You are an experienced nurse. You have

You are an experienced nurse. You have worked on the same medical- surgical unit for the past 5 years. During a Saturday night shift, Mrs. P., a 72-year-old patient diagnosed with COPD, complains of abdominal pain. You assess Mrs. P, who has been a patient on the unit many times in the past. The patient’s vital signs are within normal limits and there is no significant change from past readings. However, you still feel uneasy. Not only does Mrs. P. complain of pain, but also she looks sick to you and you sense there is something seriously wrong. You call the medical resident, who tells you to call back if there are any changes in the vital signs. As the shift progresses, you become more convinced that Mrs. P. is seriously ill. Although there are no changes in Mrs. P’s vital signs, you call the resident a second time. The resident yells at you and tells you to stop bothering him. After a couple of hours, you decide to call your supervisor, who checks Mrs. P and encourages you to “get a grip.” You repeatedly check on Mrs. P, who remains awake throughout the night. The next morning, you report your assessment to the charge nurse and asks her make sure someone evaluates Mrs. P’s abdominal pain. The charge nurse responds, “Don’t worry about her. If there is anything seriously wrong, she will let us know.” When you return after 2 days off, you learn that Mrs. P died on Sunday evening of a ruptured abdominal aortic aneurysm. Answer the Following questions related to the scenario: Describe the ethical problem in this case. Evaluate whether your actions were sufficient in this scenario and assess how you could have responded to the situation in a way that would result in a better outcome. Describe the institutional and professional constraints to action. Relate whether you have faced similar constraints and if there has been any change due to patient outcomes. Describe how you felt when you learned that Mrs. P died and whether you had moral distress or moral reckoning. Recommend ways to prevent a similar situation in the future. Describe how you could have these recommendations accepted.

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