The Case

Ethical Decision Making

Length: 1500 words

 

Case Scenario:

Rosalee Johnson, 72yrs, is a resident at Rose Gardens Aged Care Facility. This facility provides a variety of accommodation to meet the needs of the elderly in the community and Rosalee is in the Nursing Home.  Rosalee and her husband of 48 years, Mario [aged 78yrs], have lived in their home together about 10Km from Rose Gardens up to 18 months ago when it became apparent Rosalee needed assistance with managing her diabetes and associated nephritis. Rosalee has limited mobility and walks with a frame, however she enjoys watching you tube documentaries on her tablet, and she also enjoys cross words and jigsaw puzzles. Rosalee’s favourite activity for the week however, is her visit from Mario every Friday at lunch time. Each weekly visit, Mario brings Rosalee a homemade meal and seasonal flowers from their home garden. Mario can only manage to visit once a week as he too has limited mobility and needs to organise community transport on a pension now that he is living alone. They are very close and have much love for each other.

Rosalee and Mario have two children together, Gina and Joseph. Joseph [43yrs] lives with his wife and 2 children and Gina [46yrs], lives with her husband of 15yrs. Gina is a Legal Guardian & Enduring Guardian for Rosalee and Mario. Kathleen is a Registered Nurse working at Rose Gardens and knows the family well as she has cared for Rosalee over the duration of her admission. She is also very familiar with Mario and his regular visits. Over Rosalee’s admission, Kathleen has seen Gina and Jo at Christmas time. Both Gina and Joe have both been noted to visit infrequently.

Two weeks ago, Gina visited on Friday instead of Mario, Kathleen was on shift and was allocated the team leader when Gina spoke to her away from Rosalee in the corridor advising her that Mario had died peacefully in his sleep at home 3 days ago. Gina told Katrina she had not yet informed the facility or anyone on the day and planned to do so as the day went on. Gina asked that no member of staff tell Rosalee that Mario had died.

She stated the reason for this was that so she could stress that Rosalee must not be told about Mario’s passing. Gina informed Kathleen that when Rosalee asked where Mario is, Gina said he had a fall at home and was in hospital. Gina expressed her fears to Kathleen that if she told her mother [Rosalee] that her father [Mario] had died, her mother would die from a broken heart. Gina told Kathleen that she planned to tell Rosalee that Mario needed to be moved into a nursing home over the next few weeks.

Kathleen said nothing for the remainder of her shift. The following week, as Kathleen put Rosalee’s lunch in her room, Rosalee said to Kathleen…

“I am worried, I know something is wrong, Mario would never not visit without calling me. Where is he?”

Kathleen approaches the room window to open the curtains as she prepares to respond……

 

Spotlight

Important: This assessment requires significant thought, learning and preparation.

Working through each of the parts requires a 4-step process:

1. You read the information associated and required to address each part
2. You process that information and develop your understanding of what it means
3. You apply the information to the specific case details
4. You use the task and marking criteria as a checklist

The Task

Having read the scenario, please read the following Assessment Guidelines, then work to address each of the 5 parts of this assignment:

1: Clearly define the problem, then objectively note the ethical issue that registered nurse Kathleen must address in responding to Rosalee.   Part 1: 100 – 150 words

 

2: Examine the legal and ethical principles that apply to the case study.  Part 2: 200 – 300 words

 

3: Identify 2 options [courses of action] available to Kathleen in addressing the ethical problem identified in question 1. For each option describe how they apply to the International Council of Nurses [ICN] Code of Ethics for Nurses [2012].  Part 3: 250 – 350 words

 

4: Reflect on the options identified in question 3 and choose ONE as a course of action you would follow if you were a registered nurse in the same position as Kathleen. In your answer, be sure to discuss your rationale as to why you would take this particular course of action in this situation and apply knowledge from the literature to inform your answer.    Part 4: 400 – 500 words

 

5: Conclude with a brief summary of how you might feel in this situation and what some of the drivers are that raise these feelings.    Part 5: 100 – 200 words

ZOOM

Assessment 2: Ethical Case study analysis

The assignment task is an exercise in making clear clinical decisions andjudgements that concern the ethics and law of nursing practice. Therefore, itis not about your personal values but rather, the ethics and law of nursing practice. The case study analysis framework is    to be used for submission of your assignment:1.   Clearly define the problem – Objectively note the ethical issue that the nurse mustaddress2.   Examine the ethical and legal principles that apply to the case study3.   Identify 2 options available to the nurse in addressing the ethical problem identified inquestion 1 as they apply to the International Council of Nurses [ICN] Code of Ethics forNurses [2012] 4.   Reflect on the options identified in question 3 and present a rationale as to which ONE of the options you would follow if you were in Sam’s position.

