Real-Life Decision Making
You've just started as a resident at a university-based nuclear pharmacy. Working under the supervision of its director, you help create the radioactive isotopes used in the radiopharmaceuticals that it produces for hospitals around the country.
Not long into your residency, the director praises you for the quality of your work. He tells you there will be a job waiting for you once you have completed your mandatory 500 hours of experience.
Although you should be pleased, you feel uneasy. The director sometimes pressures you to work faster, presumably to increase productivity, and you wonder whether you have been given too much responsibility in such a short time.
Other safety issues crop up. The lab repeatedly sends shipments of radioactive materials to other departments within the university without properly labeling them. Even though it isn't part of your job, you take it upon yourself to stick the warning labels on the packages.
By the end of your first month, you're not even sure if you want the job promised you. On the one hand, the nuclear pharmacy does wonderful work -- making radiopharmaceuticals to help people with rare cancers that no other lab makes. On the other hand, in its haste to fill orders, it seems to have forgotten the need to obey the rules.
"Nuclear pharmacy is the most regulated area of pharmacy practice," says John Yuen. He is a nuclear pharmacist. "Radioactive materials and their waste products must be received, stored and discarded in accordance with several regulatory sources and agencies."
Nuclear pharmacists who decide to ignore these regulations do so at their peril. They compromise not only their health, but also their careers.
Things come to a head just as your residency is nearing its conclusion. One morning, you arrive at the lab to find the director staring at a large stain on the floor. He explains that he accidentally broke a vial of one of the radioactive substances while heating it, but he thinks he managed to clean it up.
Still, for your own sake, he advises you to stay home for the day until he's sure things are under control.
You know from your courses on regulations that the nuclear pharmacy must report the accident within 24 hours. When you return to the lab the next day, you ask the director if he called the regulatory authorities yet.
Admitting he didn't, he tells you that the lab has been reprimanded for several violations in the past, and that he'd prefer it if the incident could be kept a secret. "Otherwise," he mutters, "they could put us out of business. Anyway, it's not like it's Chernobyl or anything."
What do you do?