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CASES FOR ANALYSIS Mrs. L. was head nurse on a medical surgical floor in a community hos- tal of 250 beds. Over the course of six months she noticed that all patients pi mitted from the Shady Rest Nursing Home had signs of severe injuries ad other than those connected with the admitting diagnosis. There appeared to be patient abuse in the nursing home. Mrs. L. investigated discreetly and found no explanation possible except abuse. In accord with the obligations of the law in her state, she reported the matter to the Department of Welfare Bureau of Inspection. The welfare department investigated immediately, found proof of abuse, and threatened to close down Shady Rest if there were any recurrences. Mrs. L. was overjoyed until her hospital administrator, bypassing the director of nursing, called her in and warned her that she would be fired if she reported any other instances of abuse. Shady Rest sent the hospital a lot of business, and good relations had to be maintained.
164 2/ PROBLEMS OF HEALTH CARE ETHICS Mrs. L. was even more shocked when she discovered that the administra- tor was a golf partner of the owner of Shady Rest and was doing an old buddy a favor. Despite fears of retaliation, Mrs. L. consulted a lawyer, who threat- ened the hospital with exposure and with the penalties that would follow if one of its employees failed to follow the reporting provisions of the law on abuse in nursing homes. Did Mrs. L. act correctly? What should she have done if she could not afford to consult a lawyer? In what other ways can whistle-blowers protect themselves? Must the art of intimidation be part of the tool chest of health care professionals in order to protect their patients? Is power an appropriate consideration in health care ethics?
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Mrs. Lewis identified the patient abuse in Shady Rest Nursing home. It is the responsibility of any health care professional to report to the welfare of the Bureau of Inspection in case of any patient's abuse. Being doing her responsibility, the administrator threatens her that she violated the law and principles of a nurse. Perhaps, Mrs. Lewis was correct in her manner, the administrator misused the power against the legal law of the state. In such a situation, It is best to consult a lawyer so that she can protect the patient from abuse and to safeguard herself from threatening. As the policy has been violated, the whistle-blower's act protects her against retaliation. This act will take action on the employer who threatens the employee and public policy. It takes severe action if the organization does not change their practice. Health care ethics implies that patients have autonomy in care decision and treatment and the health personnel has authority and power only to protect the patient and employees and to misuse. In the same way, the employee has the right to report if anyone has act unethical to the laws.

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