Real-Life Decision Making
In your job at the hospital, you are assigned patients that you tend to on a daily basis. One of your current patients, Mr. Smith, has recently undergone surgery for cancer, and he is in a lot of pain.
His doctor has left a standing order that Mr. Smith is to receive pain medication every six hours. The RN (registered nurse) assigned to his case is responsible for delivering the medication on schedule.
When it is time for the next medication to be administered, the RN shows up and you are pleased to see that it is your favorite nurse, Reesa Thompson. Thompson is your friend, and she has done many favors for you in the past. Mr. Smith is also pleased to see Thompson. He immediately begins begging for his pain medication.
But when Thompson administers the medication, she doesn't use the prescription medication that the doctor ordered. She gives Mr. Smith a placebo (a sugar pill) and lets him think it was the real thing.
You take Thompson aside and ask why she is doing this. Thompson tells you that she believes Mr. Smith is exaggerating his pain in order to get the medication. The medication is habit-forming, and patients sometimes fake problems to get more pills. Thompson says it's time Mr. Smith is taken off this medication before he becomes addicted.
Thompson knows you are supposed to report any incidents in which a nurse doesn't follow a doctor's orders. She says to you, "Don't say anything and no one will ever know. This is for Mr. Smith's best interests in the long run, and he probably won't have very much pain. It is long enough now since his surgery that he should be able to go without pain medication."
As the hours pass, Mr. Smith continues to complain of pain. He doesn't sleep through the night.
If you report the incident, your friend will be very angry with you. She will remind you that she has done you many favors in the past and that now you have gotten her in serious trouble. She will say that if she is disciplined, it will be your fault.
If you do not report the incident, Thompson will continue to give Mr. Smith placebos instead of medication and he will continue to suffer. If it is ever discovered that you knew about the incident and didn't report it, you will be in trouble yourself.
What do you do?