Scenario 1
Patient: Mr. Jackson
Mr. Jackson is in the end stage of aggressive prostate cancer. He is experiencing an exceptional amount of pain, which is uncontrolled with strong medication. He expresses his thoughts of suicide to one of the respiratory therapists and asks that he keep secret. Ethical question: Should a promise to a patient be upheld even when it could be harmful to them?
Caring for patients who have been diagnosed with cancer who are nearing the end of life may be accompanied by many ethical dilemmas (Saigle & Racine, 2018). In this case, a Patient expressing thoughts of suicide and asks for caregivers’ role in confidentiality is challenging and also a difficult situation for the caregiver to encounter. If the caregiver informs the patient health care team, he or she will have violated patient confidentiality (Saigle & Racine, 2018). However, if confidentiality is kept, then patient safety is at risk. Therefore, when responding to the patient desire to commit suicide, the therapist has to come up with a care plan such as;
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Step 1: Making an overall assessment, including patient social support, mental condition, and physical condition.
Step 2: Consider the patient cultural background and religious believes since faith traditions may consider the passage of life to death as a critical, meaningful process.
Step 3: Attempt to assess what the patient hopes to achieve from death to help the therapist identify alternative ways to achieving the patient goals.
Step 4: Counselling a patient to explore options that fit their values and situation within the acceptable bounds of ethical nursing practice.
Scenario 2
Patient: Gentleman who has a gunshot wound
Marrieta is asked to care for a gentleman who has a gunshot wound. She knows that he opened fire in an elementary school yesterday and killed ten children. One of them was the friend of her own child. Ethical Question: Does a healthcare worker have a responsibility/ expectation of caring for someone when they have personal anger/hatred towards them?
According to the ethics of nursing, nurses’ primary commitment is to the patient. Patients have to be the first and primary concern for every healthcare worker (Brown, 2015). Therefore, healthcare workers have a responsibility to care for every patient, including someone they have personal anger towards them. To handle personal issues with the patient, the healthcare worker has to;
Step 1: Consider their role in helping the patient.
Step 2: Think of ways that would help them associate with the patient.
Step 3: Seek help where necessary.
Step 4: Decide on the course of action in dealing with their emotions.
Scenario 3
Patient: Mentally ill
Juan is assigned to care for a client that is mentally ill and has a sudden violent outburst. She has already injured two employees, requiring hospitalization. Ethical question: Should healthcare workers place themselves in harm’s way to care for another?
Providing adequate healthcare and avoiding harm are the challenges of ethical practice in healthcare. In this scenario, dealing with a mentally ill patient with sudden violent outbursts makes work harder for Juan, but it is her responsibility to provide care for the patient. To handle this problem, healthcare workers need to use intuition, communication, and quick thinking. The healthcare worker can ensure ethical decision making through;
Step 1: taking a moment to collect and prepare themselves for the unexpected.
Step 2: Gathering Information to determine the source of the problem.
Step 3: Deal with the patient's emotions by apologizing without admitting fault. This is because violent people don't like being told that they are incorrect. Therefore, it will be appropriate to ask the patient what he or she thinks would best resolve the problem.
Step 4: Listen to the patient since they want to be heard.
Scenario 4
On the way to work, an obstetrical nurse passes an automobile accident where there are obvious injuries. No emergency vehicles are on the scene yet. Callum, the nurse, knows that if she stops, she will be late for work, and she’s already been warned about tardiness by her boss. Ethical questions: Does a healthcare worker have an obligation to help the public when not "on the clock."
Healthcare workers have a responsibility to care for patients. The knowledge and skills they obtain, qualify them to help care for every patient (Borsook & Bernat, 2017). Health care institution trains its healthcare workers to handle emergency cases. This makes healthcare workers prepared to face emergency cases. Therefore, healthcare workers have an obligation to help the public when not "on the clock." To handle public emergencies, the healthcare providers have to;
Step 1: Identify the incident. Identify what kind of emergency it is and its extent of harm.
Step 2: Determine how to respond to the incident. Analyze how they have to respond to the situation before taking any action.
Step 3: Determine the incident action plan. Determine the best action to take in the incident.
Step 4: Take the necessary action.
Scenario 5
A nurse practitioner is approached by a good friend who asks if she will write a prescription for her son who’s got a skin infection. Her son is not present and cannot be evaluated by the nurse practitioner. Ethical question: To what extent should we “help” our friends navigate the healthcare system?
Healthcare workers owe certain responsibilities to their patients, and therefore, a breach of any of these duties gives a cause of action for negligence against the healthcare worker. Patients approach medical experts for medical treatment due to the knowledge and skills they possess to bring relief to the patients’ medical problems. Therefore, medical evaluation is an essential factor when prescribing medicine. In the extent of helping our friends navigate healthcare, the healthcare workers have to:
Step 1: Gather the facts of the disease.
Step 2: Determine the ethical approach to the situation. Consider the nursing ethical approach regarding medical evaluation and prescription.
Step 3: Identify the consequences of their actions
Step 4: Advise on the importance of medical evaluation before prescribing.
References
Borsook, D., & Bernat, J. L. (2017). Headache Professional Societies: Ethical Challenges and Suggested Solutions. Headache: The Journal of Head and Face Pain , 57 (8), 1273- 1283.
Brown, G. (2015). Ethical and Moral Courage is Distress among Professional Nurses: A Workplace Issue. ABNF Journal , 26 (3).
Saigle, V., & Racine, E. (2018). Ethical challenges faced by healthcare professionals who care for suicidal patients: a scoping review. Monash Bioethics Review , 35 (1-4), 50-79.
