What Annie wanted Sally to do – sign for an order of a schedule 8 drug ordine was both unethical and illegal.
Ordine, a highly addictive drug, has been classified S8. In other words, it is restricted, therefore, could not just be administered to any patient without following specific procedures. According to the clinical guidelines issued by the Department of Health of Western Australia, all orders of a drug like ordine made for patients who are staying in the hospital should be put in writing using a “hospital medication chart” or any such form which was duly approved by the “Medical Records Committee.” Then every transaction should be entered in the register of the ward where the patient is staying, such register showing particular information like the date the order was placed, the name of the patient, the specific quantity which was ordered by the attending physician, the name of the prescribing physician, and the time of day that the drug was given to the patient (Government of Western Australia Department of Health, 2003).Although Annie was her superior, Sally was right in refusing to do her bidding.
No register for the ward and no hospital medication chart which covered the transaction were shown to her, making the practice not only out of hospital protocol but illegal as well. Therefore, Sally had no choice but to refuse Annie. Her action was in accordance with the competency standards laid down by the Australian Nursing and Midwifery Council Incorporated (ANMC) which emphasized that a nurse should function in accordance with the laws regulating the nursing profession. In addition, the standards require a nurse to be able to identify the “interventions which prevent care being compromised and/or law contravened” (Australian Nursing & Midwifery Council-a, n.d.). In fact, Annie’s practice was a valid cause for whistle-blowing on Sally’s part.Sally was also justified in her refusal for a second reason.
According to the Code of Ethics for Australian nurses, they “have a right to refuse (conscientious objection) to participate in procedures, which they judge on strongly held moral beliefs to be unacceptable.” Sally strongly believed (and correctly at that), that the practice was unacceptable – therefore, Annie could not force her to go along. The bullying and intimidation techniques employed by Annie could therefore have been a valid reason for whistle-blowing (ANMC-b, 2002).Sally was likewise required to refuse Annie’s bidding by Value Statement 2 of the Code of Ethics which states that: “Nurses accept the rights of individuals to make informed choices in relation to their care.” This means that the patient in question should be informed that the drug being administered to him or her by Annie to ease his or her pain is highly addictive. If the patient agrees in spite of the risk of becoming an addict to the drug, then nurses are justified in using the drug. In the case scenario, Sally was not provided with any evidence of the patient’s consenting to the use of ordine, therefore, Annie’s method was against the Code of Ethics (ANMC-b, 2002).Another valid reason for whistle-blowing was the unsupportive reaction shown to Sally by the Clinical Nurse Consultant (CNC).
Such indifference violates the Code of Ethics. According to explanatory statement number 4 of Value Statement 5 of the Code of Ethics, “Nurses have an ethical responsibility to report instances of unsafe and unethical practice. Nurses should support colleagues who appropriately and professionally notify instance of unsafe and unethical practice.” Sally did her part. She reported an “unsafe and unethical practice.” However, the CNC failed to live up to her responsibility of supporting Sally who reported such an unethical practice. If Sally decided to report the CNC’s violation, she would therefore enjoy the protection of the Code of Ethics for Australian nurses (ANMC-b, 2002).
Armed with the protection of the relevant provisions of the Code of Ethics for Australian nurses, Sally could have been justified if she decided to blow the whistle. The Senior Nurse in the new ward was, however, correct. If Sally decided to blow the whistle, she would only need to have documented proof and credible witnesses to back up her story in order to qualify for the protection of the “South Australia Whistleblowers Protection Act of 1993.” Without documented proof and credible witnesses, however, Sally could instead be charged with disclosing “false public interest information” which is punishable under section 10 (1) of the “South Australia Whistleblowers Protection Act 1993.” Unfortunately, credible witnesses would have been impossible to obtain because Annie was well-liked in the ward. And Sally had no documented proof either. Regarding the unsupportive attitude of the CNC, Sally had no witness to their conversation where she reported the matter either.
So, as far as the scenario was concerned, Sally could not make her report stand (South Australia Whistleblowers Protection Act 1993).All is not lost yet, however, because Sally knew better already. If, in the future, she could come up with these two requirements (documented proof and credible witnesses), she could make a report of the unethical practices and avail of the protection provided by the Whistleblowers Protection Act of 1993 provided she satisfy certain conditions. Under section 6 (1) of the Act, she should assist in the investigation to be conducted by the police or any other authorized investigating agencies.
It follows that after making her report, she should do everything in her power to see the investigation through. If she fails to assist in the investigation “without reasonable excuse,” she would be effectively relinquishing her role as a whistle-blower. This would mean that she would be denied of the Act’s protection pursuant to section 6 (3) of the Act (South Australia Whistleblowers Protection Act 1993).Section 5 (1) of the Act, on the other hand, assures Sally that if she decides to report illegal practices in the future, she would not have to worry of any criminal or civil liability. And if she wishes to keep her identity a secret, she could avail of the protection of section 7 (1) of the Act which specifically provides that “A person to whom another makes an appropriate disclosure of public interest information must not without the consent of that person, divulge the identity of that other person except so far as may be necessary to ensure that the matters to which the information relates are properly investigated” (South Australia Whistleblowers Protection Act 1993).Another statute which could be of help to Sally if she decides to disclose an unethical practice is the Queensland Whistleblowers Protection Act 1994. This Act “gives special protection to disclosures about unlawful, negligent or improper public sector conduct or danger to public health or safety or the environment.” As in the case of the South Australia Whistleblowers Protection Act 1993, once she made the disclosure about the unethical act, Sally would not be held civilly, criminally, or administratively liable.
In other words, she would not be considered to be committing anything wrong by disclosing any unethical or illegal practice. This is specifically provided for under part 5, division 2 of the Act (Queensland Whistleblowers Protection Act 1994).Her identity would also be kept secret. However, in case her identity is inadvertently disclosed, she would be protected against reprisal on the part of the offending party. Part 5, divisions 3 to 5 specifically provided that “causing or attempting or conspiring to cause detriment to any person because of a public interest disclosure is declared to be a reprisal and unlawful, both under the civil law of tort and the criminal law” (Queensland Whistleblowers Act 1994). In other words, even if Sally’s identity is discovered by the party who committed the unethical practice, she has nothing to worry about. In fact, she could even feel secure because any move against her would be considered unlawful.
Part 5, division 7 provides that injunctions against any reprisal would be granted by the Supreme Court of Australia (Queensland Whistleblowers Protection Act 1994).In the future, if Sally encounters other unethical or unlawful practices by nurses or other personnel of the hospital, she should obtain documented proof, look for credible witnesses, and file her disclosure behind the protection of the above-cited statutes.