nurse. These issues were resolved to some extend after the nurse manager and the nurse preceptor talked to JC. During the following week the preceptor reported another incident to the nurse manager about JC’s inappropriate documentation. During the previous shift, the preceptor and JC had cared for a patient with peritoneal dialysis and the preceptor had explained the process of dialysis to JC. After one of the dialysis exchanges, JC was told to empty and measure the output under the preceptor’s supervision. The fluid removed from the patient measured 1400 cc and at the end of the shift the preceptor realized that the amount of dialysate fluid recorded by JC was only1000 cc. When JC was questioned about the documentation, JC responded that she did not want her recordings to be different from those of the previous recorded amounts. Because of the limited knowledge of JC, the preceptor reinforced the reason behind the actual fluid removed from the patient and the need to document it as that. Afterwards JC did not correct the dialysis fluid record and the preceptor recorded the actual dialysate output. The nurse manager documented the incident and contacted the nursing instructor to say that JC will not...

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