The Scenario Sandy Wilson, fifteen years old, had just completed a three-month check-up for a fractured ankle. The fracture had healed completely without complications, but her haemoglobin level was...

The Scenario
Sandy Wilson, fifteen years old, had just completed a three-month check-up for a fractured ankle. The fracture had healed completely without complications, but her haemoglobin level was in the low-normal range. As a precautionary measure, she was sent to Mary Jones, a nurse practitioner, for diet counselling.


Not long after Sandy had met in Mary’s office, she confided that she thought she was pregnant, but that she did not want anyone else to know, especially her mother. After some questioning, however, it became clear to Mary that Sandy had no clear idea of what she was going to do about the suspected pregnancy.


Before Mary could begin to think the situation through, Mrs Wilson knocked on the door and asked to come because she wanted to speak to Mary. Mrs Wilson entered and told Mary that Sandy had been nauseated and very tired lately, and asked Mary ‘Do you have any idea what could be causing this?


As Mary prepared to respond, Sandy remained silent and glared at her.


Professional judgement requires that Mary, the Nurse Practitioner [NP] recognises the full range and complexity of issues involved in the ‘Sandy Wilson’ scenario and be able to ‘weigh these in the balance’ and come to a considered decision about what is best given the circumstances. In the scenario, there are legal, ethical and clinical issues which the nurse must attend to. Such judgement improves with experience and reflective attention to that experience.



All the following questions must be attempted. Please note that the majority of time should be spent on section 4 as this carries the highest percentage of marks. The word limit is 1200 words.


Case Study Questions
1. Briefly note the ‘problem’ that exists for Mary [what is the most basic thing ethically that the nurse must address]
2. Make a list of the things YOU think are the most ethically/legal significant factors in the scenario. In other words what things would have to take into account if thinking and decisions are to be ethically and legally appropriate in this situation?]
3. List 2 (two) options available to Mary, which are the most obvious courses of action, given what she takes the problem to be. Then choose ONE course of action

4. Develop an argument/rationale for the stance (course of action) taken by Mary.