Critical Decision Making for Providers

Mike is caught in a dilemma of reporting or not reporting a spill in the lobby. The dilemma arises because he is the breadwinner of his young family and reporting the spill may delay his clocking in thus endangering his job given that he had run late before. Failing to report the spill means that anyone can get injured when they step on the spill. Mike can assume either that no one will step on the spill or someone after him will see the spill in time before it causes injury. 

A utilitarian theory would be a wrong choice in this scenario because it would demand for the greatest good. The greatest good in Mike’s subjective situation would be he retains his job even though someone gets hurt because of his choice of failure to report. The deontological school of thought is the best applicable decision-making tool here because Mike will consider the moral aspects of the situation and not the outcomes or consequences (Xu & Ma, 2015). For any virtuous or moral individual, the best and only moral action in this situation is to report the spill and inform his supervisor no matter the consequences.

The consequences of reporting and not reporting are unknown. Reporting on the spill will lead to Mike’s lateness which may see either dismissed from work or not. On the other hand, Mike’s failure to report may either cause someone to be injured or not, therefore looking at this situation on a utilitarian lens magnifies the dilemma. Looking at this situation on a deontological lens, Mike should ask himself, what would a moral person do in such a situation? And the answer would be simple: report the spill. There is nothing moral about failure to report the spill.

There are several consequences that would arise if Mike fails to report the spill in the lobby. Mike is compelled with the issue that if he reports the problem he will be late for work and also that it might be seen by another person therefore there is no need to report since he is in a hurry. The first consequence in failure to report is the spill might lead to an injury as a person may slip in the lobby. Mike will be detected by the cameras in the lobby as the first person to see the spill but fail to report, this will be tantamount to negligence on Mike’s side. This is an avoidable accident that could have been prevented. On realization that a patient was injured due to the spill, Mike will feel guilt and faced with a new dilemma as if to report what happened or be discrete because admission might cost him his job.  

A lawsuit is a possibility in this case. The general principles of the law of negligence outline that a civil liability is possible if someone with a duty to report an incident fails to do so.  Mike is bound by duty and even ethics to report the spill even though he is facing the possibility of losing his job because of lateness. If a patient is injured through slipping, the civil suit will be against the facility and not Mike; this is because it is a collective action problem that does not meet strict liability standards (Gilo, Guttel, & Yuval, 2013). The injured party may seek damages depending on the injury acquired from the slip. The incident will increase on the workload of the facility because they must attend to the injured patient disrupting the normal schedules because the injured patient becomes a priority. Just like any other facility or situation, emergency or severely injured patients become a priority especially in a situation such as a broken hip. The financial burden of such an incident if there is no lawsuit filed will be carried by the facility. 

Mike may face personal consequences which may involve either a reprimand by the facility or even dismissal due to negligence. Failure to report such an issue whilst he was the first person to see it may not be taken lightly by the management especially after an accident. If the person injured was an employee of an institution there will be lost productivity for the organization because the individual may not be able to work for days or weeks due to injury. In such a situation the healthcare institution will be forced to take stern measures to ensure that the incident does not recur. 

There are other consequences that may not be direct but are likely to occur. The first consequence is to the dependants or families of the injured individual because they may suffer out of Mike’s neglect to report the spill. It takes only a small effort to report but lack of it may either cause emotional or financial suffering to the patient’s loved ones or dependants. A law suit or a word about the incident may dent the reputation of the health facility in the public eye. Such a small neglect may send a strong message to the public that the hospital personnel are negligent of such instances therefore there will be a general perception of neglect against the hospital. 

The lateness should not only be approached on only reprimand aspect by the supervisor. The supervisor should assess the situation first to know the pertinent facts of the lateness. According to Plump (2010) employers can deal with employee issues by providing structures in the workplace to address the problems minimizing application of extreme measures such as dismissal. The first step by the supervisor is to understand Mike’s behavior because his issues might be genuine because issues such as accidents or weather happen. A study by Elicker et al., (2008) indicates that job satisfaction, job involvement and affective commitment should be considered in employee lateness. The supervisor should not accept the tardiness to go for long. When a trend is noticed, the supervisor should be proactive in the situation avoiding any threatening action. The supervisor should express their disappointment verbally to any late employee so that they can be aware of their pattern of tardiness. 

The supervisor should come up with an action plan to solve the issue. The action should allow for exceptional cases where the employee may have family obligation or sickness. The supervisor should set rules that govern lateness e.g. persistent lateness consequences, making up time for lateness, how to report lateness, flexible working arrangements, and how to monitor time keeping. It is important for the supervisor to be fair and flexible. The behavior of the Mike and other employees can be reinforced through rewarding improvements. 


Leave a Reply