Case Study: Nurse Amanda Needle

A nurse attending stated “during the morning’s second surgery, he actually dozed off. The nurse took him aside and recommended that he take a break, but he refused and returned to the operation.” The nurse here was in fault in more ways than one. This nurse should never allowed the doctor return back to operate on the patient, he should have been removed from the operating room immediately. The nurse should have

The two ethical dilemmas that stick out to me in the case are patient autonomy, and distributive justice. Patient autonomy is the patient’s right to make decisions about their care, including whether to accept or decline treatment (Taylor, 2014). Because the patient did not fully understand the information relayed in the consent form or the procedure, her patient autonomy may have been violated. This also may mean the consent form may not be valid. A signed consent form from a patient affords the hospital with an assumed duty to care for that patient (as cited Taylor, 2014). And the patient has given the medical professional permission to provide treatment. Therefore, it is important that the patient fully understands and can communicate that understanding when consenting to

It is no secret that communication is key when providing direct patient care in a skilled nursing facility. However, there is a noticeable lapse in the communication between the care team when providing care to the individual or groups of individuals. Two main parts of any care team are the registered nurse and the certified nursing assistant, as these are the two people whom have the most direct and impactful roles with residents in a skilled facility. The Registered Nurse and the Certified Nursing Assistant play similar roles in providing patient care, but have different roles in its entirety. The role of the Registered Nurse (RN) is defined as having the competency and skill to provide direct and indirect health care to individuals, their families, and communities around them. Services are also provided designed to give out medications, to promote comfort or healing, promote healing, and to also provide the dignity of their patients and patient’s families (American College of Rheumatology, 2015).

The facts of this case are that Dr. Guiles who is self-conscious of his prostate cancer diagnosis is treated horrendously when he finally decides to have surgery ( Buchbinder, Shanks & Buchbinder, 2014). Considering that Dr. Guiles is already sensitive about his condition, his unbearable symptoms are not helping matters (Buchbinder et al, 2014). Upon arrival at the hospital, he is treated subpar. The admitting clerk is rude and unbecoming to a patient who isn’t feeling well and who is embarrassed about his sickness (Buchbinder et al., 2014). To make matters worse, he has to find his own way up to the floor by walking, which causes him to be even later in checking in because of the need to stop frequently to urinate as well as having difficulty in walking (Buchbinder et al., 2014). Once he arrives on the floor, the charge nurse is not welcoming and unprofessional (Buchbinder et al., 2014). After figuring out what to do with the paperwork; and the nurse aide delivers Dr. Guiles to his room, the nurse aide does not offer to help settle him in (Buchbinder et al., 2014). Therefore, Dr. Guiles is faced with battling obnoxious family members who are on his bed and to make matters worse someone is in the bathroom which doesn’t help his need of having to frequently urinate (Buchbinder et al., 2014). When the issues are brought up to the charge nurse, the charge nurse accuses Dr. Guiles of wanting preferential treatment

The resident was uncivil by calling the patient a “She-Male.” It is possible for the patient to delay seeking testing and treatment due to insensitivity among health care professionals.

University Hospital is a well known hospital with a level 1 trauma treatment center for the tri-county area of a northwestern state, the hospital enjoys the fact they are known for their promising reputation among healthcare professionals and the public they serve. Jan Adams is an OR supervisor that has been working there for ten years, as a professional she makes surgeons follow protocol as required and enjoys working with trauma patients. One Friday night, which is the busiest day of the week for the trauma department; the unit was notified that a helicopter was on its way with a 42 year old man who had been in a car accident. Shortly after the patient arrived to the trauma center, the resident and other medical staff noted that he was in very bad physical conditions, needed immediate surgery or otherwise he was going to die. The issue was that the on call surgeon had to be present during the surgery and had not yet arrived, but regardless of the matter and protocol they proceeded with medically treating the patient immediately. The concern is that in doing so they violated medical procedures and put the patients safety at risk, this lead to a long list of ethical issues for example, patient well-being, impaired healthcare professional, adherence to professional codes of ethical conduct, adherence to the organization’s mission statement, ethical standards, and values statements, management’s role and responsibility, failure

Sule stated that, “The Patient Bill of Right adopted by American Hospitals Association states that ‘a patient possesses the right to be informed of the medical consequences of his or her actions and decisions and refuse treatment to the extent permitted by the law’. However, this is true only if the patient is in position to understand the consequences of his treatment. Incompetent, senile patients neither have the correct judgment regarding which treatment is appropriate for them, nor are they in a state of understanding the implications of their treatment. In such case, their willingness to grant or deny consent cannot dictate the course of treatment.” Problem with the Act is being able to find that the patient component enough to make such a call. Another issue that Sule stated was on confidentiality and autonomy. According to Sule, “This is another ethical issue erupting from the conflict of patient's rights and professional ethics in nursing job and profession. The Patient Bill of Right makes it mandatory for the medical practitioners to reveal the form and extent of the ailment along with the course of treatment to be undertaken by the practitioners. However, this law of autonomy clashes with the nursing ethic that the professional should maintain high degree of confidentiality regarding the patient's health and treatment.” This can cause conflicting issues in the NP’s

