Case Study Carlos, an experienced RPN, goes home from work and tells his partner that he is quitting nursing. Today he gave two weeks’ notice and will be on vacation until his resignation date. Carlos is employed in a forensic unit at a correctional institute. His partner, Philip, is not surprised by his decision to quit. Carlos has kept his sexual orientation private at work because certain employees are homophobic. Philip listens as Carlos tells him about the events that led him to reach this decision. Carlos had decided that he would take action to improve the ethical climate at the correctional institute. It was a hard sell, but he gathered a group that agreed with him that changes were needed. The group members had witnessed unethical and harsh treatment of prisoners by nursing colleagues. Carlos found he was expected to be a hybrid nurse-guard, yet felt these responsibilities must be separated. He also encountered a conspiracy of silence. In the institute, there was a high percentage of First Nations prisoners with a high incidence of tuberculosis, HIV, and illegal drug use who were not receiving proper treatment. Carlos asked the health unit administrators to raise their practices to provincial standards for the treatment of addictions and infectious diseases. Carlos and the other group members met with the administration, who concluded that the current health care programs would continue. They explained that the proposed policies were expensive and would not improve the prisoners’ health. Racist and homophobic remarks were also made at the meeting.a. Review the guidance given in the BCCNP RPN Code of Ethics about the responsibility of nurses to maintain well-being and achieve a healthy workplace. Based on the Code of Ethics, (i) what advice would you give Carlos? (ii) Could he have proceeded differently? (iii) Do you think his resignation is justified, or at least understandable?b. Carlos experienced moral distress on the forensic unit. (i) Identify the reasons for this distress. (ii) What legal protections did he have? (iii) Would it have been productive for Carlos to exercise these rights? (iv) Could his professional and regulatory body have offered him assistance when he responded to the ethical and legal issues he experienced?c. Reflect on where you have worked as a student nurse or are currently employed. (i) How would you rate the practice environment in terms of supporting ethical practice? (ii) What are some ways to support or improve nursing practice and the workplace culture? Be specific and ensure they are practicable, providing reasons.
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