Reference no: EM133288002

Question - You are a newly hired RN whose first assignment after graduation is in the recovery room of a hospital that specializes in cardiovascular procedures. You have learned the recovery room procedures quickly and have further developed your nursing skill set to meet the demands of the position. After working there for two weeks, you are assigned to Phoebe as a one to one nurse.

Phoebe is a 58-year-old woman who coded during valve replacement surgery and is not doing well in the recovery room. Nurses are only assigned one to one to the most unstable and critical patients. Phoebe finally regains consciousness several hours after surgery, although the endotracheal tube remains in place, and she is still connected to a ventilator. The surgeons speak to Phoebe about the severity of her condition and the likelihood that she may die, then they leave the recovery room.

Phoebe indicates that she wants a pen and a paper pad to on because she cannot speak with the endotracheal tube in place. She writes about half a page, folds the note, and writes an address on it. Using the pad of paper, she asks you if you will send the letter out for her after you get home. You gladly agree. As you leave the room, you fold the letter and place it in your pocket. As you walk out of the room, you notice that the recovery room supervisor has been watching your interaction with Phoebe. The supervisor motions you over to her, and the following conversation occurs.

Supervisor: What were you doing with the patient?

You: I'm just helping the patient write a note to her daughter.

Supervisor: Recovery room policies don't allow it, and anyway, it is not part of your job to do such things. You're here to keep the patients alive after surgery.

You: I was only trying to help the patient mail the note to her daughter because the physicians told her she might die soon.

Supervisor: We are not running a post office here!

You (angry response): Well, what do you want me to do with this note now?

The supervisor turns her back and walks back into her office. Several days later, the supervisor files an incident report stating that you violated recovery room procedures and were insubordinate because you argued with her. Because you are still in your six-month probationary period, you are reprimanded and then fired from the hospital.

You really loved this position, felt like you were learning a lot, and enjoyed the unit you were working in. You also realized that having been fired from your first job as an RN may make finding a new job more challenging. You set up an appointment with the supervisor and Human Resources in an attempt to get your job back.

1. What ethical principles are involved in this situation?

2. Did you violate any ethical principles? Explain.

3. To whom do the nurses have an obligation? Why?

4. How might you have handled the situation differently?

5. What communication skills could you have used in dealing with this difficult person?

6. What should you do first in determining whether or not you were wrongfully terminated?

7. What other elements might have been factors in the supervisor's response to you?

8. What lessons can be learned from this situation?