You are a team leader for 10 patients on a busy medical unit. Your team includes Lori, a Licensed Vocational Nurse (LVN), passing medications and assisting with patient treatments, and Tom, an experienced Certified Nurses Aid (CNA), who provides basic care such as monitoring vital signs, ambulating patients, and assisting with hygiene. On several occasions in the past, Tom has failed to report significant changes in patients’ vital signs to you until some time had elapsed or you discovered them yourself. Despite confronting Tom about the need to report these changes and the specific vital sign parameters that need to be reported, this behavior has continued. You have become concerned that patient harm might occur if this pattern of behavior is allowed to continue. Assignment: Identify possible motives that Tom (the agent) may have for failing to share this information with you (the principal). What incentives might you employ to modify his behavior?
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