by Karin Swendsen

Nursing

Mary Ann graduated as a Registered Nurse six months ago. She has only been able to find part employment since graduation. Two weeks ago, John, a Registered Nurse she met in the Army Reserve, told her of a position at St. Luke's Hospital on the Oncology (Cancer) unit where he has worked for five years.

Mary Ann applied for the position and was hired, mainly because of John's recommendation. One of the benefits of working at St. Luke's is tuition reimbursement, which will allow her to pursue a Master's Degree in Nursing. She is a single parent and needs the additional education in order to support her four children.

Mary Ann arrived for work on the unit at 3:00 p.m. and was asked by John to count narcotics with him for the shift change. She and John signed off that the narcotic count is correct and John gave her the narcotic drawer key. She began making her rounds of patient rooms when John returned and asked to borrow the keys, stating he "left his wallet in the narcotics drawer ." Since she was busy with a patient, she gave him the keys. Minutes later, she entered the nurses' station to find John with the narcotic drawer open, a ten cc syringe full of liquid, an empty morphine vial, and a ten cc vial of Normal Saline on the counter.

John admitted to her that he was diverting morphine for his own use and begged her not to report him. He promised that he would get professional help. He then stated that he will deny he is diverting narcotics if she does not agree to help him. He will waste the Morphine in the syringe in the sink. The narcotic count was correct when he left his shift, but her count will be incorrect at shift change.

Mary Ann knew that John would lose his job, his license to practice nursing, and his commission in the Army Reserve. He will also be an embarrassment to his family, especially since his father is the hospital administrator.

Questions:

What are the ethical issues of this case for Mary Ann? For John? For his father? For the patients? For the hospital?

What should Mary Ann do?

What do you think John will do?