Advice P.R.N.

March 2011 
Volume 41  Number 3
Pages 14 - 15
  PDF Version Available!

The economic downturn hit our hospital hard, and nurses are expecting another round of layoffs. As a nurse manager for over 10 years, I know my nurses as friends as well as colleagues. The vice president of nursing has told me which staff nurses will lose their jobs, but this information won't be announced for several weeks.Several nurses I supervise have asked me to tell them what I knownow. One nurse plans to buy an expensive new home, but doesn't want to make an offer if she'll soon be out of a job.From a legal standpoint, I know I can't say anything. But how can I deal ethically and emotionally with the guilty feeling that I'm letting my friends down?-D.R., MICH.Certainly this is a difficult position for you. But by accepting the role and responsibilities of nurse manager, you've made a commitment to certain obligations, such as not divulging information that you've been told in confidence regarding administrative decisions.Our ethics consultant advises you to be honest with your staff nurses about this. Explain simply and directly that you can't speak to them about layoffs. By keeping your statement general and giving the same response to everyone, you can head off continued pressure from questioners. You also avoid favoring some nurses over others by divulging information not available to all.As for feeling guilty, ask yourself whether you should hold yourself responsible for economic downturns, administrative decisions to cut staff, or difficult financial choices facing nurses you work with. The answer should help you put your role in perspective.I work in a community hospital ED that employs critical care technicians (CCTs). Most are emergency medical technicians (EMTs) or paramedics whose certifications are recognized in the prehospital setting, not in the hospital.Recently the CCTs requested that they be permitted to insert indwelling urinary catheters, and our manager supports the idea. Many of the RNs are uncomfortablewith letting CCTs perform this invasive

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