Week 3 Mid-Term

.doc

School

West Coast University, Ontario *

*We aren’t endorsed by this school

Course

500

Subject

Health Science

Date

Dec 6, 2023

Type

doc

Pages

Uploaded by mlocampo08

Running head: FINANCE AND ETHICS 1 Finance and Ethics Maria Ocampo West Coast University: MSNC 500 July 23, 2023

FINANCE AND ETHICS Finance and Ethics As Advanced Practical Nurses (APN), depending on the state and facility we work for, there are different policies and politics we must follow. Many times, APN’s are faced with ethical conflicts resulting from moral distress due to perceiving the policies and regulations as unfair. In the video, Practice and Principles Episode 3 (2023), the hospital staff are faced with an ethical dilemma regarding the discharge of a patient that suffered a stroke and must be discharged because her insurance no longer covers her stay. In the video a staff member decides the patient must discharge because the bed is needed for other critical patients, other staff is concerned regarding the patient not being physically ready to return home. The ethical issue in the video for medical staff is discharging a stroke patient without any rehabilitation, the patient needs long term rehabilitation or home rehabilitation services. To solve this ethical issue, the narrative ethics approach is more relevant to the scenario. According to Hamric & Hanson’s Advanced Practice Nursing , the narrative ethics approach “gathers views of all parties to provide more complete basis for moral justification,” in this video, there are several opinions from different medical staff members (Tracy et al, 2023, p., 352). With the narrative ethics approach, the different opinions from all the staff members can be analyzed. According to Application of Narrative in Medical Ethics (2019), in the medical system, the narrative approach uses other patients’ stories and experience to improve the health decisions made (Daryazadeh, p. 1). Other medical staff members have treated stroke patients and know their stories, therefore they’re decision to not discharge the patient because she isn’t physically ready is the correct decision. Evidenced-based interventions should be applied when making ethical decisions for positive outcomes. Medical staff should do research to provide interventions that have had 2

FINANCE AND ETHICS positive outcomes and go on to make the best decision for the patient this will lessen the moral distress. The main issue in the scenario is the conflict between two different points of view of the medical staff. One is discharging the patient because of her insurance coverage, adding to that the patient can acquire an infection from being in the hospital too long. The other medical staff are against discharging the patient because she isn’t physically ready to be on her own. My advocacy solution to this dilemma is to not discharge the patient until arrangements have been done for rehabilitation. This patient needs advocacy from the nurse and other interdisciplinary team to prevent her discharge. Discharging this patient is unsafe because she is not physically ready, the patient suffered a stroke and needs long term rehabilitation to become as independent as she can. According to Rehab therapy after a stroke ( 2023), a stroke patient must have rehabilitation services after suffering a stroke. Case manager needs to provide resources and options in which her insurance has coverage to help the patient with rehabilitation. If the patient is to be discharged just because her insurance doesn’t cover longer stay, the patient will go home with no 24/7 care. The patient has deficits from a stroke and cannot care for herself at home, her daughter can’t be there because she has a job. The deficits the patient suffered prevent her from performing daily ADL’s, going home will just make the patient decline and suffer falls or injuries. The health care system works with different payment and reimbursement models. Health care costs are very expensive, many people have health insurance provided by their jobs, other people purchase insurance on their own, while others have no insurance. There are different reimbursement models for providers, for example fee-for-service (FFS) and value-based. In the FFS model, providers are reimbursed for the number of services performed, for example an 3

Your preview ends here

Eager to read complete document? Join bartleby learn and gain access to the full version

Access to all documents
Unlimited textbook solutions
24/7 expert homework help