In small rural hospital, on a weekend patients are few. Doctors are on call, available via telephone, attending the hospital only in exceptional emergencies. A single nurse is responsible for taking care of the patients coming in through the emergency room, as is the normal practice in this community.
At the reception desk that serves the emergency cases door, a patient is wincing in pain as he holds his head and ribs. There is no reception staff on the weekend so it is also the nurse who gathers all the details of the patients and triages the order for which care or medical help will be given to them. (Hope & Hope 2004)
This patient is in need of help, to seek medical attention very quickly as he is bleeding from his forehead and his left side. He has multiple bruises and the pain is unbearable as he struggles to call for help. Today the extra pair of hands belonging to a student is welcome.
I feel nervous and nauseous, am I ready to help; do I know what to do? I take a deep breath and clear my head. OK, let us start at the beginning ABC airway, breathing, circulation my adrenaline kicks in and I am ready. (Peter 2004)
Looking weak and exhausted, his skin is pale and diaphoretic, and the pulse rate getting low we have to evaluate on what needs to be attended to first. While my buddy nurse is making the first assessment, I am calling the Doctor and passing on information from the assessment to him.
The cause of bleeding at the forehead is a large laceration and the patient is bleeding from his left side. The bruises too are many and a deep cut has just been identified at the right thigh. Medical personnel need to address all this critical issues. (Myers et al 2004)
Due to the blood loss, the Doctor gives a verbal order for IV therapy to be commenced. As I repeat the order out to the registered nurse, I wonder if this is legal, so erring on the side of caution I change the phone to speaker mode and ask the doctor to once again repeat the order. (Gregory et al 2004)
While my buddy nurse inserts the cannula and sets up the IV, I apply a pressure bandage to the thigh and hold pressure on the bleeding side. (Peter 2004)
Our greatest fear is that one of the ribs might have caused injury to an internal organ and more dangerously the heart. Having not identified or come out with a conclusive finding we work on a principle of not causing more pain or suffering. As we wait on having a doctor addressing the issue the casualty has little to tell as we try to give first aid on his bleeding sites. (Elearn, 2007)
The assumptions made in this analysis were that this case needed comprehensive care despite the inadequate staffs. The health assistance in a professional and uncompromising manner is the norm and belief in giving adequate assistance to patients. Further more, medical professionals’ major concern is to ensure survival and health maintenance of patients. In this case the values uncovered were that despite the dire need to save life, respect of professionalism was important. In fact, all efforts should have been directed and executed to the patient without any delays as this relieves pain and suffering.
The approach that was given to handle this case was to have the medical evaluation with the objective of preventing further harm. The greatest priority is to give the medical aid rather the looking at the likelihood of making money from the quality of delivered service. The services need to be given equally and in a professional manner so that one can be accountable for the health response or progress that the patient shows. All the interventions given are taken into account in the hospital summary letter at the time when the patient is discharged. The medical needs of our patient required the help of nurses and a doctor so that they would assist in diagnoses and proper medical interventions being done is a rather consistent and professional way. (Arvidson, 2005)
What was beyond the nurses’ specialty could not be addressed as this might have caused more harm but at least the best that could be done was offered. The operating procedures stipulate methodology and qualification of the medical personnel. The code of practice shows that the aim of nurses is to save life and through this first aid was given.
In the critical analysis of the incident, it was necessary to brainstorm and weigh all the possible options through which help would be administered. Contacting a doctor was a worthy course as such directions would go along way in saving the life of the patient. This is aimed at building trust and confidence in a patient. (Gregory et al 2004)
Professional dilemmas do arise and the approach given is on past experience on what seems to be appropriate and at the same time professional is used to solve the crisis using ethical acceptable interventions. Ethical grounds should be maintained at all times and should be the basis upon which the decision-making process evolves. (Jonsen et al 2002)
The belief in human nature and the value of professional practice was the bottom line for the decisions arrived at and this influenced our practice in the case presented. The responsibility that one has of preventing more pain should not be conflicting and as such, all options available require critical analysis of the path to be followed and weighing of the consequences. Practical problems need psychological principles being at work so that a significant contribution is made to the patient. (Lammers, & Verhey1998)
The code of values should be used as a guide to the decision making exercise as this determines the choice of action that can demonstrate professionalism and at the same time maintains the corporate identity at check. Organizational ethics also can determine the corporate social responsibility in the medical professionals having public accountability. Ethical management can also be a good strategy that can increase the competency, accountability and confidence of the workforce. Moral philosophies and ethical principles can determine good conduct and behavior of the workforce and the management.
Value based leadership can be a motivator to having teamwork. This means that issues can be addressed as they come due to the collective responsibility of each person in maintaining good care and handling of the patients. An organization that sets a mission to have quality service, accuracy and efficiency the patients are able to have confidence in the operation procedure that medical personnel use on them.
Reference:
- Arvidsson, B. (May 2005) “Journal of Nursing Management.” Volume 13 Issue 3, 231-237.
- Elearn (2007). Reaching Your Goals Through Innovation. Elsevier Publishers
- Gregory, M., Myra K., H. and Vincent J. (2004). “Annals of Occupational Hygiene.” An Exploratory Study of Changing Occupational Injury Risk during the Closure of Industrial Operations 48(7):623-633 Oxford University Press
- Hope R. A, Hope T. (2004). Medical Ethics: A Very Short Introduction Oxford University Press
- Jonsen, R., A., Siegler, M., Winslade, W., J., (2002) Clinical Ethics: A Practical Approach To Ethical Decisions In Clinical Medicine. McGraw-Hill Professional
- Lammers, S.E., Verhey, A. (1998) On Moral Medicine: Theological Perspectives in Medical Ethics. Wm. B. Eerdmans Publishing
- Loewy, E., H. (1989) Textbook of Medical Ethics Springer Publishers
- Myers, D., G., Myers, D., David F.(2004) Disaster Mental Health Services: A Primer for Practitioners – Page 203. Psychology Press
- Peter L., Pearson J., and Galletly D.(07-May, 2004).”Knowledge and attitudes towards cardiopulmonary resuscitation in the community” Journal of the New Zealand Medical Association, Volume 117 No. 1193