Ms. Pratt is an 80 year old patient who had a cerebral vascular accident
(CVA) and repeatedly chokes on food and fluids whenever being fed. The
nurse, Michele, recognizes the risk of aspiration pneumonia and significant
complications if the patient continues to be fed by mouth. Ms. Pratt,
however, also has a terminal illness and says she wants to experience
the pleasure of eating during the time she has left. What is the right
thing for Michele to do?
Denise is a nursing supervisor. She has evidence that one of the best
and most experiences RNs, Lisa, has been taking a controlled substance
from patient supplies. When Denise confronts LIsa about this, Lisa admits
to the diversion of narcotics, but promises to go into treatment. The
two women have been friends for years and apparently no patients have
been harmed. What should Denise do?
Rich has recently been hired by an ambulatory surgical center. He was
enthusiastic about the job at first. After a few weeks, however, he became
aware of practices and policies that were demeaning to nurses (cleaning
rest rooms) and threatened safe patient care (improperly trained staff
doing nursing tasks without supervision and competence). His complaints
have gone unheeded. In fact, his employer has hinted that he will be fired
if he doesn't comply with the rules. What should Rich do?
Grace has been in and out of the hospital for several months while undergoing
treatment for cancer. She's become the special favorite of Joan, a registered
nurse. They are both young mothers about the same age. Grace becomes violently
ill from her chemotherapy during the night shift, and Joan is at her side
providing emotional support. An aide rushes in, saying another patients
needs a nurse immediately. Grace begs Joan to stay. What should Joan do?
Gail is a registered nurse in a long-term care facility. She has been
a supervisor for many years, but due to the short staffing, she finds
that she often had to pass medications in the past several months. Although
she has tried to keep up with the changes in new medications, she finds
that she often passes medications that she is not familiar with to patients
she is not entirely familiar with. On a particularly hectic evening shift,
Gail has administered 4 times as much Seroquel to a combative, agitated
patient with Alzheimer's disease, as was ordered by the physician. The
patient was to receive 25 mg , instead she received 100 mg. Gail recognized
the error when she returned to the medication cart to chart the medication,
immediately after the patient took the meds. Gail knows she made a mistake,
but after looking up Seroquel, she also suspects that the patient might
actually benefit from the higher dose. She is fearful of reprisal from
the facility administration, as this is the 2nd time she has made a medication
error in the past several months. What should Gail do?
What is the ethical thing to do in each of these situations?
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