An Ethical Dilemma

[StudentRN_Sara]

Hello! I'm a second year nursing student with UWO, andwas hoping for some input. I'm taking a professional nursing course where I need to validate an ethical dilemma that was given to us and just wanted some opinions.

Here it goes...

A 14 y.o. female has just completed a 6 month checkup for a fractured ankle. The fracture had healed completely and with complications, but her blood results showed that her hemoglobin was in the low-normal range. As a percautionary measure, her doctor sent her to a nurse practitioner for diet counseling. Before long the patient had confided that she thought she was pregnant and she did not want anyone else to know, especially her mother. With more discussion it became evident that the 14 y.o. patient had no clear idea what she was going to do about the suspected pregnancy. Before the nurse practitioner could begin to help the patient think it through, the mother walks in. The mother tells the nurse that the patient has been nauseated and very tired lately, and asked the nurse if she had any idea what could be causing it. As the nurse prepares to respond, the patient is silent and glaring at her. The nurse has a dilemma.

So is this dilemma is based on confidentiality? Or being able to make decisions for herself?

It is essentially doing the most for the patient, without sacrificing her rights.?!

I'm just hoping for some opinions for a basis to my thoughts.

Thanks for your help in advance!

Sara

[Rustyhammer]

Not that I want to form a base for your thoughts but If I were the NP I'd send Mom out of the room for a bit to create a chance to talk to this pt. If you bring up to Mom that daughter might be Pg then you have blown trust with your pt. This gives you the oppourtunity to chat with the pt and do a preg. test, and give resources.

-R

[medpsychRN]

I think the key word is suspected. I agree with sending the mom out of the room.

[CharlieRN]

Patient confidentiality is the primery concern at this point. There is no emergent concern that would override it. If possible mom should be sent from room and patient counseled to let the NP do a preg test and talk with mom about it. Alternatively, teaching toward good prenatal sleep and diet without saying anything about the suspected pg and scheduling a follow-up soon to talk to pt somemore.

[canoehead, BSN, RN]

"Why don't we do a urine sample/take some more blood and see if we can come up with an answer?"