Ethical dilema anyone?

[trini1186]

I'm a nursing student and I'm currrently taking an ethics class and one of our assignments is to interview a healthcare worker or human services worker (i.e teacher) who faced an ethical dilema or moral conflict. Does anyone have any stories that they are willing to share with me? Your task would include describing the situation, what actions were taken or were not taken to resolve the conflict and why; describe the outcome of the situation and what are some your personal reflections of what happened (i.e what would you do differently and why). Your help would be greatly appreciated. Thank you.:)

[5860TomCat]

I don't know if this will qualify for what you need, but here is my story

I am a new RN, I graduated Jan 08 and passed the Nclex Feb 08. I have been working for 5 months on a medical surgical floor at a large hospital. This story happened after I just got off training and had been working about 2 months.

I was switched to night shift. I was taking care of an elderly women (70's) who was scheduled for surgery tomorrow.

She was confused and only oriented X1, she had a necrotic toe (black and shriveled) and a lot of dying tissue you on her feet. her surgery was going to be for her foot.

She had an IV that was not connected to anything, but her blood sugars where in the 300's and we had to start an insulin drip on her.

Now she let me get her vitals and check her blood sugar, but she would not let me hook the IV up to her. She also denied anything was wrong with her foot.

I had to get the doctor to come assess this patient, because I did not know what to do. When he came it became apparent that not only was she orientated only to her self, but she was having hallucinations as well. She saw people in the hallway, she thought the doctor wasn't real and a that I was something Evil. She also was thrashing and throwing her arms in bed and grabbing her self. Which puts herself and the IV in danger.

So that she would be safe to have surgery in the AM, we had to hook her up to an insulin drip, but with her mental state there was a risk she could hurt herself or pull out her IV.

We had to restrain her with soft wrist wraps. First of all I felt bad restraining a elderly women, but the doctor helped and it was for her safety and so her blood sugar would go in range and she would be ok to have surgery in the AM.

Now the dilemma: As the night went toward AM and her blood sugar started to go with in normal range. The patient became more alert and stopped having hallucinations. She stopped thrashing and wanted to be unrestrained and said she would not pull out her IV. She became orientated to her self and the date.

I wanted to un-restrain her: It was the last hour of my shift. But she was scheduled for surgery early (like 7:30). But she still has in a state where she could hurt herself or in the very least pull out her IV. So I asked my charge nurse to re-assess the patient. My charge nurse re-assessed her and said for safety leave her in the restraints.

I went home that morning feeling so guilty and worried. I had to call my dad (an old EMT) and a friend who is a mentor to me (she has been an RN for a while). To make sure I had done the right thing and was not evil.

Turns out when I came to work that night. The patient surgey was canceled (because the doctors where worried about her mental state) I was so upset I restrained her for nothing!! If we had not had to had an IV running then she would not of had to be restrained.

HOWEVER, That shift I found out that as soon as she was unrestrained she did pull out her IV, and then had to be supervised for the rest of the shift for safety and she tried multiple times to pull out the new IV they put in her.

So the ethical situation; use of restraints for patient safety and when to stop using them.

Hope this helps. If this is not what you need, Sorry