NHS 4000 Assessment 1. I want Case Study Incident 9

Sample Answer for NHS 4000 Assessment 1. I want Case Study Incident 9

Healthcare professionals have a responsibility to ensure that they offer high-quality and safe patient care in the care environment. However, they usually face cases of varying magnitudes that they have to solve. Even though some may be simple, others are not straightforward forward hence needing them to settle for value challenging ethical decisions (ACHE, 2019). Fortunately, the profession offers principles that can be integrated with moral values to guide the decision-making process. The implication is that the professionals have to understand and recognize that dilemmas are common; hence one has to remain unbiased while making the decisions regarding such cases based on ethics. Therefore, the purpose of this assignment is to explore an assigned case involving an ethical dilemma and use the ethical decision-making model in the case analysis to explore the factors which led to the problem and the ethical problem.

The Case Overview

The assigned case concerns a recently recruited director, E.L straight, who is working at the Hopewell Hospital as clinical services director. He oversees the daily operations and has made several improvements in the center since his appointment by formulating new programs. An established surgeon, Dr. Cutrite has served in the hospital for years, but he has been deteriorating clinically in terms of his physical and mental capabilities. The doctors’ case worries Straight and has been pondering over reducing his load and privileges, but apparent Cutrite is connected and politically powerful. He has been responsible for some of the medical mistakes happening in the hospital. In one of such cases, the surgeon operated on a patient named Jameson but apparently forgot to take a surgical cap from the patient when closing the wounds. The operating room supervisor who identified the problem immediately brought it to Mr. Straight’s attention. Straight asks the possibility of taking the patient back to the operating room through pretense to search for the cap, but the patient was already discharged.

When the case was brought to Dr. Cutrite’s attention, he insisted that there is no reason to take action, the patient should not be notified, and that it may only result in mild discomfort and the patient can never know. Mr. Straight then seeks the opinion of the chief of surgery by creating a hypothetical situation and inquiries about the likely outcome if a surgical cap remains inside a patient. While the chief of surgeon immediately knew that something was amiss, he did not pursue the case further and argued that the patient would only have mild discomforts, but one can’t be sure of what might be. Even though the supervisor loves working at the facility, he is wary of Dr. Cutrite’s influence and power, hence has to carry out his tasks more cautiously. From the case, Mr. Straight is encountering an ethical dilemma, whether to proceed with disciplinary action against the surgeon and make the patient know what happened, which is the right thing to do, or to completely ignore the case and proceed with other assignments.

The Case Ethical Analysis

Mr. Straight is facing a dilemma caused by the surgeon leaving a surgical cap inside Mr. Jameson and failing to neither consider taking it nor informing the patient. From the inquiries, Mr. Straight realizes that the patient faces a risk even though it may be low risk with the cap still inside her. In addition, he knows that Dr. Cutrite is declining hence leading to medical mistakes performed during surgical procedures. Worrying still is the fact that the chief of surgery is turning a blind eye to this situation. While the supervisor wills to solve this case, there is a lack of will from both the chief of surgery and Dr. Cutrite, who hold the opinion that that patient may only face minimal risk. He is also concerned that while the doctor continues making more mistakes, he does not want to take responsibility. However, Mr. Straight faces a tough task against the clinically declining yet politically powerful surgeon in trying to lower the privileges, which will help lower the surgical mistakes cases.

Application of the Ethical Decision-Making Model for Case Analysis

This model can be useful in analyzing various cases. The model is composed of components such as ethical behavior, moral judgment, and moral awareness (ANA, n,d). These components can be important for ethical decision-making. In this case, Mr. Straight has to recognize and acknowledge that there is an ethical dilemma by applying moral awareness. He also has to make a decision and choose to go with what is wrong or right; hence moral judgment comes into the picture. Besides, the results of the judgment are what constitutes ethical behavior. As such, the framework can be an important tool for critical thinking when an individual is countering an ethical dilemma.

The application of the moral awareness component means that Mr. Straight acknowledges the ethical dilemma resulting from the surgical error and the resultant lack of will to address and correct the issue by both chief of staff and Dr. Cutrite. Therefore, moral judgment is applied by trying to do the right by notifying the patient of the surgical errors performed during the operation through the chief of surgery or the surgeon. Through the model, Mr. Straight can think critically and apply moral judgment and awareness (ANA, n.d). Hence the ethical behavior he displays will be a reflection of the choice he makes in the face of this ethical dilemma. Even though he is not a member of the clinical staff, he is in administration. One of his tasks is to ensure that the patients get the expected levels of quality care. In addition, as a health care administrator, he has to uphold the four principles of justice, non-maleficence, beneficence, and autonomy. Therefore, these four principles will be key in helping Mr.Staight to arrive at an ethical decision.

