When Personal Ethics and Work Assignments Conflict

When Personal Ethics and Work Assignments Conflict was originally published on Hospital Recruiting.

Artur Szczybylo/123RF.com

I hung up the phone from our weekly conference call and immediately thought, “I’m gonna lose my job over this.”  After several years of sticking with a company that I loved through staffing shortages, technological changes, and various other rough patches, I was completely floored by the managerial decisions that had been dropped during that call. I had asked questions. So. Many. Questions. But, they were prepared for pushback and every inquiry was met with a scripted legal statement that left no room for discussion. I knew that I had two choices. Comply, thus compromising my own ethics and putting myself and my patients at risk or refuse and risk my career.


If you’ve ever been in a situation like mine, you know that it’s extremely disheartening.

We work for years to obtain our medical licenses and we study ethics as a part of that, being sure to understand our own biases and training to ensure that we always provide the best possible care for our patients. Above all else, we strive to DO NO HARM. Yet, there are instances when decisions are made that, while legally and scientifically “recommended,” are carried out in harmful ways. I think of the countless nurses and doctors that have spoken out during the recent COVID-19 pandemic when organizations took measures that would previously been thought of as harmful behavior (think reusing disposable materials, transferring positive patients into facilities without appropriate infection control, etc). Were their voices heard? I’m not so sure.

So, what are we to do when we’re faced with such a conundrum? Do we sacrifice ourselves for the sake of the company, and out of necessity of money and insurance? Or do we throw it all away and hope that our next organization will have an ethical stand that lines up more closely with ours? Unfortunately, it’s a deeply personal decision with no easy answer. Regardless of your decision, the most important part is how you carry it out.


If you land in a messy ethical situation, your first course of action needs to be self-reflection.

Take a day, or two, or ten if you need it, to consider how the new policy relates to your morals and ethics. If you can’t continue working without directly facing the dilemma, take a few days off. Whatever you do, don’t rush your decision. You may find that a good night’s sleep, and the council of friends and family gives you a new perspective and a clear idea of what you want and need to do.

If you realize, during your time off, that you cannot carry out the new policy and walk away feeling like you did the right thing, then DON’T CARRY OUT THAT POLICY. You should absolutely, never breech your own ethics for the good of a company. If you do, you’ll have to live with your actions for the rest of your life, while the company itself won’t think twice of the emotional harm done to you. It’s not that the organization’s management doesn’t care about you as a person, it’s simply that they have a mission to carry out and the moral dilemma of a single employee isn’t enough to dictate change.


Realizing that you have to make a change is one thing, but actually taking the leap is another.

It can be intimidating to move on, and having to inform management of your sudden decision can be downright scary, especially if you are unable to give proper notice. Just remember that you’re doing the right thing and be 100% honest with your supervisor about your reasoning. It’s unlikely to change your current situation but may spark conversation that could change the policy in the future. This course of action may also help with receiving positive references.

When you start your journey to a new position, remain open and honest with perspective employers about why you left your previous position. Not only will you avoid ending up running head on into the exact same policy, but the perspective employer will appreciate the opportunity to understand you more as a person and as a professional. At the end of the day, you’ll be happier when you find a new gig that lines up more closely with your own moral compass, and they’ll be confident in knowing that you have a strong sense of values and ethics.

After hearing of the new policy implementation, I took a day off. Surely, I don’t recommend taking un-approved days off very often, but in this case, I felt that it was necessary for me to have a day to think over what I had heard. This gave me time to consider if I was simply frustrated with yet another policy change, or if my ethics truly were at stake.

On my day off, I sought the council of some trusted friends and colleagues. Hearing their feedback helped me to realize that I was not alone in my concern, but also that not everyone agreed with my stance. I knew then that my company would not receive pushback from all of us, and that I would likely be mostly alone in my non-compliance if I chose that route. However, I also felt the support and love from those around me, which gave me strength to go on. It was at this point that I discussed my options with my husband and gained his support in case things were to go poorly.

When I returned to work, I sat down with my chain of command and informed them of my stance on the policy and why I personally felt that I could not comply without breeching my own personal ethics. I fully expected to be fired. I was nervous and deeply saddened by the impending loss, but I knew I needed to have a discussion before moving forward. Surprisingly, behind closed doors, outside of earshot of upper management, my direct supervisors agreed with my position. I knew they would never publicly support me, but it was reassuring to know that they were understanding, even if they weren’t willing to advocate for our shared ideals.

For several days after the discussion with management, I was preparing for a job change emotionally. But, without explicitly saying so, it was almost as if they took measures to exclude me from the policy to the best of their ability. My work assignment was changed in such a way that I simply wasn’t faced with that particular facet of my position, and I was allowed to go about my days with relative normalcy. It was a kind and generous act by management that I never expected, and while I was deeply appreciative, I knew it couldn’t last forever.


Eventually, I had to leave the organization.

I never intended to put my direct management in a position where they needed to defend my ethics against the company. They have their own ideas, values, and priorities to deal with, and that just wouldn’t be fair of me. Additionally, I knew it could only go on for so long, and eventually I would be faced with the same issue again. What made the final decision for me though, was knowing that I no longer wanted to be part of a team that was carrying out harmful practices. These were not bad people, and I really enjoyed them as friends/colleagues, but I just couldn’t continue to support the practice in place.

Each day is a series of decisions for us all. I had to make several difficult choices during that period of my life, but at the end of the day, I found that when I laid my head on my pillow, I could rest easy in knowing that I had not caused any harm to my patients and I had advocated for what I knew to be right. When you’re faced with a dilemma of this sort, and you certainly will be at some point in your life, you need to do the same. Take the path that allows you to sleep at night. Everything else (money, benefits, status, seniority) can be recouped or worked out, but none of it will ever be worth it if comes at the expense of your soul.


By Tammy McKinney, RN - Hospital Recruiting
Hospital Recruiting
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