Question

Chapter 9, Ethical Aspects of Gerontological Nursing B. Scotty Story is 69 years old. Scotty is currently suffering from end-stage kidney failure. Scotty has been living at home with his wife of 36 years. He has been receiving dialysis for the past 2 years, three times a week. Scotty has obtained an infection in his dialysis port, and his vitals are steadily decreasing. His family is at his bedside around the clock. 1. What if…You are struggling with letting Scotty pass? You want the physician to do whatever is possible to help Scotty survive. How can you look past this and accept Scotty’s wishes? 2. What if…The physician you are dealing with gives you an order to give 1 mg of morphine every 15 minutes for pain? While assessing your patient, you count Scotty’s respirations; the count is only 5. Morphine should be held for respirations less than 12. The physician states to give the morphine, regardless of the respirations. What should you do to protect yourself and the patient?

Answer 1

1. What if…You are struggling with letting Scotty pass? You want the physician to do whatever is possible to help Scotty survive. How can you look past this and accept Scotty’s wishes?

Passing of the family and struggling of the family member with deteriorating health condition is always difficult. We can indeed request the physician to take necessary actions and provide the treatment for his recovery from current delicate situation. We cannot look past from medical treatment and it is pertinent to try to the best of the abilities to save the patient in this case scotty. If Scotty wishes to die we cannot as per ethics accept her wishes as due to such serious health condition her ability to take rational and sound decisions might be severely hampered. In such situation her wishes cannot be accepted and we have to provide her with medical treatment to take a chance with her recovery and save her.

2. What if…The physician you are dealing with gives you an order to give 1 mg of morphine every 15 minutes for pain? While assessing your patient, you count Scotty’s respiration's; the count is only 5. Morphine should be held for respirations less than 12. The physician states to give the morphine, regardless of the respirations. What should you do to protect yourself and the patient?

Doctor or physician might take unethical ways in prescribing medications such as morphine for pain relief but in such as case with low respiration count it can be fatal to the patient and this pain reducing medication could end up being the prime reason of patient fatality. To protect our self we can request the physician to give in writing the prescription dose to be given and explain why the dose should not be administered with low respiration count. This shall help in protecting us as care givers and maintaining ethical professional conduct. Meanwhile to save patient we can explain the doctor the unsuitable dose prescribed and serous implications that might lead to fatality and law suits for malpractice which can jeopardize the physician's career and hospital's reputation. This can help with physician prescribing a non-fatal dosage and we can protect patient in this way with the help of medical rational, ethics and strong persuasion for the ethical medical care.