scenario: Louise, a 46 year old female, attended the rural accident and emergency department with her partner and complaining of upper abdominal pain. Louise was initially triaged by the registered nurse (RN), having her vital signs and a pain score completed. Her vital signs were recorded within normal parameters and her pain score was six out of ten. Louise also complained of nausea and abdominal bloating and told the nurse that she had been taking Mylanta for indigestion. Additionally, she had a urine sample tested and this had no abnormalities. Due to a motorcycle road traffic accident, it was a busy evening in the rural emergency department. The driver of the motorcycle had obtained significant leg and chest injuries; hence Louise was kept waiting. She was aware of the accident and did not want to bother anyone as they appeared to be short of staff and very busy. Despite the department being busy, the RN did manage to intermittently assess Louise, however, she was increasingly nauseated and vomited dark ‘coffee ground’ fluid approximately two hours after her admission. When the RN checked her observations, her heart rate (HR) was rising and her blood pressure (BP) was falling, therefore, she notified the medical officer (MO). Intravenous fluids were commenced, a full blood count performed as was a group and hold (blood matched and prepared in case it is required for transfusion). Louise was prescribed and received Pethidine 100mg for her pain and Maxolon 10mg for her nausea. Drowsy from the pain relief, Louise vomited again and her vital signs continued to be monitored. She was prepared for theatre following consent for an emergency endoscopy. During the procedure, the anaesthetist encountered difficulty maintaining her oxygen saturation levels and she was transferred post endoscopy to the high dependency unit. The anaesthetist perceived that Louise had aspirated whilst vomiting in the ward, prior to the procedure. The overall aim of this presentation is to demonstrate your knowledge and understanding of the unit content listed: • Possible ethical dilemmas associated with the clinical scenario • Utilitarianism and Deontology • Beneficence, Non Maleficence, Autonomy, Justice (distributive justice) • Capacity/ legal capacity and competence • Consent/ the elements of informed consent • Veracity (truth telling) • Fidelity • The Tort of Negligence/ Components of Negligence/Acts and Omissions • Duty of Care/ Scope of Practice Create a synthesis using the relevant unit content (the legal and ethical concepts specified above), linking it to the relevant and specific areas of the clinical scenario and the relevant nursing legislation e.g. The Registered Nurses’ professional codes and standards)."
Sample Solution