Case Study Of Ethical Dilemma In Nursing Essay

Question- A 6-year-old develops a high fever accompanied by violent vomiting and convulsions while at school. The child is rushed to a nearby hospital. The attending physician makes a diagnosis of meningitis and requests permission to initiate treatment from the parents. The child’s parents are divorced. The mother, who is not the biological parent of the child, has primary custody. She is a Christian Scientist who insists that no medical treatment be offered for religious reasons. The biological father, who resides in another state, is also contacted. He insists that treatment be given and seeks independent consultation from another physician.
(i)What is the ethical dilemma here?
(ii)Describe the decision-making model you selected from your readings.
(iii)How would you resolve this dilemma using the model?

Answer

Patient consent is one of the important concerns that is necessary to be included in the scope of routine health care practice. The justification of concerning the patient autonomy and consent is crucial according to the fundamentals of holistic approach of nursing. The scope of taking consent for the treatment and care plan is important as because it provides opportunity to the patient to take decision with respect to suitable health care plan in accordance to self-judgment and financial prospect of patient itself. The concern is more effective when it comes to taking consent for patient having serious or emergency condition. Similarly, in case of childcare, it is more important to consider the decision and consent of parents, family member or any consent carer. The reason is associated with the age factor of children, and hence they are not considered to be mature for taking decision with respect to their health condition and situation upto the age of 18 years old. The ethical measure is applicable in many of the developed as well as developing countries (Uhl, 2013).

According to the give case, the consent with respect to treatment plan and care intervention is necessary to be taken from the parents of the child, owing to the age factor. The child was found to suffer from meningitis and having a serious time with vomiting and convulsion related signs. It is hence the requisite concern is to provide care and treatment, in order to control the situation and condition. Furthermore, the given case study was found to be in dilemma, as because the parents of the child are divorced and there lies certain cultural and spiritual believed form both the parents. Particularly, the mother of the child (who is not the biological mother) is a Christian Scientist and based on her cultural believe she express the concern of using no medication related intervention for the concerned health issue. On the other hand, the father of the child is agreeing with the application of any particular medication and care plan, with the objective to solve the health concern as soon as possible. The ethical dilemma thus exist is with reference to the adoption of care and treatment plan for the children, which should not only provide relief to the children, but should also provide and ensure the satisfaction with respect to the concerned parents.

It is hence the process of decision-making and providing care support to the child is solemnly dependent on the nurse. The use of wisdom and evidence based nursing practice is thus required in the present case. The process of decision making is thus dependent on the basis of framing an effective care plan, which should be designed with following mentioned points:

  • Patient assessment should be carried out with respect to the interrogation to school staff, teachers, friends and children itself (if possible)
  • Possible suggestions and effective means of treatment that are available with respect to the available resources and workforce of the health care settings should be analyzed and framed in the hand over.
  • An immediate discussion should be carried out in presence of senior nurse, physician and other relevant health care professionals.
  • For the purpose of taking consent, immediate contact to the parents should be taken.
  • Since there is an ethical dilemma, where the mother (not biological mother) and the father of the children are differing with respect to the spiritual and cultural belief for the adoption of any medication and treatment plan, thus the concern should be made with respect to discussion with relevant expert in the field.
  • Use of effective and efficient conversation skills is more essential, where the job responsibility of nurse lies in explanation and advocating the benefits of medication and related intervention to the parents.
  • Furthermore, based on the judgment by the health care professionals and relevant experts in the field, the care plan should be initiated.

The possible way for the resolving of ethical concern is the use of effective communication skills. It is hence the counseling of the mother should be done with the help of counseling member and other health care professionals. Possible means of verbal and non-verbal communication should be made into utilization while attempting to explain the concern to the mother. Moreover, it is also important for the health care professionals, especially nurse to show relevant statistics and evidences that are relevant to the present case.

In conjunction to obtaining the consent and permission for the proceeding of the care and treatment plan, it can be considered that one of the parent (actual father) have mentioned the usage and decision in conjunction to the opinion of related expert, which should be followed by the nurses. It is hence, the details of the intervention, clinical decision and support for using evidence in the care plan should be recorded and that can be used for evidence based nursing approach and training in the near future.

In particular, to the treatment and care plan, it is important to consider the medication and other related needs in accordance to the ethical and legislative concern for the medication management. This concern should be properly diagnosed, analyzed and recorded for the usage of oxygen support, intravenous fluid administration, and use of steroids for any swelling. The transfer to the intensive care unit for the children thus should be based on the decision-making and judgment of the patient. Concisely, it can be said that the usage of effective communication skills, identification of appropriate and effective treatment regime and wisdom of the nursing approach is most essential part to be considered according to the concerned case study. The part of heritage and ethical dilemma can be further resolved with respect to explaining and advocating the emergency of time and need of the medication to the parents. Furthermore, to avoid any conflict in utilizing the mentioned care plan model, it is important to make the record of clinical-decision, decision support and possible reason for the adoption of wisdom in the care plan.

References

Barry, M. J., & Edgman-Levitan, S. (2012). Shared decision making—the pinnacle of patient-centered care. New England Journal of Medicine, 366(9), 780-781.

L?gar?, F., Stacey, D., Pouliot, S., Gauvin, F. P., Desroches, S., Kryworuchko, J., ... & Graham, I. D. (2011). Interprofessionalism and shared decision-making in primary care: a stepwise approach towards a new model. Journal of interprofessional care, 25(1), 18-25.

Uhl, T., Fisher, K., Docherty, S. L., & Brandon, D. H. (2013). Insights into Patient and Family?€ђCentered Care Through the Hospital Experiences of Parents. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 42(1), 121-131.

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