The Effectiveness of the Communication Strategies Applied

Effective communication is key in passing the intended message across (Ennis-O-Connor & Mannion, 2020). Mr. Straight ought to have communicated assertively, confidently, and directly to the chief of surgery and the surgeon. This would have enabled him to uphold patient safety in any decision he was to make. Communicating directly is key here as the surgeon is politically powerful and has a connection.

Even though she also knew the surgeon as powerful and influential, the operating room supervisor decided to be direct in her communication to Mr.Staight and report the event. Hence, she upheld her integrity and was also honest. Through such open communication, she offered the surgeon a chance to swing into action and address the mistake and only when to Mr.Straight when she realized that it wouldn’t be possible. She presented the case concisely and clearly, which enabled him to adequately evaluate the case and make an informed decision. Mr.Straight, on the other hand, sought the chief of surgery’s opinion through a hypothetical situation which is not a clear and concise way of communication. This strategy was ineffective as the chief of surgery only had an idea that something was wrong but could not make an informed decision due to a lack of facts. This led to an apparent lack of concern in the case hence hindering ethical decision-making.

Even though there is strong willpower in Mr. Straight to solve the problem, he noticed that he did not effectively communicate since he decided to minimize direct communication with the surgeon. This is not the first case, as he has a history of refraining from fingernail-biting situations in the past years. This is an indication that he does not have sufficient capacity to handle ethical dilemmas, as he was reluctant to confront the surgeon regarding the errors and his clinical decline. By applying the four principles of healthcare ethics, Mr.Straight can effectively address the ethical dilemma he is facing.

The Solution to the Ethical Dilemma

As earlier indicated, the four principles of health care of justice, non-maleficence, beneficence, and autonomy are key in making sound ethical decisions when faced with ethical dilemmas. When applied, Mr. Straight could have better understood the ethical situation and the decision to be made. While autonomy entails patients’ rights, non-maleficence entails the responsibility of not intentionally causing harm to the patient. In addition, beneficence is engaging in actions that focus on upholding the patient’s interest while justice is giving fair and equal treatment to every patient (Sanders et al., 2018). It is evident that Mr.Straight fell short in using the principles as the patient was not informed of the case and offered a chance to decide on the next course of action. The decision was arrived at to leave the cap and not inform the patient without consulting her; hence, she was not treated fairly, and the action has the potential of leading to harm.

The solution to this problem lies in being more direct and assertive and eliminating fear so that ethical decision-making can follow (Sanders et al., 2018). Therefore, the clinical decline and surgical mistakes performed by the surgeon have to be addressed by taking away some privileges and responsibilities. The patient should also immediately be informed of the event. He has to communicate to the chief of surgery and the surgeon that he intends to constitute a committee to investigate the case of neglect and lack of concern regarding the patient’s case. In addition, Mr. Straight has to report what has happened to the medical board, where the case can be looked into further and possibly take away the surgeon’s privileges.

Conclusion

Ethical dilemmas need immediate attention for the best resolution. Therefore, Mr. Straight has to take immediate action and apply ethical principles in solving the issue. The ethical decision-making model can also be used in making decisions that would be helpful to everyone involved and do not violate anyone’s rights.

References

American College of Healthcare Executives. (2019). ACHE code of ethics. https://www.ache.org/about-ache/our-story/our-commitments/ethics/ache-code-of-ethics

American Nurses Association. (n.d.). Ethics topics and articles. https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/ethics-topics-and-articles/.

Ennis-O-Connor, M., & Mannion, R. (2020). Social media networks and leadership ethics in healthcare. Healthcare Management Forum, 33(3), 145–148. https://doi.org/10.1177%2F0840470419893773.

Sanders, S., Wisse, B., Van Yperen, N. W., & Rus, D. (2018). On ethically solvent leaders: The roles of pride and moral identity in predicting leader ethical behavior. Journal of Business Ethics, 150(3), 631–645. https://doi.org/10.1007/s10551-016-3180-0