staff shortage – Ethics In Practice

Care During Short Staffing

The Medicine program in your hospital has been struggling with high volumes of acutely ill patients, and short staffing due to sick calls and burnout. Normal “surge” protocols are no longer working and even the float pool is depleted. The headlines are describing a dire situation indeed, with patients and families reporting long waits for call bells to be answered, and patients left in pain and without help to get to the bathroom. After a straight week of being unable to fill all vacant nursing assistant shifts, and months of overtime, the staff on one unit ask for an ethics consultation, to help them identify priorities for care. This is a situation that might benefit from a meeting to identify the major ethical concerns and collaborate on interventions that could relieve some of the pressure on staff. You attend the unit just before morning shift report. Gathering as many people as possible, you convene a short unit meeting to identify the biggest...

Public Health Crisis

Your organization includes several pediatric and neonatal intensive care units, located in different hospitals. The facilities were built at different times in recent history and so have different layouts – some with open bays, some with multi-bed rooms, and some with private rooms. The province has been facing a public health outbreak where hundreds of people are testing positive for a little-known pathogen. While public health experts figure out what is going on, it has been determined that the number of people entering and leaving the facility should be absolutely minimized and that anyone entering the facility should fully dressed in PPE – which itself is in short supply. As a result, all NICU and pediatric units have been observing a strict policy of allowing only one parent at a time to be present. Staff, also in short supply, are spending time ensuring that parents coming onto the unit are donning and doffing PPE appropriately. The number of positive cases in the community...

Winds of Winter

The health care organization you work for serves a rural population and most staff members commute to work, some for 45 minutes or more, over roads in varying states of repair. The past winter there were several storms that made it challenging for some people to get to work, and the organization found itself short staffed when this happened. In addition, some managers required employees who couldn’t make it in to take the time as a sick day, while others did not. The lack of consistency in practices raised concerns at a leadership level and has resulted in a degree of antagonism between those who live close to the facility and those who live further away. You are part of a policy working group tasked with developing policy around reporting for work in adverse weather conditions. Committee members have significant concerns about justice. In this case, their concerns about justice focus primarily on fair distribution of risk and fair distribution of workload. In...