Sometimes Things Go Wrong Assignment
You have been working as a registered nurse on an orthopedic unit since your graduation from your nursing program 2 years ago. Both the doctors and supervisor respect your work, and you have found it exciting to work with the home health nurses as many of your patients need home health follow-up for physical therapy and other needs following their surgeries.
Mrs. George is an elderly widow who has recently had bilateral hip replacement. Although she has made good progress, she continues to need quite a bit of assistance with ambulation.
Normally, if family members cannot assist them at home, patients with bilateral hip replacements are sent from the hospital to an assisted living facility for several weeks. Mrs. George does not have any immediate family to help her, but she has pleaded with her doctor, you, and the home health nurse to let her go back to her home, which she refers to as a cabin in the “piney woods” to complete her recuperation. The doctor tells you and the home health nurse to work on a plan to see if it is feasible.
The home health nurse reports after her home assessment that with some assistance every day, she could probably manage at home, and although her cabin is not near any neighbor, she does have a telephone. Mrs. George is insistent that she will not go to what she calls “a nursing home” and her insurance will no longer pay for her to stay at the hospital.
Eventually, it is decided that Meals on Wheels will deliver her meals and that a home health nurse will call on her every other day and a physical therapist will visit every other day so that she will have at least two people in her home each day.
Although you and the home health nurse and the doctor are a bit uneasy, you feel that you have solved this ethical dilemma (a choice between two negative solutions) and have selected the one that is the least damaging to Mrs. George’s quality of life.
Seven days after Mrs. George is discharged, there is a severe storm, which disables most phone lines including Mrs. George’s. The storm also causes the flue in her wood stove to overheat in the middle of the night causing a fire. Mrs. George is unable to use her walker fast enough to get outside before the fire consumes the small cabin. Mrs. George dies in the fire.
Would you have solved this problem as described? Does knowing the outcome change the way you would solve the problem? Having a negative outcome may or may not mean that the ethical problem solving was faulty. Do you feel the people in this story made a faulty decision? If so, what would you have done differently?