SARAH MUTHONI NJAMBI

B010-01-0533/2021
ASSIGNMENT, BUSINESS ETHICS
Case 1:
Betty, the chief nursing officer, had to make a decision about buying 120 new hospital beds for
patient rooms. After she interviewed nurse managers at the units where the beds were going to be
placed, Betty compiled her findings and decided to contact a well-known equipment company to
obtain prices and contracts. The equipment company’s executive sales person, Jim, discussed
options at length with her and invited her and her significant other to an upcoming all-expense-
paid lavish retreat at a five-star hotel in Hawaii to see demonstrations of the beds and to hear a
comprehensive sales pitch. Betty thought to herself, “We badly need some relaxation and stress
relief. Hawaii would be so much fun. Would it be wrong for us to go?
Questions
1. If you were Betty, what should you do? Give your rationale. Justify your answer with an
ethical framework – a theory, approach, or a principle.
If I were Betty, I would politely decline the offer to attend the all-expenses-paid retreat in
Hawaii. The rationale is that accepting such a lavish gift could compromise my impartiality and
objectivity in making a business decision. From an ethical standpoint, this decision aligns with
deontological ethics, which emphasizes duty and adherence to rules. In this case, the duty is to
act in the best interest of the hospital and its patients, free from undue influence. Accepting the
trip could be seen as a breach of this duty since Betty will be having some relaxation and stress
relief and might create a conflict of interest.
2. What ethical principles are at stake? What breaches?
The ethical principles at stake include integrity, objectivity, and non-maleficence:
- Integrity: Maintaining honesty and strong moral principles in professional decisions.
- Objectivity: Ensuring decisions are made based on merit and without bias.
- Non-maleficence: Avoiding actions that could potentially harm others, in this case, the potential
harm could be to the hospital if a suboptimal decision is made due to bias.
Potential breaches could involve a conflict of interest, where personal gain (the all-expense-paid
lavish retreat) might influence the decision-making process, leading to a potential compromise in
patient care or hospital resources.
3. Do you consider this situation a conflict of interest? Why or why not? Give your rationale
Yes, this situation constitutes a conflict of interest. A conflict of interest arises when a person's
personal interests could potentially interfere with their professional duties. In this case, the offer
of a lavish retreat trip could influence Betty's decision-making process, making her more inclined
to favor the equipment company’s proposal, even if it might not be in the best interest of the
hospital.
4. How would Betty handle this case if she believed she needed to seek advice from someone in
a higher authority? With whom would she discuss this issue?
If Betty felt uncertain about how to proceed, she should seek advice from her supervisor or a
member of the hospital's ethics committee. Discussing the situation with someone in a position
of higher authority would help ensure that her decision is aligned with the hospital's ethical
guidelines and policies.
5. What policies should be in place regarding a scenario such as this one?
The hospital should have clear policies regarding gifts and inducements from vendors. These
policies should explicitly prohibit employees from accepting gifts or favors that could influence
their professional decisions. Additionally, the hospital should require employees to disclose any
offers of gifts, inducements or favors from vendors and to recuse themselves from decision-
making processes if a conflict of interest arises. Regular training on these policies would also
help employees navigate such situations appropriately.
Case 2:
Savannah, a registered nurse attended a party the night before a schedule 12-hour work day,
overindulged in cocktails, got to bed around 3am, and came to work the next morning at 6:45am
with a hangover and alcohol still on her breath. This situation placed Savannah in ethical
violation of the organization’s values and the Code of Ethics for Nurses, as well as a legal
violation of the state board of nursing, because if alcohol is smelled on her breath, it is still in the
blood stream, which could alter her judgment. Savannah’s altered judgment could result in
unsafe patient care and treatments.
Questions
1. Discuss the ethical implications of Savannah’s partying before work. Do you believe that
Savannah engaged in an ethical conflict of interest? Why or why not? Please explain your
rationale.
Savannah’s decision to party the night before a 12-hour work shift, leading to her coming to
work with a hangover and alcohol still in her bloodstream, has significant ethical implications.