The healthcare industry has intensely advanced throughout the world, in turn changing the principles that incorporate the practice and culture of nursing practice. Altering the model of care to a patient-centered mode signifies an organizational culture shift and requires the participation of executives at the senior level (Cliff, 2012). To practice this care to provide the best care possible, it goes beyond the nurse to all healthcare professionals and senior leadership. The days of patients and nurses following a physician’s order without favor to care has now loaned themselves to more of an interdisciplinary approach to practice. Though, it is encouraged that the patient makes decisions for themselves, after receiving the proper education and information on their condition. Part of the patient-centered care is to be the patients’ advocate, by letting them know you are there for them when they are unable to speak and advocate for themselves and what is in their best interest. That goes in hand with educating them on “self-management of care, health literacy, patient, and family education through nurse-patient communication and interaction (Finkelman & Kenner, 2016, p. 271).”

“Running a health care organization is a team sport. It is very important that all members of the team-whether on the medical staff, in management or on the board-understand the role of governance and what constitutes effective governance” (Arnwine, 2002). Running a hospital is a difficult task. Several factors need to be seriously thought of and considered in every decision and undertaking. Unfortunately, all the three important factors in governing a hospital is not always in harmony. As likened to a team sport, if the three major components are not working with each other as a team, there will be tension and a great divide will be experienced. And often times, the patients will be in the middle and will be greatly impacted. This writer believes that there are several factors that contribute to the tension that usually exists among the medical staff, the board and administration. One factor is the disconnect, where each entity is not seeing each other eye to eye and their visions may be different from each other. Another factor may be the lack of communication in order to bridge the gap and to build a respectful and a relationship wherein there is trust for each end every member of the group. Often times, the medical staff is concerned with ensuring that patients are cared for in a manner that their practice is protected as well as the patients are getting the appropriate care. On the other hand, the board of trustees may be focused in ensuring that that

Patients, in any healthcare setting, deserve respect and care that is centered on their unique needs. Nurses and health care are required to assist them to achieve this goal. Changing the health care system will require us to reestablish our

Elana Needle, an adjunct social work professor at New York University, was suddenly faced with the challenge of finding affordable health insurance. After being laid off from her full time job as a data systems director for a national non-profit and an inability to afford the expensive insurance packages offered to adjunct professors, she reached out to our field organizer Liza Lederer-Plaskett for help. “I knew she was an advocate for women’s healthcare rights”, Needle recalled, “She gave me the Community Service Society’s number where I was able to find a navigator”.

I was particularly impressed by way this meeting dissected critical issues. The participants of this gathering welcomed openness and honesty from all. This meeting investigated ethical issues regarding patient care, and scenarios in which one’s discretion licensed him/her to question a patient’s judgments. This gathering also addressed the issue of productivity, in terms of sustaining it and enhancing it amid a taxing and demanding environment. The participants then proceeded to address common relational issues, which involved disagreements among nurses, and conflict mitigation. After witnessing the dynamics of this meeting, it became readily apparent that conflict

I believe they should hand out free needles. We would first need to see what the demand for needles are. If the sterile needles are high in demand the better chance it increases the quantity and will not decrease in price. As sterile needles quantity increases, diseases like HIV/AIDS will likely lower. The demands for drugs are different. As drugs and sterile needles are complements, sterile needles prices will fall while the drug demand will increase. This indicates that the cross-price elasticity of demand of drugs and sterile needles will be negative. The cross-price elasticity of demand will be closer to zero for drug and sterile needles. Then the demand for drugs of sterile needles will be less and priced at a low rate. This means that

During the home health observation day, there were several opportunities to observe a variety of patients with varying levels of functioning ability, different illnesses, and different needs and levels of interaction with the nurse. The first patient seen was a seventy-three year old Caucasian female with an ulcer on her right heel. Several weeks prior, she had scratched her left leg and she also had several small wounds on her left leg. The orders were to clean and redress the ulcer. She has a history of end stage renal disease, pneumonia, weakness, diabetes, dialysis, and right hip fracture. Upon entering the home, the patient was found to be sitting in a wheel chair in the living room watching television with her husband close by her side. She greeted the nurse with a smile and began to update her on her current condition. Her heel was “hurting” and she rated her pain an 8 on a scale of 1 to 10. She also had some “swelling” that she could not “get to go away; because, she could not get up and walk. They need to fix my foot so that I can get up and get around.” She told the nurse that she had been to see the doctor “yesterday” and the doctor had given her a written order that she wanted her to see. The order was written for an evaluation for a soft pressure shoe fitting. The nurse read the order to

f you were the patient in this story, what reasons might you have for wanting your friend in the room?