Values have a major influence on the actions of practitioners and are integral to socialization and the consequent development of professional identity (Woodbridge and Fulford, 2005) However, a lack of opportunity to express values in nursing practice and a conflict between values and organizational constraints have been strongly associated with low job satisfaction and high attrition rates (Forsyth and McKenzie, 2006).
I have worked at a facility where a nurse came to work impaired after partying the night before her scheduled shift. she reported to work for day shift feeling tired and restless. she had consumed alcohol at the party and only slept 4 hrs before she came to work.
The ANA Code of Ethics for Nurses (ANA,2001) notes that the Nurse Executive has the obligation "... to protect the patient, the public and the profession from potential harm when a colleague 's practice, in any setting, appears to be impaired" (section 3.5). A nurse executive is likely to experience moral distress when the organization does not address impaired practice in a compassionate way, and instead terminates the nurse.
The Nurse Executive completed an investigation, interviewed the staff, sought information from experts in the field, and came to a well-thought-thought-out conclusion and plan. Her recommendations were based on a comprehensive analysis of the situation, and a desire to demonstrate respect for the nurse while ensuring patient safety. She wanted to counsel the nurse with compassion, in a fair and impartial manner. She wanted to do what was best for both the nurse and the
References: American Nurses Association. (2001). Code of ethics for nurses with interpretative statements. Curtin, L. (2007). Facing up to fallibility: A manager 's guide to ethical decision-making. Nurse Leader, 5(40), 23-27 Forsyth S, McKenzie H (2006) A comparative analysis of contemporary nurses’ discontents. Journal of Advanced Nursing; 56: 2, 209-216Washington DC: ANA. Retrieved May 23, 2012 from http://www.ananursingethics.org/nursingethics.htm. Woodbridge K, Fulford B(2005) Whose Values? A Workbook for Values-Based Practice in Mental Health Care. London: Sainsbury Centre for Mental Health.