Does this sound like an ethical dilemma? I'm not sure what grade my teacher gave me but I did my calculations on my overall grade in Blackboard and it seems like she gave me a 2/40 for the assignment. The ethical dilemma was the last assignment to be graded. Throughout this Thanksgiving weekend my grade dropped from a 75% to a 73.12% to a 71.93%. I need a 73% to pass and clinicals is over. I don't get it, my teacher told me on the last day of clinicals that I passed but I had 1 more assignment to turn in which was the ethical dilemma, worth 5% of my grade and worth 40 points. Do you guys think this might be a typo? If she only gave me 2/40 points on the assignment, shouldn't she have just given me a 0% for the assignment? Is the 2 points just writing down my name? I'm so sad, angry, and confused. I feel like all of my hard work throughout this semester was all in vain. Anyways, here's my ethical dilemma.
1. Identify the clinical setting the situation occurred in. Describe the situation and ethical conflict in detail. You will not receive full credit if you do not describe the complete clinical setting/situation along with the ethical conflict. (4 points)
The clinical setting was in the Labor and Delivery Unit at X Hospital. The patient was diagnosed with Gestational Hypertension and was given Hemabate and Cytotec to control her postpartum hemorrhage. The patient was feeling nauseous, had vomited, and had constant, heavy diarrhea due to the Hemabate and Cytotec. Methergine was not given to control her postpartum hemorrhage because the patient had gestational hypertension and Methergine could have the potential of increasing her blood pressure even more, leading to a stroke. If the patient did not receive Methergine, then she would lose electrolytes and water from the vomiting and the heavy diarrhea caused by the Hemabate and Cytotec. The loss of electrolytes would affect her heart by causing dysrhythmias, and the loss of water could affect her kidneys from dehydration. The nurse gave the patient medications to control her vomiting but none were given to help control her diarrhea. When I came back from lunch and went inside the patient's room, the patient was sitting in a huge pool of diarrhea and the room smelled horrible.
2. Select the top 3 Principles/Rules of Healthcare Ethics involved and describe them in detail utilizing references. (16 points)
The top 3 Principles/Rules of Healthcare Ethics involved are Autonomy, Beneficence, and Nonmaleficence (American Nurses Association, n.d.). Autonomy is allowing the patient to choose the treatment of his or her choice (American Nurses Association, n.d.). Before the patient started pushing, the patient should have been informed of the potential of a postpartum hemorrhage, and the medications available to control the postpartum hemorrhage such as methergine, cytotec, and hemabate, along with the contraindications, side effects, and possible outcomes. After the patient's education, the patient should be allowed to decide which medications to use in her treatment. Beneficence is to promote wellness in our patients (American Nurses Association, n.d.). The nurse should have gave the patient medications to help control her vomiting and diarrhea. Nonmaleficence is to avoid hurting the patient (American Nurses Association, n.d.). The nurse should have monitored and consistently cleaned and changed the patient due to her heavy, constant diarrhea to prevent skin breakdown.
3. Select the top 3 AWHONN Standard X. Ethics involved in this issue and describe them and how they specifically relate to your ethical conflict (in detail). You must utilize references. (16 points)
The top 3 AWHONN Standard X Ethics involved in this issue are promoting patient advocacy and helping them learn the skills to maintain their advocacy, compassionately delivery patient care to promote their dignity, and safety, and protecting patients from unethical healthcare decisions and practices (Association of Women's Health, Obstetric, and Neonatal Nurses, 2009). Promoting patient advocacy and helping patients learn the skills to maintain their advocacy as well as compassionately delivering patient care to promote their dignity, and safety (Association of Women's Health, Obstetric, and Neonatal Nurses, 2009) relate to my ethical conflict because when I came back from lunch, my patient was sitting in a large pool of diarrhea and the room smelled horrible. The nurse should have consistently monitored the patient helped changed her chucks, and made sure the patient had her call light in reach so the patient could call for assistance whenever possible if she had another episode of diarrhea. Protecting patients from unethical healthcare decisions and practices relates to my ethical conflict because the doctors and nurses chose the treatment option for the patient instead of letting the patient choose what treatment option was best for her. Before the patient started pushing, the nurse should inform the patient of the potential for a postpartum hemorrhage, the medications available to control the postpartum hemorrhage such as methergine, cytotec, and hemabate, and their contraindications, side effects, and possible outcomes.
If known, describe the actual outcome. If known, then points will be deducted for choosing this ethical dilemma. (4 points)
Before my nurse and I handed the patient to the postpartum nurse, the patient still felt nauseous and had diarrhea. However, she was able to get up to the bathroom and urinate with our assistance.
Anyways, here's my ethical dilemma.