Nate, Jen, Luke, Gabby, & Adrianne The CI Struggle Nate, Jen, Luke, Gabby, & Adrianne

The Scenario It’s Bruce's first year as a PT at The Rehabilitation Institute He just got promoted to Lead PT and was asked to be a CI He begins to realize that no other PTs on his neuro floor like to take on students Too busy treating patients Don't like answering questions Should Bruce require the PTs to take on student or respect their wishes? Bruce’s next step is to seek professional backup

Step 1 - RIPS. Realms Individual: Organizational: Job satisfaction of the PTs may be affected if they are given a CI role. Bruce may not be as well liked by his employees if he carries out his own opinion about his job description and the role of the hospital. Organizational: The implied role of a teaching hospital is to take on a lot of students. The PT clinic may benefit long-term by having new students in the pipeline that can fill roles in the future.

Step 1 - RIPS. Individual Process Moral motivation- to put moral values above other values Well liked by colleagues vs PT Code Of Ethics As lead PT, Bruce must make the right decision based on what value is more important for the profession Moral courage- whether or not to implement the decision or take action at all Once Bruce weighs the values, he must decide whether or not to implement his decision

Step 1 - RIPS. Situation Dilemma: By not requiring PTs to be CIs they would have more time for patients and have a happier working environment BUT the Code of Ethics states PTs must cultivate an environment for learning Both of these have right aspects to them Quality of care vs. professional code

Step 2: Reflect Value Ethics Liberalism PTs will do the right thing- outlined in the Code of Ethics APTA Code of Ethics 6D. Physical therapists shall cultivate practice environments that support professional development, lifelong learning, and excellence. Liberalism By practicing in a teaching hospital, the PTs contractually agree to provide an educational environment by taking students

Step 3: Decision Bruce will set an expectation that all of his PT’s act as CI’s on a regular frequency, placing primary value on the APTA Code of Ethics Principle 6D.

Step 4: Implement, Evaluate, & Re-assess Clearly communicate expectations and rationale to the team (Value Ethics, Liberalism) Seek feedback from PTs, students, and patients on a regular basis (Utilitarianism, Principlism, Duty Ethics) Clarify job responsibilities and contracts for future new hire PTs (Liberalism)

Other Philosophies Considered Kant Multiple duties at play. Duty to patients and duty to other physical therapists Lack of hierarchy of duties to determine which is right; Ironic Moral judgment necessary Utilitarianism Make the decision that would bring the greater amount of happiness The PTs would not be forced to take students because it would assure their happiness They have voiced displeasure over the idea Difficult to measure happiness quantitatively Principlism More applicable in practitioner-client interaction Autonomy of other PTs in clinics Benevolence and non-maleficence to PTs/students