Susie’s fieldwork site is a very busy acute care hospital in a large city. The OT staff consists of 25 OTs and OTAs. Due to maternity leave and unfilled positions, there are only 20 OT staff members. Susie’s fieldwork educator is stressed and has given Susie a full caseload in her third week because she is “doing so well”. Susie feels overwhelmed and believes she is not getting enough supervision.
Issue 2: Beneficence — “Occupational therapy personnel shall … ensure that all duties delegated to other occupational therapy personnel are congruent with credentials, qualifications, experience, competency, and scope of prate with respect to service delivery, supervision, fieldwork education, and research” (AOTA, 2015, p. 3).
Without the appropriate level of supervision, Susie’s fieldwork educator is putting the patient at risk as well as not providing the best qualified and competent service to the patient.
Issue 1: Justice — “Provide appropriate supervision in accordance with AOTA official documents and relevant laws, regulations, policies, procedures, standards and guidelines” (AOTA, 2015, p. 5).
As stated above, the level of supervision provided by Susie’s Fieldwork educator does not meet the regulations and policies AOTA official documents require.
Issue 3: Fidelity — “ Address incompetent, disruptive, unethical, illegal, or impaired practice that jeopardizes the safety or well-being of others and team effectiveness…Abide by policies, procedures, and protocols when serving or acting on behalf of a professional organization or employer to fully and accurately represent the organization’s official and authorized positions” (AOTA, 2015, p. 7-8).
It is a practitioner’s responsibility to uphold the profession of occupational therapy and treat their clients, colleagues, and other professionals with respect, fairness, discretion, and integrity at all times. Susie’s fieldwork educator does not demonstrate this behavior; therefore, this must be addressed and modified.
Solution 1: distribute the patients amongst the qualified, experienced therapists, which will decrease Susie's caseload to the appropriate level.
Solution 2: actively searching and hiring more OT staff members to fill those unfilled positions.
Solution 1: Increase Susie's supervision to meet AOTA standards.
Solution 2: Susie should discuss with her fieldwork educator her concerns and expectations.
Solution 1: reducing Susie's caseload to an appropriate level for week 3 fieldwork level II, which is about a 3-5 patient caseload.
Solution 2: Providing more supervision for Susie so she can receive a better education and that patients can receive the best quality care.
Responsibility issue: Due to the low number of staff members, each therapist may be assigned an overloaded caseload.
No: This can cause a decrease in the quality of care.
Yes: This would solve the ethical issue of Susie treating a full caseload without enough experience and supervision.
Responsibility issue: With fast hiring, therapists may not be the best fit to this setting, not as experienced, or may take a longer time to adjust to the new work environment.
Yes: More staff is needed to fill the positions. This solution will lessen the load for all therapists, which then increases the quality of care for the clients.
No: Fast hiring may result in a "bad" fit therapist or a less experienced therapist. Additionally, it may take the therapist some time to adapt to the new environment, but the staff may expect more faster due to the need.
Responsibility Issue: Increasing Susie's supervision may mean placing more stress and clients on the other OT staff members.
Yes: This will ensure Susie receives the appropriate level of supervision she needs.
No: This places more stress on the other OT staff members, which may result in lower quality of care for clients.
Responsibility Issue: If Susie does not speak up to her fieldwork educator, she is violating ethical conduct and possibly putting patients in danger.
Yes: Communication with her fieldwork educator will clear herself from any ethical dilemmas, as well as, allow her FE to adjust and make changes.
No: This could disrupt the relationship between Susie and her fieldwork educator. However, it is best that she speak up to avoid further risks.
Responsibility Issue: This is a liability issue for patients and for Susie's fieldwork educator.
Yes: This will keep patients safe and providing client's with the best quality of care
No: This creates stress on other staff members who will need to help share the load of the clients that need to be treated.
Responsibility Issues: Susie would not be getting the appropriate and best education without the supervision of her fieldwork educator.
Yes: This will allow for Susie to benefit and learn more from her experience.
No: Other staff members would have to absorb the other clients in order for Susie to have the appropriate level of supervision from her fieldwork educator.
Chelsea Lim
Week 4 Ethical Issue Concept Map