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I currently work in the healthcare field as an Assistant Coordinating Manager for Hospital Police.  I originally went to school for criminal justice and got my bachelor’s in it. After working in the hospital, I have decided to change my route. I am currently 2 semesters away from getting my master’s in Healthcare Administration: Public Administration and I am completing my pre-requisite for nursing school. My goal is to be an administrator in quality management or the nursing department. Nurses are known to be patient care professionals that are expected to follow moral and legal rules. They must use critical thinking, problem solving and be able to make decisions on highly sensitive things through their practice (Yilimaz, 2021).

 

The chapter that connects to my aspiration is chapter 12 and 11. I have decided to focus on chapter 11. Nurses are an essential person in the healthcare field. States recognize this and has created formal or informal agreements that recognizes their licenses. To be a nurse, it is not a walk in the park. They are liable for a lot of things if their job is not done properly. For instance, if a nurse fails to monitor a patient’s vital sign, this can get the patients injured. If a nurse finds an equipment defective and they do not say anything, then they can be found negligent. Th ethical issue that has currently happening to during this pandemic is that they need to be able to be multi-discipline to the policies and strategies. In this pandemic nurse had to work in areas they were not familiar with, which opened some issues and things we learned we need to improve in (Turale, 2020).

Nurses work closely with doctors. If a nurse fails to not follow a doctor’s order to watch a patient closely. If they do not and something happens to the patient, their actions is liable. On the other hand, if a nurse does not agree with a doctor with a discharge order for a patient. The patient must show signs that they could be more injurious. The nurse has right to question the physician’s order. In nursing education, they have incorporated ethics stimulation on human. As technology improves, stimulations feel more surreal. In these training it is more focus on patient-specific interventions and management (Honkavuo, 2021).

A biblical reference that connects to this topic is “Do not fear what you are about to suffer. Behold, the devil is about to theory some of you in prison, that you may be tested, and for ten days you will have tribulation. Be faithful unto death, and I will give you the crown of life (Revelation 2:20, ESV)”. In nursing, the nurses are identified as essential. On the other hand, there is pressure to ensure that they can do their job. If something happens to the patient, there can be legal and ethical issues open. Nursing ethical ideology has their decision making into a challenge at times. It has been shown that knowledge should be treated as the truth (Peirce, 2019). It is important to “Not fear what your area about to suffer”, even if you were not wrong. It is important that we can learn from our mistakes, understand why it is wrong and move on.

Based off of the three chapters we reviewed this week, I chose chapter 10 to analyze as it covers the organization of the medical staff and most closely relates to my personal professional aspirations of being a health care administrator. I was able to eliminate the other two chapters as chapter eleven pertained mostly to nurses, and chapter twelve seemed to be more along the lines of first responders/hospitals. According to our text, the medical facility organization is comprised of many committees made up of key personnel charged with ensuring not only the success of the organization, but a safe organization that will in turn provide high quality safe care to the patients. (Pozgar, 2019) I firmly believe that God has a plan for me, and for now, His plan is for me to continue my current career in health care administration and to pursue my higher education as an avenue to further my purpose. I am encouraged along this journey by reading verses such as Ephesians 2:10 “For we are God’s handiwork, created in Christ Jesus to do good works, which God prepared in advance for us to do”. (New International Version)

One of the highest committees within the medical facility hierarchy is the Executive Committee. The Executive Committee “is responsible for recommending to the governing body such things as medical staff structure, a process for review credentials and appointing members to the medical staff, a process for delineating clinical privileges…” amongst many other things. (Pozgar, 2019, pg. 220) In my research I found that even though the names may vary slightly, many facilities have similar committees dedicated to areas such as a committee dedicated to patient safety, quality, credentials, records, infection control, and laboratory services. (Committees, n.d.) For those facilities that are teaching facilities, there are more-than-likely some additional committees such as those dedicated to graduate medical education, residency education and medical students. (Committees, n.d.)

It is possible, and very likely probable, to face ethical dilemmas and legal issues in almost every area of the health care profession whether you are a health care provider or a health care administrator. When it comes to health care administration and the ethical issues an administrator may face, I found an interesting article that summarizes a few ethical dilemmas specific to those in the health care administration profession. First off, the financial burden of balancing “the costs and effectiveness of treatments with the quality of care” as well as how to care for patients who may not have the financial means to pay for care nor the ability to readily access care. (Ethical Diligence in Healthcare Administration, n.d.) An administrator may find them facing this ethical dilemma regarding finances when a patient is unable to afford a new procedure and their insurance will not cover it. What would you do? What would I do? Another ethical issue to be considered is one that may be seen as being no-big-deal when in fact, it is. This issues is the one of professional conduct, conduct such as respect, honesty, and following the set rules and expectations of the organization you work for. For example, be on time, don’t take supplies for personal use, speak respectfully to everyone, don’t claim hours of work that you did not do, and do not break patient confidentiality. (Ethical Diligence in Healthcare Administration, n.d.) Being late for work, but putting your regular hours on your timesheet may feel ok, but it’s not. We are reminded of this in Leviticus 19:11 “Do not steal. Do not lie. Do not deceive one another”, it’s as simple as that. (New International Version).

Additionally, health care administrators are not immune from legal concerns either. Many administrators work with electronic health records and a breach in the system resulting in a  violation of the Health Insurance Portability and Accountability Act of 1996 is one such legal issue very likely to be faced. Another legal issue that could arise is that of the False Claims Act. “The False Claims Act allows individuals or healthcare providers to be prosecuted for defrauding government healthcare programs” such as false claims made through Medicare/Medicaid. (Legal Issues in Healthcare Administration, 2020) And finally, this legal issues falls into the realm of finances as well, and that is the organizations tax-exempt status. In order for a facility to maintain their tax-exempt status they must “provide certain services that add to the general welfare of the communities they serve. These services include limits on charges to patients, annual community needs assessments and emergency care policies, among others”. (Legal Issues in Healthcare Administration, 2020)

Before we face these types of ethical and legal dilemmas in our careers, we must first learn how to solve them and then continuously exercise our training so it doesn’t go to waste. There are several ethical decision making models out there for review, but I went to the American College of Healthcare Executives website to read the information they provide to there members. Amongst the recommendations was the mention of ethical committees within the organization, clearly written policies, and even ethics consultation services to better equip health care administrators with ethical decisions. “It is incumbent upon healthcare executives to lead in a manner that sets an ethical tone and models ethical behavior for their organizations”. (Ethical Decision Making for Healthcare Executives, 2016) Ways to exercise our ethical reasoning include: create a culture within the organization that encourages ethical decisions, add ethics to the mission/vision of the organizations, be the example and set expectations of an ethical organization, educate yourself and others on resources to face ethical issues even if they fall outside your area of expertise. (Ethical Decision Making for Healthcare Executives, 2016)

This research was eye opening for me. I knew that administrators would face ethical dilemmas but every time I would consider the potential for legal action I tended to envision healthcare providers only. But this of course is not correct. HIPAA violations, financial irresponsibility, and professional misconduct are all big players when it comes to potential legal disputes and must be recognized as such.