Hey everyone ...

[RnNurse22]

Hey everyone .I am a newbie!!! I hate to start of like this....I will be asking for your help yall'll So i am a pre-nursing student please excuse my user name. They didn't have much available. Any way I am finishing up my associate in pre-nursing this June, I can't wait!! And I am just appyling to several school, about 3. My hopes in getting in isn't too high but it wouldn't hurt to try, right! If it doesn't work out , I will try again. Any way I am soooooooooooooooooooooooo happy to come across this forum. It is such an amazing community. :yeah:And please let me know do you think its wrong for me as a nurse to sit with his parents and tell them to tell their son? I understand that in prodessional careers you shouldn't get into plp business....i will let you read ahead.

Ok Here is the deal....I am applying to BSN nursing program here is the question below. I just started my essay lease excuse the grammer and spelling...but could you let me know if i am making sense. Thanks.

Bobby is an 8-year-old boy with hemophilia. He has developed early acquired immunodeficiency syndrome (AIDS) from a previous blood transfusion, but he does not know that he has AIDS. His parents have chosen not to tell Bobby that he has AIDS, and do not want any health care provider to tell him either. His parents have gone to great lengths to make certain that Bobby's AIDS diagnosis has been treated and followed under the guise of needing tests or treatments for his hemophilia. In the last year, Bobby has been hospitalized twice for pneumonia and responded well to treatment. Imagine yourself as being his nurse and that you were involved during his last 2 hospitalizations. Bobby is knowledgeable and understands his treatment for hemophilia. He has talked to other kids with hemophilia who have not had any problems with pneumonia. He asks you at his third admission to the hospital for pneumonia if he can talk to you for a few minutes. He says he cannot talk to his parents about this because they will not talk to him. He asks you if he has AIDS.

There is no right or wrong answers in this dilemma. You should write a logical essay that shows your critical thinking about your decision to tell or not to tell Bobby of his diagnosis of AIDS. In your essay, discuss the following points: 1) do you tell Bobby about his diagnosis of AIDS or not; 2) what are the issues and points of conflict; 3) who are the interested parties; 4) what are the consequences; and 5) what are your obligations? (

As a nurse caring for Bobby, I would have chosen not to tell Bobby of his condition. The reason why I wouldn't disclose such information to Bobby is because his parents request for the health care providers to not enclose any information about his condition. Although I disagree with his parents, it isn't my place to disrespect their decision. As a nurse, I understand that I am able to share sympathy and relationship with my patients to a certain extend but to transgress the guardian rights is beyond unacceptable in whatever field we work in. Bobby question would encourage me to sit and discuss with his parents about the importance of enclosing this complex situation to their son. I would share my thoughts and reasons and inform them that my reason of discussing with them is because of their son wanting to know if he has aids. The interested parties would of course be his parents, because the matters lie in their hands. My obligation as a nurse is to make my patient as comfortable as he can be. By discussing wi

[talaxandra]

I know you said to ignore spelling and grammar, but make sure both of these are immacualte before submitting your essay.

Your response so far makes sense - you've made your position (not disclosing his diagnosis), and your rationale (it's not your place to override his parents' decision) although you disagree with their decision (you might like to discuss why you think they're wrong),clear.

I would be careful to avoid absolutes (eg " to transgress the guardian rights beyond unacceptable in whatever field we work in") because there are always exceptions and I would want to demonstrate that I will judge each situation on its merits. I would also take care discussing what your role as a nurse is in this situation - in this case, you have many obligations in addition to making Bobby comfortable and sharing sympathy with him.

Fianlly, your statement that you'll discuss this situation with his parents assumes that you will be bringing them new information, and that their decision was not considered when they made it. Both these are unlikely - if Bobby's been hospitalised before, odds are other health care providers have felt the same way and talking with the parents. If I were the parents I'd be sick of people who have less of a vested interest that I do in my own child trying to tell me what's best to do. I'm not saying don't address it, but perhaps acknowledge that this isn't exactly virgin territory.

Good luck, and welcome to allnurses :)

[Daytonite, BSN, RN]

you were given 5 specific points to discuss. you did not accomplish that. in particular, what are the issues and points of conflict and what are the consequences. bobby, from the scenario, is the patient. yet the only attention in your essay is to the parents. the scenario specifically asks you: he [bobby] says he cannot talk to his parents about this because they will not talk to him. he asks you if he has aids. i think that is the smoking gun here and it has been completely ignored. bobby, after all, is the patient, not his parents. those last two sentences should be the focus of your answer. now,

1. do you tell bobby about his diagnosis of aids or not?
   
   • yes or no
     

[*]what are the issues and points of conflict?

• patient right to know, uncommunicative parents (are they possibly in denial that their boy can't handle the truth of the situation?), patient confidentiality, parental rights
  

[*]who are the interested parties?

• the patient, the parents, the nurse, the state in which they live (there are laws in every state pertaining to aids and disclosure of aids status--perhaps you should find them out for your state and bring them into this discussion)
  

[*]what are the consequences?

• this relates back to the issues and points of conflict. address each one and what the consequences are of doing or not doing each (you know what the parents and bobby want, how can you facilitate some kind of meeting of the minds between them without violating the parents wishes yet getting an answer for bobby?)
  

[*]what are your obligations?

• this is what you must do by law
  

let me give you an idea of what rns are. we are problem solvers. the scenario they gave you has an ethical dilemma for the nurse as well as a nursing problem. the admissions committee wants to see your thinking process in putting together some kind of resolution to this problem. that's what all those questions are designed to do--bring out your thinking about all the sides to this issue and how you get to your final decision not to spill the beans. (this is called critical thinking and is something nursing students are taught to do from day 1 to day of graduation. they are testing you to see if you have the ability to think rationally here.) disclosure of aids has legal implications in most states. parents have total say in the treatment of their children in most situations. federal law now tells us that all patients have the right to know their diagnoses--children are an exception. i'm not sure about aids in your state. you need to probably check that out. this kid obviously is quite astute and has a pretty good idea what is going on and wants some answers. he can't get his parents to talk so he asks the nurse. how do you handle this compassionately and not cross legal or parental boundaries? how do you talk to bobby sincerely and compassionately and not spill the beans? nurses face this kind of situation from time to time.

i graduated from a bsn program. they are very big on communication and writing skills. you need to have this essay well organized and answer all 5 questions. take the finished essay to your campus writing lab for critique of the organization and grammar as well.

[RnNurse22]

Thank you guys sooooooooooo much!! I really appreciate your help!!!!