Need some help/opinion for our case scenario

[itsmecathie]

You are a SPN working with a 46 year old male client on a busy medical-surgical unit. He was admitted with an MRSA infected foot wound that required surgery and daily dressing changes. He is a known IV drug abuser, is also hepatitis C+ and is homeless. Normally, clients with this problem are sent home once the wound is stable for home care dressing changes and then come into outpatients to continue their IV antibiotic treatments. Because he is homeless, he is given a private room so he can be on isolation for the MRSA and to continue to receive his medications. As a patient, he is demanding, gets angry and verbally abusive at the nurses, complains about the food and the service and abuses the isolation protocol by leaving his room unprotected and going outside for a smoke. However, it is known that IV drug abusers admitted to hospital frequently meet their dealers in the parking lot to obtain and do drugs. This is very convenient for him as he has IV access line in place.

What are the legal and ethical issues in this situation and what is the role of the nurse (SPN)?

[Asystole RN]

In many states, in fact all states that I know of it is not illegal to use illicit drugs. However, it is illegal to buy, sell, or possess illicit drugs or their paraphernalia. That being said drug abuse is a disease that needs to be managed.

The fact that he is homeless, demanding, angry, abusive, addicted to IV drugs, and is Hep C+ should not diminish the care he recieves.

The best thing you can do is ensure his safety and educate him the best you can. Hopefully managing his pain inhouse will reduce or stop his drug seeking behavior outside the hospital. I would definately involve the risk manager, physician, social worker, case manager, and DON and let them know what your concerns are and what facility policies are in place to manage a high risk patient.

Remember that you are there to assist the patient to achieve his health related goals.

[itsmecathie]

Thank you so much for your help. And by the way, states u mean states in america?? Cuz I live in Canada. Just a dumb question maybe.