Nursing Ethical Dilemmas

• Ethical Dilemmas
Patient 1: This patient is admitted to ER with Respiratory Failure and Septic Shock. The patient was transferred to LTAC for long term management of disease. Patient’s chart states that she has DNR/DNI order, but her son was disagreeing with that decision. One of the ethical principles that direct ethical decision making in health care is the autonomy-the ability of the individual to chose for him or herself.
Patient 2: This patient was admitted with endocarditis and had a tracheostomy tube and Peg tube in place. Patient refuses PT and OT in his treatment care. In this situation the ethical decision making in patient care is beneficence-to do good. Patient needs more education and explanation abut benefits of PT and OT in
The patient has a Foley catheter and tracheostomy tube and also patient cannot walk. His medical history as well as his current status puts the patient for fall risk.
Patient 2: The patient had unsteady gait. Fall risk is also an important safety concern for this patient.
• Accountability and Professionalism
Patient 1 and Patient 2: The nurses must be accountable for their own professional practice. Nurses should have a good work ethic and not pawn off their work to others. Nurses need to be reliable, honest, and fulfill their nursing duties to the best of their ability. The nurse must have good conduct of character and must be a role model.
• Health, Wellness and Illness
Patient 1 and Patient 2: Both patients were on contact precautions rooms. The nurse needs to spend more time in each patient’s room and listen to their concerns and encourage expressing their feelings.
• EBP
Patient 1: This patient had a PEG tube. As we learned through EBP that tube feeding should be administered with gravity. Pushing feeding fast will result further problems in patient’s health.
Patient 2: The patient is incontinent and needs good skin care. Patient also needs to be turned every 2 hours to prevent pressure
This includes: a physician, unit manager, nurses, clinical nurse educator, physiotherapist, occupational therapist, dietician and pharmacist. Frequent meetings help discussion and negotiation among health care team members to formulate the best plan of care.
• Health care system and Resources
Patient 1 and Patient 2: LTAC facility uses paper charting. Electronic health records have potential to improve healthcare by making patient health information more accessible at the point of care, reducing medical errors, assuring that guideline and standards are applied in the care of patients with acute and chronic conditions. This will help to improve of documentation quality, increase team communication and more effective organization on nursing tasks.
• Legal Concerns
The facility needs to use electronic charting to allow physicians and other staff members to access patient’s charts. Many times nurses note are left lying around or misplaced and a violation in patient confidentiality may happen. An electronic charting system would help prevent against this by allowing staff to use passwords to access computers to obtain patient’s