Which issue frames the values in tension?
How to accommodate patients’ religious views while maintaining a standard of optimal medical care.
How to overcome parental objections to appropriate care without filing a dependency action.
How best to assure that Rachel and her baby get appropriate medical care while respecting hospital policy and the wishes of the parents.
How to assure nurses are trained to provide care for minors while deflecting any parental opposition.
Who are the primary stakeholders in this problem?
Rachel Banks
She is the pregnant patient who may need more medical care than her parents want.
Mr. and Mrs. Banks, Rachel’s parents
They are the patient’s legal guardians and do not appear to want additional care for their daughter.
Joseph Banks, Rachel’s brother
He is concerned for his sister’s well-being and for the safety of her child.
Rachel’s unborn daughter
This is the child who is about to be born and may need medical intervention to assure safety.
Dr. Emerson Rogers, Chief of Staff
He is responsible for everything that goes on in the organization and often liable for ethical mistakes.
Rachel’s physician
The doctor is dealing with another emergency, but Rachel is still a patient for whom the doctor is responsible.
You, Supervising Nurse
You have to make and implement the decision.
Father Giles Mumford, hospital chaplain
He may be called on to provide religious support.
Yvonne Napier, RN
She is the one primarily responsible for assuring Rachel has a safe delivery.
Other Ob/Gyn nurses
They are responsible for assuring that Ob/Gyn patients receive appropriate and timely medical care
Which duties do you owe the stakeholders?
Duty to follow hospital policy.
Duty not to interfere with competent staff in doing their jobs.
Duty to support your staff’s professional improvement.
Duty not to accommodate parents who are harming their child.
Duty to make parents do the right thing for their daughter.
Duty to provide the best patient care possible.
Which option best fulfills your duties?
Option 1
Confront the parents about their daughter’s need for medical attention.
Option 2
Ask the nurse to do a thorough check to verify that the situation has not reached the point where intervention is necessary.
Option 3
Trust your nurse to provide sufficient care to prevent the fetus from going into medically dangerous distress.
Option 4
Call the physician on duty without seeking input from or informing the parents or the assigned nurse.
Option 5
Ask the assigned nurse to call a physician and a chaplain. Make sure that the mother is assessed medically and that the parents are provided a ministerial response.
Option 6
Involve the assigned nurse and the parents in assessing need for medical intervention to ensure a safe delivery. Provide contacts for aftercare support and education.
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