She has compromised her ability to perform her duties safely, thereby putting patient safety at
risk. This situation does not constitute a traditional conflict of interest, which typically involves
personal gain; however, it is an ethical lapse that violates the principles of non-maleficence (do
no harm) and professionalism. By attending work in an altered state of mind, Savannah may be
unable to provide the necessary level of care, which could result in harm to her patients.
2. What ethical violation existed in Savannah’s case regarding her personal behaviour, the
hospital’s ethics and values, patient safety, and the state board of nursing?
- Personal Behavior: Savannah’s personal decision to drink excessively before a shift
demonstrates a lack of responsibility and poor judgment.
- Hospital’s Ethics and Values: Her actions violate the hospital’s expectations of professionalism
and commitment to patient care.
- Patient Safety: By working in an impaired state whereby alcohol is still in her blood streams,
Savannah directly threatens the safety and well-being of her patients.
- State Board of Nursing: Savannah’s conduct is in violation of the legal standards set by the
state board of nursing, which mandates that nurses must be fit to perform their duties and must
not engage in behavior that compromises patient care.
3. What other options could Savannah have considered other than going to work in an altered
state of mind? Make a list of the pros and cons of at least two other alternatives Savannah
could have chosen.
Option 1: Call in sick or request a substitute nurse
The pros of this option is that this would ensure that patient care is not compromised, and it
would allow Savannah time to recover and return to work when she is fit.
The cons of this option is that it may create a short-term staffing challenge for the hospital, and
Savannah might face consequences for calling in sick at the last minute, especially if this
behavior becomes habitual.
Option 2: Go to work and inform her supervisor
The pros of this is that transparency about her condition would allow the supervisor to make an
informed decision about whether Savannah can safely perform her duties or needs to be sent
home.
The cons of this is that Savannah might face immediate disciplinary action for arriving at work in
an impaired state, and it could damage her professional reputation.
4. Describe and justify how you would have handled this situation had you been Savannah.
Justify your strategies by using an ethical framework – a theory, approach, or principle.
If I were Savannah, I would have opted to call in sick or request a substitute nurse. The ethical
principle of non-maleficence dictates that I should avoid causing harm to others, and by going to
work in an altered state, I would be at risk of making errors that could endanger patient safety.
Additionally, the principle of responsibility suggests that I should be accountable for my actions
and their impact on others. Recognizing that I am unfit to work due to the after-effects of
drinking, I would prioritize patient safety over my professional obligations for that day.
5. What are the risks of Savannah attending work after drinking so much at the party? Explain
your answer.
- Patient harm: Savannah's impaired judgment could lead to mistakes in administering
medication, performing procedures, or making critical decisions thereby placing patients at risk.
- Professional repercussions: If her impairment is noticed, she could face disciplinary action,
including suspension or termination, and it could also damage her reputation as a nurse.
- Legal consequences: If any harm comes to a patient due to her impairment, Savannah and the
hospital could face legal action, and she could lose her nursing license since the affected patients
may sue her and the hospital.
- Colleague burden: Her colleagues might have to pick up the slack and correct her mistakes,
leading to additional stress and potential errors in their own work.
6. Do you believe that the nursing supervisor should take action against Savannah? Why or why
not? If you believe that the supervisor should take action against Savannah, describe the
specific options for disciplinary action based on your general knowledge of institutional and
state board of nursing disciplinary protocol.
Yes, the nursing supervisor should take action against Savannah. Allowing her to work in an
impaired state could have serious consequences for patient care and the hospital’s reputation. If
the supervisor does not take any action, Savannah may make this a habit since she’ll be aware
that no action will be taken against her. The specific options for disciplinary action could
include:
- Formal warning: Document the incident and issue a formal warning, making it clear that this
behavior is unacceptable and will not be tolerated in the future.
- Suspension: Depending on the severity of the impairment and the potential risk to patients,
Savannah could be suspended for a period of time.
- Mandatory counseling or rehabilitation: If this is not a one-time occurrence, Savannah might be
required to undergo counseling or attend a substance abuse program which will help her
overcome the addiction.
- Reporting to the state board of nursing: In severe cases, the incident may need to be reported to
the state board of nursing, which could lead to further investigation and possible revocation of
her nursing license.