Monday, February 04, 2008

Covering up for a colleague

Covering up for a colleague

Covering for a careless colleague endangers patients and jeopardizes the quality of your own work.

Jan 1, 2008


I work with a nurse who knows how to do her job but doesn't always do it. If she is reprimanded, she improves for a while, but it doesn't last. I can't stand seeing patients get less than quality care. How responsible am I to cover her carelessness?

In this time of a severe nursing shortage, it might be tempting to overlook the actions of a marginally competent colleague rather than report her actions and risk having no colleague at all. However, slowly allowing the erosion of quality nursing care not only puts patients at risk of harm but the profession as a whole, as well.

Your personal responsibility for the incompetent conduct of others is limited by the duty to protect patients' interests. Covering for a careless colleague only enables the process to continue and jeopardizes the quality of your own work.

That said, the answer to a question like yours is not always clear. One problem is the ethical conflict between the obligation to serve the patient's best interest and loyalty to a colleague whose interests would be jeopardized if you reported her to a supervisor or took other action to get her to clean up her act.
Before deciding if an intervention is in order and what kind it would be, you'd also have to determine whether you have any duty to your colleague to serve her interests. Loyalty to those with whom we work is an important principle. It establishes a foundation of trust among members of a working team. So as colleagues we have a collegial duty to protect the reputations of those with whom we work—but only to a point. We also have a duty to future patients who could be injured by a careless colleague.

One issue to consider is whether the nurse should be viewed as responsible for her behavior. Is she in a position where she should clearly realize that she's failing to meet the standard of professional conduct? Has she been properly oriented to her position? The answers to these questions may determine whether you and others hold her responsible.

AMY HADDAD, RN, PhD, a member of the RN editorial board and a widely recognized ethicist, is a professor at the Center for Health Policy and Ethics at Creighton University in Omaha. She is the co-author of Ethical Dilemmas in Perioperative Nursing, Ethical and Legal Issues in Home Health Care, and The Arduous Touch: Voices of Women in Health Care.

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