Running head: ETHICAL ISSUES AND PROFESSIONAL MISCONDUCTS

Ethical Issues and Professional Misconducts in Nursing

Oladapo Olowoyeye
N01027823
NURS 127
Janet Jeffery
November 13, 2015.

ETHICAL ISSUES AND PROFESSIONAL MISCONDUCTS

ETHICAL ISSUES AND PROFESSIONAL MISCONDUCTS IN NURSING

There are increasing cases of nurses failing to maintain the standard of practice of the
nursing profession. As stated in the Ethics 2008 Standard (CNO), nursing is a self-regulating
profession. This means that the government have given the profession the authority to regulate
itself. The College of Nurses of Ontario (CNO) has a duty to regulate the nursing profession and
to protect the interest of the public. This paper will generally focus on the ethical issues
surrounding Registered Practical Nurse A (Nurse A) discipline hearing and decision. According
to the Ethics 2008 Standard (CNO), professional misconduct is failure to maintain the
standards of practice of the profession. Nurse A was alleged to have committed an act of
professional misconduct. The allegations against Nurse A includes: stealing a credit card from
client; knowingly used a forged cheque and document; pretending to give a client a dose of
medication in order to keep the clients daughter happy; resided in the vacant home of the client
without the permission of the client or family; and misappropriated property from the home of
client by removing items without the permission of the client (Discipline decisions, CNO, 2013).
Registered Practical Nurse A worked as director of care at a retirement home
facility in Ontario. She used her position as director of care to obtain her client property by
manipulating and pressuring the client. The client was an elderly and cognitively impaired
resident in the retirement home where Nurse A is the director of care. Nurse A is the only one
responsible for her professional misconduct behavior. She knowingly exploited the client and she
was not under substance abuse or mentally ill. The Discipline Committee recognizes the
seriousness of Nurse A actions, and because she was found guilty of criminal offences, the
Discipline Committee unanimously directed the Executive Director of the College of Nurses of
Ontario to revoke Nurse A certificate of registration. The writer agree with the decision of the
Discipline committee because Nurse A behavior was dishonest, appalling, and were contrary to
the values of the College of Nurses of Ontario. She was unprofessional by showing serious
disregard for her profession and lack of integrity. Nurse A contravened some ethical values
which were described in the Ethics 2008 Standards by the College of Nurse of Ontario.

ETHICAL ISSUES AND PROFESSIONAL MISCONDUCTS

Firstly, Nurse A breached the ethical values of truthfulness. As stated in the Ethics 2008
Standard (CNO), truthfulness means speaking or acting without intending to deceive.
Truthfulness also refers to providing enough information to ensure the client is informed. In the
case of Nurse A, she forged the cheque and stole the credit card of a client. She also deceived the
daughter of a client by pretending to give the client a dose of medication. These actions violated
the ethical value of truthfulness. It is important for nurses to be sincere with their client. Honesty
will help the nurse to be able to build trust with the client. For example, when a client realizes a
nurse is not truthful with them, it will have negative effect on the therapeutic relationship
between the nurse and the client. It will be hard for the nurse to build a therapeutic relationship
with the client, and this will affect the quality of care the nurse is providing for the client. By
deceiving the clients daughter that she was giving the client medication, and also forging the
cheque of the client, Nurse A was dishonest with the client, and she jeopardized the nurse-client
relationship between her and the client. She violated the ethical value of truthfulness.
Furthermore, Nurse A contravened the ethical values of maintaining commitment to the
client and the nursing profession. As stated in the Ethics 2008 Standard (CNO), maintaining
commitment means keeping promises, being honest and meeting the implicit or explicit
obligations towards clients, themselves, each other and the nursing profession. Nurse A violated
the ethical value of maintaining commitment to the client by knowingly stealing a credit card
from client, forging a cheque of the client, residing in patient home without the permission of
the patient, and removing items and furniture from client home without the permission of client.
Nurses should try to act in the best interest of the client because of their commitment to client
(Ethics, CNO, 2008). Nurse A behavior was not in the best interest of the client. For example,
she used her position as director of care at the retirement home to exploit the client, and obtain
his credit card and property. This is very wrong; Nurse A was put in a position to take care of the
vulnerable people, and she was supposed to know that all her actions must be in the best interest
of the client. By deciding not to keep to the promises of acting in the best interest of client, Nurse
A breached the ethical value of commitment to the client.

