Teaching About Legal and Ethical Issues

Plagiarism

As a faculty member of an ADN nursing program, you and your fellow faculty have identified students using internet resources in papers and clinical care plans that they are submitting for grading. In several instances, clinical instructors have identified entire care plans that have been copied and pasted from the internet. When confronted, several students have commented that they thought, because "it's on the internet for everyone to see," that the content could be used without crediting the source or developing their own work.

Because this is a serious problem, it was discussed at the recent faculty meeting. The director of the program was adamant that it has to be stopped. After brainstorming ways to address the issue, it was decided that all faculty, including clinical instructors, would be asked to review the college's policy on academic dishonesty, and the director would emphasize in her message to faculty the process for reporting academic dishonesty. Additionally, it was decided to do a presentation to each nursing class on plagiarism—what it is and the correct means of giving credit for any work used. The school's policy on academic dishonesty was also to be included in the presentation. You were given the responsibility for this presentation.

Family Education Rights and Privacy Act (FERPA)

You are the lead clinical instructor for a BSN program, and as such, you are responsible for assisting arrangements for clinical placement and addressing any problems that arise in the clinical instruction of the nursing students. You also work a few shifts a week at a local hospital on the neurology unit. Neurology is your specialty area, and you are the BSN clinical instructor for the nursing students in neurology. When you come in to work an evening shift, the nurse manager asks to see you in her office after report. The manager tells you she is hiring for a beginning staff nurse position and that Eric H., one of your former students, is an applicant. You know that Eric will be graduating in two months from the BSN program, but he has not asked you to provide a reference for him. The manager asks you for your opinion on his clinical skills and his abilities to assume the staff nurse position. You explain that you can't discuss is performance as a student and that you would be violating FERPA if you do so. The manager expresses surprise and says that other clinical instructors that work part time at the hospital are always willing to give their opinion on former student's potential when they are applying for positions. You explain that FERPA is similar to HIPPA and that information on students cannot be shared without their written consent.

Realizing this is a serious violation, you discuss it at the next opportunity with the Associate Dean of the BSN program, to whom you report. She states that all the clinical instructors need to be better informed and should change the behavior of discussing student performance with possible employers without having the consent of the student. She assigns you to the task. You have quarterly meetings with the instructors and can contact them all via the school's e-mail.

Clinical Education Issue

You are the lead instructor for the medical/surgical nursing course taught to second year students in an ADN program. Your responsibilities include team teaching the classroom content with a part time instructor, coordinating the clinical on the medical surgical hospital units, and supervising the clinical instructors. The students have two clinical rotations during the semester long class: one on a surgical unit, and one on a medical unit. They receive a pass/fail grade for each clinical and a letter grade for the theory class. It is a requirement for students to pass each clinical in order to pass the class and receive the letter grade. One of the students, Sharon W., is doing very well in the theory portion of the class, and at the half way point she has an A. She has not done well in the surgical clinical, and despite directions from the clinical instructor, she has not improved. The clinical instructor believes Sharon is unsafe and will fail her for the clinical. You were not aware of the concerns with the student until now. Sharon is very upset when she talks with you. She says that she only had feedback once from the clinical instructor during the five weeks that have been completed in the six-week rotation, and she thought she had corrected the concern. She tells you that if she fails the course she will appeal. You advise her you will consult with the clinical instructor and determine a plan for her going into the medical unit clinical.

After discussing the situation with the program director and consulting with the instructor (who agrees that she should have provided Sharon with feedback more regularly), a plan is devised for you to spend the last week in the clinical with the student and add your observations. The program director also asks that you provide further direction to the medical/surgical clinical instructors on evaluating students in the clinical area..

Ethics in Staff Education

As the nurse educator responsible for orienting new staff on four medical/surgical units, you have a group of nurses that you depend on to precept new hires. Marcy is a new RN who is a recent graduate of a local BSN program; she has been hired as a staff nurse on a cardiology unit. She advised HR and her nurse manager when she was hired that she has a hearing deficit and has a special amplified stethoscope that she uses. She also shared this with you and with her precepting nurse, Jason. You note that in orientation classes she is attentive, engages in class activities, and relates well to the others in her class. When you meet with Marcy and Jason to review orientation progress, her skills check list is more than halfway completed. Jason compliments Marcy on her patient education skills with CHF patients and their families. You ask if either has any concerns about how the orientation is going. Marcy shakes her head no, but Jason encourages her to discuss a concern. Marcy tells you that there are several nurses on the unit that have asked about her stethoscope and have made negative comments about her abilities to work in cardiology. Marcy says this has happened several times. Jason states he did not hear it because he was on the phone or out of the nurse's station; however, Marcy told him about it later. You are concerned because you recognize this as horizontal violence or bullying and a potential violation of the Americans for Disabilities Act. You tell Marcy and Jason that you will discuss it with the nurse manager.

After talking with the nurse manager, who agrees this is a serious issue, a plan is devised. The nurse manager will follow-up with her assistant manager and both will be alert for any further incidents with any staff. You will do a presentation on horizontal violence or bullying that will be presented to all nurses over the next month with a discussion session. Attendance will be mandatory.