In my work environment, there is a moral and ethical issue that has come up in the past few weeks that I feel I must intervene in as a moral agent. We have a new nurse in our practice, one who is relatively inexperienced and who is effectively straight out of nursing school. Because of her inexperience, she often receives a bit of verbal abuse from other nurses, who are frustrated at her mistakes and errors. This has resulted in the new nurse having a difficult time adjusting to her practice, having little positive experience to help her hone better behaviors, and is resulting in an overall drop in office morale. As a fellow nurse, I feel the need to step in, but I am at an ethical crossroads regarding what to do if I choose to fulfill the role of moral agent.
In this respect, I feel as though my situation constitutes moral distress – I understand the right thing to do, but it is hard to do this considering my role as their equal (McGonigle & Mastrian 2011, p. 70). I have a great deal of moral sensitivity to the new nurse’s plight, and I believe my own nursing education contributed greatly to the cultivation of this sensitivity (Park et al. 2012, p. 578). To that end, I feel an obligation to act as a moral guide for this nurse. However, this may also be mistaken for rewarding the nurse for doing poor work, which she has done. Though these mistakes are costly and often time-consuming to fix, the toll it is taking on her via the abuse given by other coworkers is too much not to step in. When creating an effective work environment in a nursing context, it is important to be able to facilitate as much ensemble building as possible – nurses need to be able to work together, and negative reinforcement of mistakes likely only discourages the nurse further. My coworkers may believe that they are intimidating her into stopping the mistakes, but it is only making the problem worse by making her uncomfortable in her work environment.
I do believe there would be negative outcomes to the lack of fulfillment of this moral role. First, I believe it would take a toll on myself to continue to allow the ethical tension to continue; ethical conflicts are typically a big source of personnel burnout in nursing contexts (Wlodarczyk & Lazarewicz 2011, p. 847; Comrie 2011, p. 116). The overall morale of the practice would be diminished by both the continuing mistakes of the new nurse and the berating of her by the other staff, thus lowering our ability to keep our attention focused on patients. If the situation were to continue without a moral stand being made on my part, this organizational culture would continue to cultivate and bring down the morale and effectiveness of the practice.
If I were to assume a moral leadership role in this situation, I believe I would use the MORAL Decision-Making Model to weigh my decision (McGonigle & Mastrian 2011, p. 81). First, I would Massage the dilemma; given the nature of the ethical problem, I feel it is my duty to address the ethical issue and make decisions. In the Outlining options stage, I weigh the pros and cons of all decisions (mostly weighing telling my coworkers to stop the verbal abuse as opposed to preventing them from tacitly endorsing the mistakes she is making through silence). I would then Review criteria and resolve, Affirm my position and act, and Look back on the decision making process to see if that works. I feel as though this model provides the simplest, most elegant way to address the problems that are inherent to this moral dilemma.
Despite how difficult it is to take a stand in this particular situation, I feel that I have to. For one thing, my experience at this practice makes me a leader among my fellow nurses, giving them guidance and encouraging them through my own behavior. Value-driven transformational leadership is often cited as a highly useful trait in professional development of nursing; that is one strategy I would like to use in my own leadership experiences (Severinsson & Sand 2010, p. 669). Given the position that I am in, I feel it is my duty to take a stand, regardless of the potential fallout: I could be perceived as being too easy on someone who is making a lot of mistakes, and may face some resentment from my fellow nurses being called out on their behavior. However, given the way that this teasing has affected the morale of the new nurse, and the need to make her feel like a welcome part of the practice, it is necessary for me to find a way to stop these negative behaviors. If I use the aforementioned MORAL decision-making model, and hold true to my own motivations, I believe I can help to resolve this ethical issue and exhibit a leadership role within my nursing practice.
References
Comrie, R. W. (2012). An analysis of undergraduate and graduate student nurses’ moral
sensitivity. Nursing ethics, 19(1), 116-127.
McGonigle, D., & Mastrian K. (2011). Nursing informatics and the foundation of knowledge.
Jones & Bartlett Learning.
Park, M., Kjervik, D., Crandell, J., & Oermann, M. H. (2012). The relationship of ethics
education to moral sensitivity and moral reasoning skills of nursing students. Nursing Ethics, 19(4), 568-580.
Severinsson, E., & SAND, Å. (2010). Evaluation of the clinical supervision and professional
development of student nurses. Journal of Nursing Management,18(6), 669-677.
Wlodarczyk, D., & Lazarewicz, M. (2011). Frequency and burden with ethical conflicts and
burnout in nurses. Nursing Ethics, 18(6), 847-861.