ETHICAL ISSUES AND PROFESSIONAL MISCONDUCTS

Nurse A also violated the ethical value of commitment to the nursing profession by her
appalling behavior. As stated in the Ethics 2008 Standard (CNO), nurses have a duty to uphold
the standards of the profession, conduct themselves in a manner that reflects well on the
profession, and participate in and promote the growth of the profession. Being a nurse, the
public respect you and trust you. Nurse A betrayed the trust and respect of the public by her
actions. Her kind of behavior damages the reputation of the nursing profession. Nurses have an
obligation to act in a manner that brings respect to the profession. She was unprofessional by
showing serious disregard for the nursing profession. For example, due to Nurse A bad behavior
towards the client, the client will lose respect for other nurses thinking all nurses behave the
same way. Her behavior does not reflect well on the profession.
Lastly, Nurse A breached the ethical principles of beneficence and nonmaleficence.
According to Beauchamp & Childress (2009), beneficence means taking positive actions to help
others; showing compassion; and desire to do good to other people. Nurse A had no desire to do
good for her patient. She only cared about how she will exploit the client and obtain his credit
card and property. Her actions were not doing any help for the patient. She lacks compassion for
the client. If she had a little compassion for the client, she would not have knowingly forged the
cheque of the client or stole his credit card. She breached the ethical principle of beneficence
because all her actions did nothing to benefit the client. Nurse A also violated the ethical
principle of nonmaleficence. As stated by Beauchamp & Childress (2009), nonmaleficence
means avoidance of harm or hurt. Nurse A was hurting the client financially because she stole
the credit card of the patient, and also forged the clients cheque to withdraw money from his
account. This violated the ethical principle of nonmaleficence because she was hurting the client.
For example, After Nurse A stole the credit card of the client, she will use up all the money on
the credit card, and the money left on the credit card will not be enough when the client want to
buy the things he need. Her actions really hurt the client.

ETHICAL ISSUES AND PROFESSIONAL MISCONDUCTS

However, it is important to come up with strategies in order to prevent situations like this
from happening again. The writer will suggest that the College of Nurses of Ontario should
create an education program on the ethical values and principles in nursing, and make it
mandatory for every practicing nurse to do this program every year. This will help to reinforce
the information on the ethical values and principles; especially for nurses that have been
practicing for over 10 years. After so many years practicing, it is easy for some nurses to forget
the information they learned in school about Ethical values and principles. When nurses take
ethics courses annually, this show to the nurses that it is an important part of the profession, and
nurses will apply the ethical values and principles when providing care for the client. As stated
by Whei & Paul (2014), continuing education in nursing enhances nursing ability to improve
patient care outcomes. This means that when already practicing nurses attend education
programs, it will improve their decision making and how they provide care for their patient. This
also means that when practicing nurses attend education program on the ethical values and
principles in nursing, they will have better knowledge of the ethical values and principles, and it
will be hard for them to forget it. This will help the nurses to continuously apply these values and
principles when providing care for the client. This will also improve patients care outcomes. This
is the reason why the writer belief creating an education program on ethical values and principles
for nurses, especially nurses working over 10 years would have worked in the case of Nurse A.
Some people might say continuous teaching of nurses about the ethical values and
principles does not change the behavior of the nurse if the nurse is a really bad person. I will say
that continuously teaching nurses annually about the ethical values and principle remind nurses
about how he or she is supposed to behave with their patient; and there is a better chance of the
nurse complying with the ethical principles and values if they are reminded of their
responsibilities annually.
Secondly, the writer will also suggest that government should provide community-based
services that will provide information for client to know their right, and when to immediately
report improper behavior of nurses towards them. In the case of Nurse A, the client would have

