How to measure ethics among potential CMs
September 1, 1999 3 minutes read
How to measure ethics among potential CMs
Evaluating ethics before hiring makes good sense
It’s possible to measure a case manager’s ethics and use ethical competency as one of your employment criteria for hiring, advancement, and firing, says Carol Taylor, CSFN, PhD, MSN, RN, assistant professor and ethicist at George town University School of Nursing in Washing ton, DC.
"You should write scenarios that are common to your own practice. Select issues that recur often and present them to case managers, or potential case managers," she suggests. "What you are looking for is evidence that they’ve had experience working with the types of ethical problems common to your practice. As you listen to the person’s response, ask yourself, "Does this person have the qualities we’re looking for?’"
Three sample scenarios
Taylor wrote the following scenarios for use in her own teaching hospital setting.
Scenario one: The wife of a patient with end-stage cancer seeks you out and tells you she is afraid that her husband is "losing hope" and "giving up." She tells you she has just learned that one of the patients on the unit was evaluated for inclusion in a clinical trial that offers some promise of arresting the disease if the patient receives the experimental drug. She wants you to get her husband in this trial and to do whatever you can to ensure that he receives the experimental drug. You aren’t familiar with the criteria for inclusion in this trial and think it probably would be futile for her husband, given his condition. You have to be at an administrative meeting in 20 minutes. What do you say to her?
Taylor suggests evaluating a potential employee’s response to that scenario for the following issues:
• commitment to patient well-being;
• sense of responsibility and accountability;
• advocacy competencies.
Scenario two: A woman who has just had a large nonmalignant abdominal mass surgically removed is seen by the case manager from her health maintenance organization (HMO) on her second postoperative day and told she needs to be discharged. She tearfully tells you she is not ready to go home, and you suspect her elderly husband will be a rather limited source of assistance. When you try to explain her situation to the HMO, the representative you speak with is adamant that the company will not reimburse for any additional days. The size of the patient’s mass, the length of time she was in the operating room, other factors in her history, and her limited at-home resources place her at higher risk for complications than other patients undergoing similar surgery. What actions, if any, would you take?
Taylor suggests evaluating the candidate’s response for the following issues:
• commitment to patient well-being;
• sense of responsibility and accountability;
• advocacy competencies;
• ability to critique the system’s potential to influence human well-being.
Scenario three: An 84-year-old Native American resident on your rehabilitation unit tells you to make sure that "Ellen never takes care of me again." When you question him, he tells you how "mean" she is and that she never treats him nicely like the other nurses do. You respect Ellen’s clinical competence and know that this patient has a reputation for being a problem. What would you do?
In addition to evaluating the response for commitment to patient well-being and a sense of responsibility and accountability, Taylor suggests you evaluate the candidate’s ability to be an effective advocate and mediate between Ellen and the patient.
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content