Question: Working Short Staffed-Again You are a staff nurse at Mercy Hospital. The hospital's patient census and acuity have been very high for the last 6 months. Many of the nursing staff have resigned; a coordinated recruitment effort to refill these positions has been largely unsuccessful. The nursing staff is demoralized, and staff frequently call in sick or fail to show up for work. Today, you arrive at work and fi nd that you are again being asked to work short-handed. You will be the only RN on a unit with 30 patients. Although you have two LPNs/LVNs and two CNAs assigned to work with you, you are concerned that patient safety could be compromised. A check with the central nursing office ascertains that no additional help can be obtained. You feel that you have reached the end of your rope. The administration at Mercy Hospital has been receptive to employee feedback about the acute staffing shortage, and you believe that they have made some efforts to try to alleviate the problem.

You also believe, however, that the efforts have not been at the level they should have been and that the hospital will continue to expect nurses to work short-handed until some major force changes things. Although you have thought about quitting, you really enjoy the work that you do and feel morally obligated to your coworkers, the patients, and even your superiors. Today, it occurs to you that you could anonymously phone the state licensing bureau and turn in Mercy Hospital for consistent understaffing of nursing personnel, leading to unsafe patient care. You believe that this could be the impetus needed to improve the quality of care. You are also aware of the action's political risks.

ASSIGNMENT: Discuss whether you would take this action. What is your responsibility to the organization, to yourself, and to patients? How do you make decisions such as this one, which have conflicting moral obligations?