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QUESTION
Case study - See attached
Your original post must address the topic below. The word count for your original post is 300-500 words ± 10%. Markers will stop reading at the maximum allowable word count
Include your own perspective on the topic to develop the idea further
Use a minimum of two relevant scholarly resources to support your original post
Read the short case study below and:
- Identify two challenging situations.
- Discuss why you have chosen your two challenging situations and why you think they are challenging (include your thoughts and opinions on the case study)
- Describe how you would feel in this situation and what you would do as a registered nurse.
- Link your discussion to any previous experiences you have had either as a student or in your professional life
- Use a minimum of two scholarly evidenced-based resources to support your discussion points (journal articles)
Please note any discussion of previous experiences need to remain anonymous and discussed in a professional manner. Linking to previous experience is to help provide real life experience examples to support the discussion.
Case study
You are a New graduate RN working on your second ward after graduating from university. The ward is short staffed, and you have been allocated as the team leader. There is an AIN and two Endorsed Enrolled nurses (EEN) also working with you. You are working on a mixed surgical ward and have been allocated patients 1-12.
You are buddied with an experienced EEN who you really enjoy working with. Sarah always makes you feel like part of the team, and you know you can ask her anything. Sarah is funny and is always laughing. You start your shift, and everything is going well, but you notice Sarah looks tired and see her crying in the storeroom. When you ask if she is ok, she states nothing is wrong.
When counting out an Endone tablet for your patient, the emergency buzzer rings for bed 6. There is only one other nurse on the ward as Tim the EEN went to the central storeroom to collect more intravenous pumps. Sarah tells you to go see quickly, and she will give the medication.
Your run into bed 6 and the Mandy the AIN is performing CPR on your patient. You remember the doctor talking to the patient yesterday about end of life care and the patient clearly stated he did not want any life-saving interventions if he had a cardiac arrest. You tell the nurse, and she screams at you to do something useful. You quickly call the doctor, and the team arrives.
The patient’s wife and the adult son arrive, and the son starts screaming for you to save their loved one. You distinctly remember the patient’s wife being present yesterday when the doctor discussed end of life care. There was no form in the notes as the doctor forgot to complete the documentation. You notice Mr Peters son roughly grabbing his mother by the arm and can see bruises which you think look like fingerprints on her other arm.
There are several patients’ buzzers alarming and Tim comes to tell you theatre has called to take Mr King to theatre. Tim informs you none of the theatre preparations has been completed and he is unsure how to do this.
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| Subject | Nursing | Pages | 5 | Style | APA |
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Answer
Nursing
Case Study Analysis
The scenario described in the case study occurs in an inpatient setting and concerns patient management, diagnosis and treatment. The two challenging situation pertains to the end of life decision and an understaffed ward. The decision by Mr. Peter (patient) to have their life terminated through withdrawal of critical care services poses dilemma between morality of the action and patient’s autonomy. The terminally ill Mr. Peterson had, on the previous day, agreed with his doctor and family members to have their life ended by halting critical care on his body. However, this agreement was neither formal nor finalized by the family. The decision to end Mr. Peter’s life qualifies as euthanasia which is a controversial ethical issue in nursing and religious perspective. Despite the patient is readiness to die, the ethics of nursing practice and moral dignity prevents the nurses and doctors from participating in euthanasia (Fontalis, Prousali & Kulkarni, 2018). This understanding undoubtedly terms the end of life decision as very challenging.
Another challenge emerging is that Mr. Peter requested his doctor to cut short his life but the details of the discussions were not documented as a requirement for such end of life procedures (Sjöstrand et al., 2013). Furthermore, the information was not communicated to all the nurses and doctors serving in the ward. The assistant nurse (AIN), unaware of the end of life discussions, performed Cardiopulmonary resuscitation (CPR) on Mr. Peter despite having given instructions to their doctor about such treatment. Only one nurse (the new RN nurse) overheard the end of life discussion and when she found that AIN was already performing resuscitation, she attempted to spot the process but the AIN shouted in protest, hence, causing confusion in the process. This situation was even more challenging because the AIN had no idea of the plan to end the Mr. Peter’s life and perhaps the AIN sticks to the moral and ethical values of life especially as pertains to patient treatment.
Working in an understaffed ward poses critical challenges while trying to address a back log in patient management and treatment. Nurse fatigue may compromise the course of care (Peters, 2018). One patient is in urgent need of theater services but the theater is not prepared for admissions and the doctor is yet to arrive. The events occur at the exact time when Mr. Peter and several other patients in the ward require urgent treatment but there are no enough doctors and nurses to address the emerging critical issues in the inpatient department. Sarah is ever joyous but appears very tired on the very day of the scenario perhaps because of the numerous tasks she performs against the huge number of patients in the ward. As a registered nurse, I would continue the resuscitation process for Mr. Peter and request his family to stay calm and let the nurses completed the process. I would then take the family through counseling process to prepare them psychologically for whatever outcome in the process.
References
Fontalis, A., Prousali, E., & Kulkarni, K. (2018). Euthanasia and assisted dying: what is the
current position and what are the key arguments informing the debate?. Journal of the
Royal Society of Medicine, 111(11), 407-413.
Peters, E. (2018). Compassion fatigue in nursing: A concept analysis. In Nursing
forum (Vol. 53, No. 4, pp. 466-480).
Sjöstrand, M., Helgesson, G., Eriksson, S., & Juth, N. (2015). Autonomy-based arguments
against physician-assisted suicide and euthanasia: a critique. Medicine, Health Care and
Philosophy, 16(2), 225-230.