Gina is the charge nurse of the 3:00 PM to 11:00 PM shift on the acute care unit where you have worked for 18 months since your graduation. Your supervisor has asked you if you would like to learn the duties of the relief charge nurse. You were thrilled that she approached you for this position. Because it was a relief position, it was permissible for your supervisor to appoint you and not necessary for you to formally apply for the position.
One day each week, for the last 2 weeks, you have been working with Gina about the responsibilities of the position. There are several things Gina does that bother you, and you are not sure what you should do. For example, if used supplies were inadvertently not charged to patients at the time of service, Gina admitted she would just charge them to whoever patients she thought were likely to have used them. When you questioned Gina about this, she said, “Well, at the end of the day, the unit needs to make sure that all supplies have been charged for, or the CFO will be after all of us. It is one of the charge nurses’ responsibilities, and I don’t have time to chase everyone down to find the correct patient to charge and besides everyone has insurance and so it does not come out of the patient’s pocket. Most importantly, we must make sure the hospital gets reimbursed or we won’t have our jobs.”
In addition, when Gina does the staffing correlation for the upcoming shift, you notice that she fudges a bit and makes sure the night shift is given credit for needing more staff than they need. When questioned, she said, “Oh, we have to take care of each other, better too much staff than not enough.”
You think Gina’s actions are unethical, but you do not know what to do about it. It does not directly harm a patient, but you feel uncomfortable about what she is doing and feel it is not the ethical thing to do.
DQ: You have many options here including doing nothing. Using the MORAL ethical problem-solving model, solve this case and compare your solution with others in the class while responding to them throughout the week.