Case Study: The Incident at Abington Hospital

In 2003 an incident occurred at Abington Memorial Hospital located in a suburb of Philadelphia, PA. A pregnant woman was admitted to the obstetrics floor for a cesarean section accompanied by her male partner. Upon admission to the hospital, the expectant father told an obstetrical resident that no African Americans were to assist in the woman's care. It is unknown if the couple was married. Abington Memorial is a 508-bed hospital, which is located in Abington and services patients from Philadelphia and the surrounding primarily white suburbs in Bucks and Montgomery counties.

The man's request was conveyed to nursing supervisors, who took several steps to ban black staffers from the couple's room. The hospital's senior administrators were never alerted to the problem. The nursing supervisors, giving in to the man's request, told black employees to stay out of the patient's room during the couple's four-day stay. To prevent black staffers from entering the room, a sign was placed outside the patient's door that read, "All visitors and staff to stop at Nurses' Station before entering the room."

The supervisors at Abington Memorial were acting with good intentions and sought to deflect any confrontation between its African American staff and the white family. There was no incident reported during the woman's stay.

The black OB nurse initially assigned to the patient, who had experience with cesarean section procedures, was replaced by a white nurse with little experience in them. A nursing supervisor told another black nurse that if the patient's call button went on, she should not respond but should instead let a white nurse check it. African American food-service workers were instructed to leave meal trays at the nurses' station so that white staffers could deliver them to the room. African American housecleaning workers and others were also kept out of the room.

Administrative response:

That directive violated the hospital's antidiscrimination policy as well as employees' civil rights under the 1964 Civil Rights Act, according to a recent ruling by the U.S. Equal Employment Opportunity Commission.

In a prepared statement, Abington Memorial vice president Meg McGoldrick said that all staff members are valued as "caring and competent." "Racism and bigotry cannot and will not be tolerated," she said. "In keeping with this philosophy, the hospital's leadership has made its diversity initiative a top priority." The hospital president Richard L. Jones Jr. sent a letter to all its employees and volunteers apologizing for the situation, which he termed "morally reprehensible." In addition to creating a diversity task force, it has hired consultants, and the hospital is revising its anti-discrimination policy.

The AHA said hospitals are constantly evaluating how to provide the best treatment for their patients, while protecting and maintaining the dignity of its employees. They also said that a hospital's constant patient turnover sometimes subjects workers to society's underbelly.

Once again, be sure to start our discussion at the beginning of the module to ensure that the discussion has been fully explored before moving on to the next module. We will work through the questions one at a time as a group, starting with the first question that asks you to share your opinion. The culture of today's healthcare organizations consists of values and beliefs that are characteristic of the community that they serve. Despite significant overlap in these values and beliefs, a clash may occur during the rendering of services to that individual or family.

1. In a situation like this, whose wishes take priority in that patient's care? The health care provider and/or the facility? The patient and/or the family? Read the case study "Abington The Abington case involves all the five levels of conflict. Using examples from the case discuss with your classmates the following questions:

2. Discuss how you see the five levels of conflict manifest in this case?

3. Where do you believe the employees, the nursing supervisors, and the administrators each fall on the Thomas and Kilmann taxonomy of conflict graph Compare your thoughts with your classmates

4. While no conflict negotiation occurred during this incident, if you were an administrator on call at the time of the patient's admission, discuss with your classmates which method of conflict negotiation might be effective in this case?