Mini-Stroke Ethical Dilemmas

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Early admission to hospital followed by correct diagnosis with minimum delay is a prerequisite for successful intervention in acute stroke. The need to seek medical or other attention promptly after stroke onset, to use an ambulance with direct transportation to the acute-care hospital, and to have more effective in-hospital organization will be required for effective acute treatment options to be available to stroke patients. There are a couple of legal and ethical issues of this case.
First let’s look the physician. Mrs. Smith presented the clear signs and symptoms of TIA (Transient Ischemic Attack) which is called mini-stroke. First of all, the doctor failed to send the patient to emergency room to get CT scan, MRI and tPA (tissue Plasminogen Activator) if there is no contraindication. The doctor also failed to follow up Mrs. Smith result. The doctor
neglected the patient need of appropriate treatment. Negligence is “a form of conduct caused by heedlessness or carelessness that constitutes a departure from the standard of care generally imposed on reasonable members of society.” (Pozgar, 2013, p. 191). He failed to order appropriate diagnostic test as an emergency bases. He didn’t accurately order the test. The doctor also involved the act of omission by failing proper order of diagnostic test which the patient did not get the scan on the right time in order to start the right medication regiment. General speaking, the physician negligence in three different acts: malfeasance, misfeasance or nonfeasance. Nonfeasance means the healthcare provider fail to act. For example, failing to order diagnostic tests or prescribe medications that should have been ordered or prescribed under the circumstances. In order to fail a case of negligence, there must be four elements caused by negligence. These elements are:- duty to care, breach of duty, injury and causation (Pozgar, 2013, p. 196). Thus, the doctor might face the charge of negligence.
Secondly, the medical technician failed to do or to help Mrs. Smith. She rather make them to handle the order for the scan. Most of patient and family member doesn’t understand the medical words. In this case Mrs. Smith and her husband didn’t know whether the order has been wrong. The medical technician disrespect the patient by telling them that she is busy to help them. Under provision 1 in Code of Ethics for Nurses states that “the nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth, attributes, and human right of the individuals.” (ANA, 2015, p.1). When the technician received fax order, she should call back to the doctor for clarification the same day she received the fax. Why the need of waiting two days? She should expedited the imagining because of the seriousness of the diagnoses.
If these were my family member, first of all I would try to get enough information about my mom diagnoses, and I would take to emergency room immediacy. I would not even going to doctor’s office. According to the doctor’s diagnoses, I will search about it and take the necessary measures right away.
If I was the medical assistance, I would clarify the order before Mrs.
Smith appointment date. I would not even ask the patient family member to handle the situation (call doctor to ask a correct order to be faxed). As a health care provider, I know the patient needed a hospital admission. I would escalate the situation to my manager. According to provision 3.5 in code of Ethics for Nurses states that “Nurses should use established processes for reporting and handling questionable practice.” (ANA, 2015, p. 12). This could help the patient more attention and prevention further distraction of related the TIA. I would took care of the patient with respect. In my world being busy in not working. I had to give my time to one patient at a time. I rather be quick to do things or delegate to other staff. As a health care provider, I have to show Mrs. Smith kindness. Kindness “involves the quality of being considerate and sympathetic to another’s need.” (Pozgar, 2013, p. 45). Mrs. Smith couldn’t handle any more stress or burden. It is up to me to ease burden by approaching respectfully, kindly and
caring.
According to my ethical lens inventory, my lens is relationship. I will tried to resolve the problem as my own problem. I make sure everybody treated fairly and respectably. My primary concern is the well-being of the whole community and I believe that assuring the community’s well-being is the best way to assure that individuals are treated fairly (Ethicsgame 2015). Moreover, I tried to make a phone call to clarify with the physician in order the patient to get appropriate image or scan. As I consider what is fair, I remember to temper my actions with concern for individuals. I look for ways to balance the rights of individuals with the well-being of the patient. As I learn to consider individual perspectives in my decision making process, I will live out the best of my ideals with compassion and care for all.

Reference
American Nurses Association. (2015). Guide to the code of ethics for nurses with Interpretive Statements. Silver Spring, MD: ANA.
Ethics Game. (2015). Ethical Lens Inventory. Retrieved from http://www.ethicsgame.com/Exec/Eli/EthichalLensResults.aspx?R=1
Pozgar, G.D. (2013). Legal and Ethical Issues for Health Professionals (4th ed). Burlington, MA: Jones & Bartlett Learning, LLC.