Question: To Work or Not to Work?

You are a nurse in a long-term care facility. The facility barely meets minimum licensing standards for professional nursing staffing. Although agency recruiters have been actively seeking to hire more licensed staff, pay at the facility for professional staff is less than at local acute care hospitals and the patient-nurse ratio is significantly higher. There appears to be little chance of improving the RN staffing mix in your agency in the near future. The nursing administrator is extremely supportive of the staff's efforts but can do little to ease the current workload for licensed staff other than to turn away patients or close the agency. As a result, all of the nurses on the unit have been working at least 48 hours per week during the last 6 months; many have been working several double shifts and putting in many overtime hours each pay period. Morale is deteriorating, and the staff has begun to complain. Most of the licensed staff are feeling burned out and demotivated. Many have started refusing to work overtime or to take on extra shifts.

You feel a responsibility to the patients, community, and organization and have continued to work the extra hours but you are exhausted as well. Today is your fi rst evening off in 6 days. At 2 PM, the phone rings, and you suspect that it is the agency calling you to come in to work. You delay answering while you decide what to do. The answering machine turns on, and you hear your administrator's voice. She says that they are desperate. Two new patients were admitted during the day, and the facility is full. She says that she appreciates all the hours you have been working but needs you once again, although she is unable to give you tomorrow off in compensation. You feel conflicting loyalties to the unit, patients, supervisor, and yourself.

ASSIGNMENT: Decide what you will do. Will you agree to work? Will you return the administrator's telephone call or pretend that you are not at home? When do your loyalties to your patients and the organization end and your loyalties to yourself begin? Is the administrator taking advantage of you? Are the other staff being irresponsible? What values have played a part in your decision making?