Ethical Dilemma Help Please!!!

[Nursingstudent173]

Hi everyone,

I am currently doing a ethical dilemma project, and I would really love some advice!

My project is based around a 76 y.o. patient who is currently receiving ulcer and diabetic nursing care from a home health service. The nurse has been going to the pt's house for 7 months, the ulcer is clean but shows no further sings of healing. The patient has smoked cigarettes for the last 55 years, and has been educated that smoking can delay wound healing. The patient has tried to quit smoking many different times, using different methods, but none have worked. The home health service is facing budget cuts, and the manger proposes that in order to save money that all cases involving noncompliant patients, and patients with no improvement should be closed.

My question is what as a nurse can you do, in order for the patient to still receive the care she deserves?

My first thought is to let the patient know of the situation, and try to encourage her to quit smoking once more.

My next thought is to speak to the manger and to tell them that this is unethical. And that patients should not be denied care based on their own health decisions.

I also was considering getting either a social worker case manger on board, so that the patient is still receiving care and being checked up on.

I would really love some thoughts and ideas on this situation! thanks in advance!

[Sour Lemon]

Was that scenario assigned or did you make it up? It doesn't make a whole lot of sense.

[Rionoir, ADN, RN]

It seems like the first question should be "Is it your responsibility as the nurse to make sure this non-compliant patient has home health care?"

Halfway through first semester and I'm already this jaded from clinicals

[kaylee.]

The question doesnt present an ethical dilemma for the nurse because you are not faced with a situation for which you have conflicting options.

From the nurse perspective you likey feel that what is happening is wrong, and you want to fight for the patient who needs care. So u can educate them, start a petition to fight the decision, or any other thing to advocate for the pt.

But YOU as an employee in this wonderflul system that is capitalist healthcare, you have no say whatsoever in how the business is run.

The manager on the other hand, should be feeling this dilemma: are patients merely items on a budget that can be "cut" to save costs, like office supplies or the holiday christmas party? Or are they human lives that depend on vital care and would be harmed by the decision?

I guess my answer doesnt help you write the paper, but that is because the posed question presents an incorrect understanding of what ethical dilemma is.

[kaylee.]

"My next thought is to speak to the manger and to tell them that this is unethical. And that patients should not be denied care based on their own health decisions."

This is why this paper is not en ethical dilemma: from your perspective its unethical so you have no arguement about the decison: the paper begins where it ends.