Professional Identity- Sandy Wilson- Case Study - Assessment Answer

Professional Identity Assignment

Case Scenario

Sandy Wilson, fifteen years old, had just completed a three-month check-up for a fractured ankle. The fracture had healed completely without complications, but her haemoglobin level was in the low-normal range. As a precautionary measure, she was sent to Mary Jones, a nurse practitioner, for diet counselling.

Not long after Sandy had met in Mary’s office, she confided that she thought she was pregnant, but that she did not want anyone else to know, especially her mother. After some questioning, however, it became clear to Mary that Sandy had no clear idea of what she was going to do about the suspected pregnancy.

Before Mary could begin to think the situation through, Mrs Wilson knocked on the door and asked to come because she wanted to speak to Mary. Mrs Wilson entered and told Mary that Sandy had been nauseated and very tired lately, and asked Mary ‘Do you have any idea what could be causing this?

As Mary prepared to respond, Sandy remained silent and glared at her

Assignment Task

1. Briefly note the ‘problem’ that exists for Mary[what is the most basic thing ethically that the nurse mustaddress]
2. Make a list of the things YOUthink are the most ethically/legal significant factors in the scenario. In other words what things would have to take into account if thinking and decisions are to be ethically and legally appropriate in this situation?]
3. List 2 (two) options available to Mary, which are the most obvious courses of action, given what she takes the problem to be. Then choose ONE course of action
4. Develop an argument/rationale for the stance (course of action) taken by Mary.

Introduction

1. The problem that exists for Mary as per the legal and ethical scenario in nursing is that Fifteen years old Sandy Wilson is pregnant. Now, the problem is that the girl confided that she was pregnant but she does not want anyone to know about this. In nursing profession there are provisions for maintaining confidentiality of the client. In this case if the nurse Mary tells this problem to Mrs. Wilson then confidentiality will violate. On the other hand if Mary will not tell Mrs. Wilson about Sandy’s health then truthfulness will not be there in her practices. Since Sandy is adolescent she is not aware about the fatal effects and it is very necessary for her mom to know about this. There are five rights that are right dose, right drug, right client, right time and right route(Robin, 2013).The nurse must address these five factors while taking into consideration this case. NSW Health’s Privacy Manual for Health Information also suggests that the nurse must address the problem that the patients have priorities in decision making about their health. In this case the patient wants not to disclose this information but since the patient is not adult the nurse must understand this fact and tell the problem to the mother (Mrs. Wilson). After doing that all the rights will be successfully addressed by the nurse and this will further result into addressing the problem (BBC, 2015).It is also important to use effective communication by the nurse to decrease the bad outcomes for sandy Wilson. In this manner the major problem lies in revealing the confidential information to Mrs. Wilson against the willingness of the patient Sandy Wilson.
2. To make ethically and legally appropriate decisions in this situation there are a number of significant factors that are required to be taken into account and these factors are described as below:

• First of all it is very important to take into consideration The Nurse Practice Act (NPA) that provides an outline about the various aspects of nursing practices. This act lays down the guidelines that help in making right decisions. The act also lays down that the child can also participate in decision making. It is suggested in the case that the patient wants to hide the truth and thus the first factor to consider is that whether the nurse shall go against the child’s willingness or not. The answer to this factor is also available in NPA(Corey, Corey, & Callahan, 2011). Te situation is critical here and along with pregnancy there are other diseases as well and thus the legally and ethically appropriate decision here would be to consult this will Mrs. Wilson.
• The State board of Nursing also laid down various factors to make ethically and legally appropriate decisions. As per this, the nurse must take into account Mutual recognition model. This suggest that if Nurse will ignore this problem and will not discuss with Mrs. Wilson then as per the law she will be held liable for giving false information or hiding relevant information from the concerned person. This is a very significant factor to take into consideration to make ethically and legally appropriate decisions in this situation.
• There are various ANA standards of nursing and in this ethically and legally bound responsibilities are mentioned for which the nurse is accountable. As per this collegiality is a very important factor and this factor has potential to govern the situation. This is why it is also important to take into consideration to make ethically and legally appropriate decisions in this situation.
• At the end the Patient Self-Determination Act also plays a vital role in this situation. The nurse shall assure the client and family about the right treatment. This is also a vital factor to take into consideration to make ethically and legally appropriate decisions in this situation (Monro, 2013).

3. On the basis of analysis of the case there are only two obvious course of actions that the nurse shall follow and these course of actions are as flows:

• The first option in front of the nurse is to discuss everything about the issue with Mrs. Wilson. This course of action involves telling about Sandy Wilson’s pregnancy to her mother. Since her mother is worried about her fatal health and sooner or later she will get to know about the pregnancy. As a nursing practitioner the dilemma in front of Mary is that she can’t go against the patient’s will but at the same time she can’t hide the truth from Mrs. Wilson. The State board of nursing laid down various factors to make ethically and legally appropriate decisions(Faden, 2013).As per this, the nurse must take into account Mutual recognition model and tell all the facts to Mrs. Wilson. The State board of nursing also suggest that if Mary will ignore this problem and will not discuss with Mrs. Wilson then as per the law she will be held liable for giving false information or hiding relevant information from the concerned person. Thus the first course of action is to tell this information to Mrs. Wilson.
• The second course of option that Mary can choose is to keep this secret confidential. As per the NSW Health’s Privacy Manual for Health Information the nurse must understand that the patients have priorities in decision making about their health. In this case the patient wants not to disclose this information but since the patient is not adult the nurse must understand this fact and tell the problem to the mother (Mrs. Wilson). The Nurse Practice Act (NPA) also suggests that it is the duty of a nurse to maintain privacy and confidentiality and thus she must not tell this to anyone.

The one course of action that shall be chosen is to tell this to Mrs. Wilson. The girl is very small to take care of herself in this situation and not telling this to her mom will lead to serious consequences in future(Freegard & Isted, 2006). Thus more than anything else the most important thing in nursing is to save the life of patient by any means. This will be true ethically as well as legally.

4. The reason behind taking this course of action is that in Nursing there are laws for maintaining confidentiality as well as for hiding the truth. In this case the patient is an adolescent who is suffering from many other problems. If the problem of pregnancy will be hide from Mrs. Wilson the situation may become fatal in future. The NSW Health’s Privacy Manual for Health Information suggests that when there is an ethical dilemma a nursing practitioner shall go for a course of action that shall not harm the health of the patient (GOV, 2016).Choosing this course of action will not have an adverse effect on the health of Sandy Wilson. This is the most significant factor why revealing this information to Mrs. Wilson is very important. This will further save the nurse from allegation of hiding truth in future. This is the reason why this course of action shall be chosen by Mary.