Question

Theoretical Application to a Critical Care Nursing Case Study

Scenario: A nurse is working the PM shift in the neonatal intensive care unit (NICU) – located on the pediatric wing of the hospital. There are 25 patients (babies) in the NICU and 18 of those patients are on ventilator support. 14 nurses are working on the unit in addition to 1 unit secretary and 2 nurses’ assistants. What should the nurse do/what ethical action should the nurse take when faced with the situation of an active shooter in the hospital’s pediatric wing?

1. Describe the actions that a nurse using utilitarian theory would take in this instance.
2. Describe the actions that a nurse using a deontological perspective would take.

Answer 1

First of all to understand this whole situation, it is important to know about an active shooter. Active shooters are basically individual with psychopathic mindset who are willing to kill or injure anyone in an closed premises with no definite pattern or motive. These kind of people are very dangerous and it is important for a registered nurse to have appropriate knowledge and education about handling such situation.

So, if it happens with me in the given scenario, the first thing that I would do is to collect myself and try to hold my nerve as strong as possible. Since, this incident happens in the hospital’s pediatric wing the most important thing would be to secure the lives of babies first. In a situation like this when everyone in the unit are horrified, someone has to take the lead. I will ask the nurses and their assistant to be courageous and take all the babies through other emergency exit. If there is no emergency exit or the only exit is blocked by the shooter, I will ask them to hide the babies with them in a safer place. In the meanwhile, I will ask all of them to call them on the emergency number 911 and if there is a possible access to the cameras I will try to monitor the move of the active shooter. Now, 18 of the babies are on ventilator support, so mobility would not be possible for these babies. I will ask at least 10 nurses not to leave those babies at any cost and secure the perimeter by locking doors and windows. When we see this situation through a deontological perspective, rather than waiting for the emergency unit to arrive we have to be prepared to take the action ourselves if required. For that, me and the other ten nurses will gather all the possible equipment like blades, knives and injection and keep them with us for safety. Any kind of burning chemical will be a good idea and can be thrown over the eyes or face of the shooter. This will buy us some time to evacuate as well as at the same time the shooter can be bought down using a team effort.