As a nurse, their job is to provide the best care their patients.
When it comes to a situation where a health care worker cannot make a decision or agree on right thing for their patient, that’s when they use ethical dilemma (Potter, Perry, Stockert, ; Hall, 2015, pg. 78). Emilio is 65 years’ old who’s being admitted for hyperglycemia with blood sugar of 589. He has been admitted to the hospital for third time in six months. He was diagnosed with DM type 2 many years ago and has been on insulin for two years. His medical history includes DM type 2, insulin dependent, hyperlipidemia and osteoarthritis.
He’s retired and was widowed one year ago. He is still active in church, gardens and likes to work on small projects around the house. He’s schedule to be discharge from the hospital and when his daughter arrived to take him home, she complaint that Emilio is non complaint with his medications and diet at home.
He also depressed since his wife has passed away, who did everything for him. Emilio also sees a healer and refuses to take his medications and only follows what the healer tells him to do. She does not agree with this and confides that she hopes to find a way to prevent her father from seeing this healer.
She’s worried sick that he’s doing this purpose. She said that she can’t be responsible for him because she also has small children to take care of. She wanted to talked to nurse if she can have her father discharge canceled and ask the to doctor about admitting him in a nursing home where they can make sure he eats right and takes his medicine and not the herbs he has been using. Then she pleads, “please just tell the doctor he wont ever take his medicine and should not be at home anymore.”Three ethical dilemma are 1.
the daughter wants her father to go to nursing home instead of house 2. He’s not competent to take care of himself 3. the daughter wants us to invade patient’s autonomy. The three possible solutions I prepared for Emilio are: 1. To discharge him to rehabilitation center for at least 2 weeks’ period 2.
I would discharge him based on in home health care service 3. talk to Emilio and his daughter about his health condition that he’s not safe on his own in a respectful way to discuss the best solution after his discharge. Patient is the primary priorities and his safety is next. The social worker and his provider can advocate him about his right and educate him more on safety and medication error, that can be fatal.
Emilio has his right to refuse to stay in hospital, but the daughter doesn’t want him at home which will make Emilio feel unwanted by his family. This issue can make him feel more depressed and can cause anxiety. It would be very disappointing to put Emilio in a nursing home because he’s only 65 and is capable of doing his own things.With my first scenario of Emilio discharging to rehabilitation center for at least 2 weeks’ period would help him with his osteoarthritis.
since he’s very active in gardening and likes to work on small projects, rehabilitation will help him regain his strength. Osteoarthritis can damage any joint in the body and it affects the joints in your hands, knees, hips and spine. So in rehabilitation center there will be nurses that can help him with his medications, PT and OT to help him with is activities of daily living.
Social worker can help with Emilio’s home environment and help set up dietary, nutrition habit, and community based program for him to get out his home. () with rehabilitation Emilio will have of what in home health care will be doing in his home environment. Even thought the daughter still feels that she’s responsible for her dad’s care and don’t have time to make up to it, then in-home health care service can come and help him with his activities of daily living (ADL) and medication administration.
Second solution is to him move on to in-home health care plan. In-home health care nurse can come and make sure that Emilio takes his pills. with home health care there will be doctors, therapists and social worker who will follow up with him at his house ().