When cost-saving strategies are unacceptable

With health care redesign, nurses in every setting are challenged to provide more cost-effective care. While quality models for health care have been developed, nurses are at times asked to implement unsafe practices in the name of cost reduction or profit building. Both legal and ethical dilemmas arise when an emphasis on economic considerations supersedes patient well-being. Nurses must recognize their primary duty as patient advocates, and work to modify unsafe plans. The ANA's Code for Nurses and Guidelines for Reporting Incompetent, Unethical or Illegal Practices, and the Nursing Practice Act are primary resources in this effort.