Does anyone have a good nursing ethical dilemma senario?

lamazeteacher · Mar 5, 2008

Hi all,
Just wondering if anyone has come across a good nursing ethical dilemma in their clinical rotations or their medical jobs? Need a really good one, my instructor keeps saying "no" when I give her a topic for one. Any help would be greatly appreciated.
Thanks :bowingpur

The most sensational one today, is the breaking news that in Las Vegas letters were sent patients telling them they may have been exposed to "lethal" diseases through the reuse of syringes there. I think they mentioned anaesthesia as a site where that may have happened.

Now how any licensed health care practitioner could even touch a used syringe (the item didn't say if a new needle was affixed to it) except to place the whole thing in a less than 2/3 filled sharps container, I'll never know! The things cost so little, it couldn't have been containment of that, and it takes little time to take the new syringe out of its wrapper.......

So my conclusion, is that the perpetrators of such an act had to be extremely mentally unbalanced, careless, etc. and deserve to have their licenses pulled!

The item said the same "vial" was used which, as long as it wasn't contaminated, is not detrimental (but who knows, with wacko's there). However, if it was an ampule, that's a different story........

How do others feel about this? Have you seen bizarre disregard for ethical practise, and what have you done about it? :nono:

Logos · Mar 5, 2008

- I think when the family says know we don't want to tell Aunt Sally that she is dying- and the nurse is supposed to go along with that- so Aunt Sally asks and what is this med for? What is the nurse supposed to do? No it's not a ca drug...it's a stool softener- do the families really expect us to lie for them?

This came up on Friday with one of my fellow students -family didn't want pt to know she was dying- mean while everyone else knew. That's just wrong IMO and an ethical dilemma. I think I would get fired, because I am not lying to people.

locolorenzo22, BSN, RN · Mar 5, 2008

How about DNRs that are not recorded and with families that are not POAs wanting you to do everything possible to save the patient if they code?

eranne · Mar 5, 2008

Thats a good one. Let me run it by my instructor. Thanks

eranne · Mar 5, 2008

Hi Logos,

My instructor loved the idea of Aunt Sally not knowing that she has CA and the family wanting the nurse to lie too--GOOD ETHICAL DILEMA-so thanks. anything you want to add to that story that would help will be greatly appreciated. Where in the world do I find info on it?

Shenanigans, RN · Mar 5, 2008

I came across a doozey on clinical once.

A 34year old with possible terminal cancer and 3 children under 4 was undergoing tests to locate the primary. At this point there was a lot of suspison that the CA was terminal, but without finding the primary tumour the doctors didn't want to make a solid statement.

The patient had presented to the A&E several months piror with serious back pain, and after Xray was found to have several tumours on a number of vertabrae. The pt's medical history was four elective termination of pregnancies, one when she was 18 and another at age 20, 21 and 24. Post the second termination she suffered complications relating to retained foetal parts, and post the fourth termination had suffered a serious of ovarian cysts.

Her children were born after the fourth termination.

Anyway, long story short, the doctors eventually found the primary - it was located on utuerine scaring, the doctors were all in agreement the primary cancerous growth was caused by the terminations. (It was a lot more complicated and lengthy explanation).

Here's the ethical problem - the pt had suffered post abortion depression and had made 3 suicide attempts within months of the first three terminations. The pt explained that she'd continued to have TOP because she had wanted to get pregnant again after each TOP because she felt "empty" and was hoping the soul of the babies she'd "murdered" would return to her, but each time she got pregnant the circumstances which "required" the TOP still existed.

Anyway, she had made comment to myself, and several other nurses and doctors that she beleived her cancer was a punishment from her dead babies for killing them.

So, the doctors told her they had found the primary on her verabrae and it was no where near her uterus to ensure she didn't get "depressed" or blame her TOPs for her "death sentance". However, the pt asked on occasion to check the uterus for cancer, as she thought it might have been there, because of all her TOPs.

She wasn't an adherant to any major religion, but was very "spiritiual" and followed a bunch of varying beleifs she had taken from a lot of Asian and Pagan religions.

Sadly, the woman died several months after my clinical finished.

ramzinriko · Dec 10, 2009

I'm having trouble picking an ethical dilemma myself and was wondering if i could use your story in reference?