 

FRAMEWORK FOR ETHICAL DECISION-MAKING

 

Legal issue / Ethical Issue?

Define the problem?

Clinical, ethical, legal?remain objective

 

Consider the responsibilities of the nurse / Define the desired outcome. These must be specific to the scenario [not generalised] EthicalLegal

 

What courses of action are available to achieve the desired Outcome? What options are available in responding to the problem? There are usually 2 options

 

What course of action is best in line with achieving the desired outcome? Of the two options above, choose the option that you feel is the best option Discuss why you would choose this option and not the other option 2?

 

A few things to consider:

1. In terms of Part 5, this was listed separately so that it is attended by all students [as it is important to consider in terms of self awareness]. In terms of the rubric, part 5 is reflective and as such factors into part 4 on the marking criteria [meaning it will make up part 4 content and be marked as such].
2. You will notice that Part 2 has 40 marks allocated to it, yet has fewer word limit allocated [see above] than Parts 3 [30 marks] & 4 [20 marks]. Reason being, while in Part 2 you identify the key themes in relation to legal and ethical principles, you will need to apply some of these to support your discussion in parts 3 & 4. You should end up with an argument to support your chosen option that integrates knowledge of legal and ethical principles as the apply.
3. The integration of legal and ethical principles throughout your discussion and how you apply these to support your argument is factored into the 40 Marks for the assessment [Part 2 of the rubric]. Application of knowledge [legal & ethical principles] and how they apply [to Rosalee’s case] forms the basis of applied subject content – hence justification as to why this forms 40% of this assessment mark. Please consider this when you are writing up and editing your submission.

 

REFERENCING- APA 7^TH

 

RUBRIC

ASSESSMENT 2: CASE STUDY – ASSESSMENT CRITERIA & MARKING RUBRIC

Question
Question 1 Clearly define the problem – Objectively note the ethical issue / dilemma that the nurse must address in caring for their patient	Demonstrates excellent understanding of the ethical issue – The problem is clearly & objectively defined. 8.5 – 10 marks
Question 2 Examine the ethical and legal principles that apply to the case study	Demonstrates excellent understanding by analysing all ethical principles that apply to the case study. Evidence of research with literature incorporated effectively. 17 – 20 marks
	Demonstrates excellent understanding by evaluating all legal principles that apply to the case study. Evidence of research with literature incorporated effectively. 17 – 20 marks
Question 3 Identify 2 options available to the RN in addressing the ethical problem identified in question 1 as they apply to the International Council of Nurses [ICN] Code of Ethics for Nurses [2012]	Option 1 clearly and specifically addresses the problem identified with consideration of the ethical and legal principles relevant to the case study. The ICN Code of Ethics for Nurses [2012] is clearly integrated into the discussion, relevant to the case study. 14 – 15 marks
	Option 2 clearly and specifically addresses the problem identified with consideration of the ethical and legal principles relevant to the case study. The ICN Code of Ethics for Nurses [2012] is clearly integrated into the discussion, relevant to the case study. 14 – 15 marks
Question 4 Reflect on the options identified in question 3 and present a rationale as to which ONE of the options you would follow if you were the nurse in this position.	Demonstrates excellent understanding of the role and scope of the RN in decision making by evaluating the important implications and consequences of the chosen option, in comparison to the option not chosen. Discussion integrates the ethical and legal considerations relevant to the case study and effectively incorporates appropriate evidence to support the rationale. 17 – 20 marks

 

English Language This assessment is considered a milestone task where students are assessed on written English Language. These include grammar, vocabulary and structure.

Level 3 – The writing is well expressed; it is comprehensible & coherent throughout. There are no – minimal grammatical errors and vocabulary is appropriate to the context. The sentences and paragraphs have a logical flow and are clearly linked.