NSG 100
Lateral Violence: The Sword in the Workplace
NSG 100 INTRODUCTION TO NURSING AS A PROFESSION
ETHICS CASE STUDY
Case Study
Melissa started on the unit as a new graduate 5 weeks ago. She is still in orientation and has a good relationship with her preceptor. The preceptor has been assigned consistently to Melissa for most of the last 4 weeks, but due to a family emergency has not been unavailable in the last week. Melissa has been assigned a new preceptor for the remainder of her orientation. The new preceptor has not been welcoming, supportive, or focused on the educational goals of the orientation. In fact, this preceptor has voiced to all who will listen her feelings about the incompetence of new BSN graduates.
Case Study(continued)
The crisis occurs when Melissa fails to recognize a patient’s confusion as a result of an adverse medication effect. The preceptor berates Melissa in the nurses’ station, makes sarcastic comments in shift report about the “inability of university-educated nurses to recognize the basics,” and informs the nurse manger “that new graduates are a danger to patients.” Melissa tells you that she thinks she should resign and that maybe her previous preceptor was too easy on her. You know her preceptor is an excellent clinician and experienced teacher. What is your advice to Melissa?
Case Study in Own Words
Melissa just started her new job five weeks ago as a new nursing graduate. She is given an amazing nursing preceptor (Preceptor A). A family emergency with Preceptor A has occurred, and now Melissa has been assigned to a new preceptor (Preceptor B). Preceptor B is very condescending and derogatory towards Melissa, and as a result, Melissa thinks that her old preceptor was too easy on her. Melissa now wants to resign from her position.
What is occurring in this situation, and what advice should you give to Melissa?
Introduction
“Ethics are crucial because moral questions are at the heart of life’s vital issues. Morality is primarily concerned with questions of right and wrong, the ability to distinguish between the two and the justification of the distinction” (Ray, 12)
All nurses should be supportive of each other
Nurses are upheld to the highest of standards
Ethical Dilemma
The ethical dilemma in this situation is that Preceptor B is not taking proper responsibly to promote the health care environment.
Preceptor B is using lateral violence against the graduate nurse.
Examples of Lateral Violence
Manipulation
Gossiping
Slander
Preceptor B’s attitude, and behavior is making Melissa feel incompetent at effectively carrying out her nursing duties and properly caring for her patients.
Melissa wants to resign
Solution
The first solution to this ethical dilemma is for Melissa to discuss the situation to the nurse manager.
Melissa needs to explain Preceptor B’s behavior to the nurse manager.
Melissa also needs to report the lateral violence to the nurse manager.
“A healthy work environment is primarily the responsibility of the leader. The leader sets the expectations, the tone, and, especially, the level of tolerance for the amount of bullying or unhealthy behaviors in the workplace” (oncnursingnews)
ANA Code of Ethics
“The nurse, through individual and collective effort, establishes, maintains, and improves the ethical environment of the work setting and conditions of employment that are conducive to safe, quality health care” (Code of Ethics for Nurses with Interpretive Statements 23).
The work environment should be free from harassment and other unethical elements
Nurses should work together to main the work environment.
Provision 6 guides us to:
The provision states that a nurse must strive to improve the workplace as an ethical environment. The new preceptor is not doing this, therefore Melissa should report her.
Preceptor B is always castigating Mellissa, instead of explaining/teaching.
Conclusion
Direct Melissa to the Charge nurse to take further action if the situation was not taken care of
It all relates back to Provision 6.
References
Code of ethics for nurses with interpretive statements. (2015). Silver Spring, MD: ANA, American Nurses Association.
Lateral Violence in Nursing Can Take Many Forms. (n.d.). Retrieved July 14, 2017, from http://www.oncnursingnews.com/publications/oncology-nurse/2017/march-2017/lateral-violence-in-nursing-can-take-many-forms
Rae, S. B. (2009). Moral choices: an introduction to ethics. Grand Rapids, MI: Zondervan.