CASE ANALYSIS #1: Jane is pregnant, 23

CASE ANALYSIS #1: Jane is pregnant, 23 years old, unmarried, and the mother of four (4) children by three different fathers. She has been an insulin- dependent diabetic since the age of 12 but had no complications from the disease during the earlier pregnancies. During clinic visits, Jane has been advised of the risks of uncontrolled diabetes for her unborn child (increased risk for congenital deformities, premature birth, and being still born) but does not seem to take the advice seriously. When questioned about how she is monitoring her blood sugar, she complains that she is too poor to buy the test strips, and even when she has the supplies, she often forgets. At 15 weeks gestation, following an office visit, she is admitted to the hospital as an inpatient to treat her diabetes. The next day, against her physician’s advice, she checks herself out of the hospital even though the diabetes has not been fully brought under control. Once at home, she again fails to monitor her blood sugar adequately. At 22weeks gestation, Jane is again admitted to the hospital as her diabetes is again out of control. The next morning, she again announces that she wishes to checkout. The physician and unit staff advise her that her actions are clearly not in the best interest of the fetus. Jane responds negatively to the advice and become belligerent, demanding to be released. : In this case, who has rights? Whose rights should prevail? Jane’s? The fetus? The hospital staffs? Should the physician attempt to get a court order to keep Jane hospitalized? In our culture we often talk of special rights for those whom we consider innocent, such as babies and children. How might such rights have evolved and become justified? CASE ANALYSIS # 2: Angel is a 35 year old attractive, intelligent, technically competent RN who worked for 5 years on a medical-surgical unit of a small hospital. She has generally been well liked by her professional colleagues, and she habitually makes concerted attempts to deliver compassionate care to her patients. Recently, she left her job and began working in the surgical intensive care unit (ICU) of Philippine Medical Center. Angel changed her job because she wanted to gain more varied nursing experience. She was very excited and enthusiastic about her new job, but shortly after Angel began working in the ICU, she began to her career decision. The more experienced nurses in the ICU are what Angel describes as “abrupt” and “exasperated” when she asks for help in learning ICU patient care and procedure. Angel states that the ICU nurses seem to be “testing my resolve” to “stick it out” and seem to want her to fail at learning how to work in the ICU. She describes many of the surgeons who regularly have patients in the ICU as demanding and impatient with the ICU nursing staff, and Angel is intimidated by them. She mentions being chastised by one of them for asking what he called “a stupid .” There is an air of dissatisfaction among all of the nurses throughout the hospital. Angel says working at this hospital is like no other situation that she has been involved with since becoming a nurse. : What do you think might be some of the underlying causes of the ICU nurse’s treatment of Angel? Do you believe it is likely that Angel’s treatment has anything to do with her personal characteristics? What could Angel do to try to improve her situation? What problems with Angel’s delivery of patient care could arise because of the treatment she is experiencing? Do you think that the “air of unhappiness” among all of the nursing staff at the hospital might be directly or indirectly affecting the treatment that Angel is receiving? Might it be affecting patient care hospital-wide? Please explain. If Angel wants to make positive changes at the hospital, what can she do? SCIENCE HEALTH SCIENCE NURSING ETHICS CA51022

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