Running head: ETHICAL DECISION MAKING 1

Ethical Decision Making

Sherwin Llevares

Grand Canyon University: NSG- 436

August 9, 2020
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Introduction

Ethical dilemma is one of the many difficult areas in nursing profession. One of these

common ethical dilemmas is reporting a fellow co-worker who have conducted unethical

behaviors that places a patient in harm’s way. Each nurse is held accountable to a high standard

of care based upon the state and federal regulation. Therefore, if a nurse is failing to reach that

standard of care, they are to be reported in order to be advocates for patient’s safety. By the end

of this essay, the author’s justification of the ethical dilemma will be reviewed, strategies that

could be used for nurse leaders will be discussed, potential components that can solve the issue

will be outlined, and a solution will be made.

Analysis and Justification

The dilemma of reporting a fellow co-worker for unethical behaviors is also known as

whistleblowing. It is a highly controversial topic for nurses because in the nursing profession, the

nurse’s utmost priority is the patient’s safety and in order for them to continue promoting patient

safety, they may have to report their fellow nurses. This is a hard task for most nurses because

they are always encouraged to work collaboratively with one another thus creating relationships.

This makes reporting more difficult for nurses. A study shows that during a nurse’s decision to

report a peer is based upon whether the wrongdoing was an honest mistake or incompetence. The

wrongdoing would be more likely to get reported if it was perceived as incompetence however,

“the thoughts and feelings that nurses hold regarding the consequences of their reporting actions

may influence their decision outcomes” (Beckstead, 2014, para. 1). Therefore, the existing

relationship between the co-workers make it difficult to build up the courage to report an act of

incompetence. However, no matter the situation, nurses must remind themselves that their top

priority is to provide patient safety and must be maintained even if it means to report a fellow
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nurse. Furthermore, in majority of the state board of nursing, nurses are obligated to report acts

that places patient at risk. Nurses who fail to report safety concerns may be at risk for

disciplinary actions as they may be accused of negligence (“How nurses can avoid the most

common ethics violation,” 2020). By not reporting a colleague misconduct, not only it can harm

the patient, but nurses can get their license revoked. With this in mind, it is not just about the

duty of a nurse to the patient to report a colleague, but it is mentioned in state’s regulation to

report it as well.

Moral Application

A great strategy that a nurse leader can utilize is leading by example. A nurse leader with

a strong characteristic of moral courage can quickly impact other nurses to do what is right. With

the nurse leader leading by example, it can helps address difficult dilemmas and in result solve

them. Ways that the nurse leader can exhibit his characteristics is to create a setting that is,

“Conductive to moral acts through a balanced, safe, and open forum for discussion” (Edmonson,

2015, para. 9). By creating a safe environment to go over ethical dilemmas such as reporting a

fellow co-worker, the staff will realize that it is the morally correct decision because it involves

the patient’s safety. Therefore, the staff is more likely to take initiative and speak up next time a

fellow co-worker is displaying unethical behavior.

Tools for Resolution

A vital tool that can help with resolving this dilemma, is the American Nurses

Association (ANA) code of ethics. When Nurses familiarize themselves with the nine provisions

outlined in the ANA code of ethics it can give an exemplar of how a duty nurse should handle

ethical issues. By far one of the best tools to utilize when it comes to handling dilemmas in a

clinical setting.
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Solution

Things that can hinder the solution of wanting staff members to report any incompetent

acts is ensuring that all reports that are made are kept confidential. One of the biggest reason

individuals chooses not to report is the fear of getting backlashed from their action (Alford,

2016). Once the individual’s identity is anonymous, that fear of getting retaliation from fellow

co-worker ends and which increases the reports on misconduct that are made in the healthcare

system.

Ethical dilemma of reporting a fellow co-worker has led to nurses being morally

distressed. In order to be advocates to our patients we must resolve the issue by utilizing the

ANA code of ethics and give out solutions such as providing 100 percent confidentiality to those

who reports incidences. By doing so, it can help create a better system by eradicating unethical

behaviors.
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References

Alford C. F. (2015). What makes whistleblowers so threatening? Comment on "Cultures of

Silence and Cultures of Voice: The Role of Whistleblowing in Healthcare

Organizations". International journal of health policy and management, 5(1), 71–73.

https://doi.org/10.15171/ijhpm.2015.183

Beckstead J.W. (2014). Reporting peer wrongdoing in the healthcare profession: the role of

incompetence and substance abuse information. International journal of nursing studies,

42(5), 325-331. doi: 10.1016/j.ijnurstu.2004.07.003

Edmonson, C. (2015). Strengthening moral courage among nurse leaders. OJIN: The Online

Journal of Issues in Nursing, 20(2). doi: 10.3912/OJIN.Vol20No)2PPT01

How nurses can avoid the most common ethics violation, (2020). Registered nursing. Retrieved

from https://www.registerednursing.org/how-avoid-common-ethics-violations/