Applying the Process
The patient, an 82 year old with hypertension, atrial fibrillation, multi-infarct dementia, and chronic kidney disease presents with a large intracranial bleed, on warfarin. Her prognosis is very poor. The patient's son who is her primary caregiver is distraught and wants to stay at her bedside at all times. The unit has an open visitation policy but asks that all visitors wait in the waiting room during shift report, to allow nurses to exchange patient information without fearing that it will be inappropriately overheard. When asked to leave, the son becomes angry, verbally abuses the nurse, Maria who is caring for his mother. When Maria attempts to reassure him that he can return after report, he throws the hairbrush he had been using with the patient toward her and storms out, punching the wall as he goes.
Sharon, the nurse on the next shift witnesses this behavior and becomes fearful of the patient's son. She recognizes her obligation to provide the best care possible to her patient and that best practice usually includes supporting family involvement. At the same, she notes she has an obligation to herself, her team, and the other patients on the unit to maintain a safe and calm environment. She begins a deliberate analysis of the situation applying the nursing process:
What information doc1 Sharon need to gather?
What kind of ethical problem ill this?
(A) Moral distress
(B) Ethical dilemma
(C) Ethical Uncertainty
(D) D Locus of authority
What options for action should Sharon con1idcr?
How can Sharon examine thi1 problem using ethics?
What 1tept1 are involved in implementing a chOICll action?
After taking action, what criteria will Sharon use to evaluate the outcome?