ETHICAL ISSUES AND PROFESSIONAL MISCONDUCTS

been able to quickly notice the professional misconduct of Nurse A, and quickly report her to the
appropriate authority. This would have prevented this situation from happening, and the nurse
would not have stolen the credit card of the patient, or forged the cheque of the patient.
As stated by Fraiser (2010), community based services help in counseling and educating
vulnerable people about abusive situations by raising their awareness and empowering them to
change their situations. This means that if government creates community-based services to
reach out to the vulnerable people to counsel them about their right, and what they need to do
when they find themselves in abusive situations, this will raise their awareness and they can
report and stop this abuse before it even started. For example, a community nurse can visit
nursing homes, retirement homes, and hospitals to counsel the patients about their rights, and the
signs that show they are being abused by a nurse. This will enable the patient to quickly know
when they are being abused, and they can stop it immediately. The client will be able to know his
right and know what behavior of the nurse is acceptable or what behavior needs to be reported to
the appropriate authority. I belief this strategy will definitely stop situations like this from
happening again.
Some people might question this strategy and say what if the patient reports an improper
behavior by a nurse to the appropriate authority, and nothing is done to stop the nurse doing the
same thing again. I will say it is very unlikely the appropriate authority in the facility will not act
immediately after hearing that a patient is being abused; but in cases where nothing is done about
it, and the nurse repeats the same behavior, the client or family of the client can report to
someone outside of the facility or the College of Nurses of Ontario and appropriate action will be
taken against the nurse.
In Conclusion, professional misconduct is a range of unacceptable acts that fail to
maintain the standard of practice of the profession. Nurse A committed professional
misconducts. The allegations against Nurse A was that she stole the credit card of a client; forged
the cheque of the client; deceived the daughter of the client by pretending to give a dose of
medication to the client; lived in client home without the permission of the client; and removed

ETHICAL ISSUES AND PROFESSIONAL MISCONDUCTS

items and furniture from the home of the client without the permission of the client. Nurse A
contravened some ethical values. She breached the ethical value of truthfulness when she
deceived the daughter of the client, by pretending to administer medication to the client.
She also breached truthfulness when stole credit card and forged check of the client. Nurses
should act in a way that will build the trust between them and the patient. Nurse A also violated
ethical values of commitment to the patient and the nursing profession. She failed to act in the
best interest of the patient and she also acted in an unprofessional way that damages the
reputation of the nursing profession.
Nurse A also violated the ethical principle of beneficence and nonmaleficence. She had
no desire to do good for the patient. All she cared about was exploiting the client and collecting
his money. She violated nonmaleficence by hurting the client financially. Nurses are supposed to
avoid hurting the patient. The writer agreed with the decision of the Discipline Committee to
revoke certificate of registration of Nurse A.
The writer came up with a couple of strategies that can be used to prevent situations like
this from happening again. The first was that the College of Nurses of Ontario should create an
education program on the ethical values and principles in nursing and make it compulsory for
every practicing nurse to do this program every year. This will help to continuously remind the
nurses of the ethical values and principles. The writer also suggested that government should
provide community-based services that will counsel clients to know their right, and when to
immediately report unacceptable bad behaviors of nurses to the right authority. The writer
strongly belief these two strategies will prevent this situation from happening again.

ETHICAL ISSUES AND PROFESSIONAL MISCONDUCT

References
Beauchamp, T. L., & Childress, J. F. (2009). Principles of biomedical ethics (6th ed., pp. 38-39).
New York, NY: Oxford University Press.
College of Nurses of Ontario. (CNO). (current edition). Fact Sheet: Discipline Decisions.
Retrieved from www.cno.org.
College of Nurses of Ontario. (CNO). (current edition). Learning Module: Ethics. Retrieved
from www.cno.org.
Fraser, A. (2010). Preventing abuse of older people. Nursing Management, 17(6), 26-9.
Retrieved from http://search.proquest.com/docview/757765082?accountid=11530.
Whei Ming Su; Paul J. Osisek. The Journal of Continuing Education in Nursing, 07/2011,
Volume 42, Issue 7.