Question

Amy is working as a new RN in an emergency department (ED). A patient has arrived in the ED and has a diagnosis of renal failure. The ED physician concludes, after testing, that the patient is in need of dialysis. The patient claims that he is an illegal immigrant and cannot pay for dialysis service. He was obtaining dialysis in his country but had to travel a long distance in order to reach the dialysis site. He came to the United States because his family is in need of money and he heard that he would be able to find a better job here.

The physician treating the patient steps out to call for the hospital medical director. The two physicians discuss the case. Amy overhears their conversation. The ED physician explains that the patient may die if he does not receive dialysis. The medical director states that the hospital is already in debt with a charity dialysis case that has cost the facility more than $100,000. If they take on another patient, it will be a huge financial burden to the hospital, which is already struggling. As their discussion ends, the ED physician returns to the patient and tells him that he will be treated for his immediate condition but that he must pursue dialysis treatment as soon as possible and discharges the patient from the ED. Amy has concerns for the patient and wonders whether the right decision has been made.

Questions:

1. Was an ethical decision made with regard to the patient’s care?

2. Should Amy react to the decision?

3. How can the hospital remain open to treat many other sick patients if it is forced to close because of the expense of a few?

4. What would you do?

Answer 1

1) As for the issue of hospital financial conditions physicians has made the right decision of providing the necessary care required, but the physicians should have explain clearly about the extend of need for dialysis & should have provide assess to other units were patient can recieve dialysis.

2) Amy should react to the decision made by physicians of Emergency Department. Amy should provide patient the health education, & explain the extend of need of dialysis.

3) Hospital should measure accurately costs & compare them with outcomes, that is the hospital administration should find out of what cost we provide care to the patients & what amount is paid by patients.

Hospital administration can use time driven activity based costing system, to assign costs accurately & appropriately.

4) As a nursing professional I will provide all the necessary care to the patient that is diagnosed with renal failure in emergency ward, & will provide him emotional support & counselling.

And for the running of hospital if have had an idea or solution for the economic crisis I would refer to the concerned department.