Question

Maggie C, an RN and head nurse of a busy neurological intensive care unit was reviewing the weekend staffing for the unit on a Friday afternoon. As usual, the unit’s nine beds were full with patients in various levels of recovery from brain surgery and head injuries. The staffing on the weekend was short, with only enough staff to safely care for eight patients. After a great deal of time reworking the schedule, calling nurses on the phone, and trading of days off, she finally managed to arrange sufficient coverage for the unit.
 
As Maggie was closing her office for the weekend, Dr. West, a neurosurgeon, approached her and related the following situation. Mrs. P, a 63-year-old patient with a brain tumor, had been scheduled for surgery 3 days earlier. She had a very rare blood type that was difficult to match, so the surgery was delayed. Although a few days’ wait would not likely worsen her condition drastically, she had become very anxious when informed about the delay in surgery. The blood bank had just obtained the necessary units for the surgery and informed Dr. West that he could now operate on Mrs. P.  Dr. West was wondering if the neurological unit would be able to safely care for Mrs. P over the weekend.
 
This unit was the only one in the hospital equipped to monitor brain surgery and provide appropriate nursing care for this type of patient. The neurological step-down unit was also full, so it would be difficult getting a bed to transfer one of the neurological unit’s patients into to make a bed for Mrs. P.  Mrs. P would most likely require one-to-one care for 18 to 24 hours after surgery.
 
Questions
 
1. Should Maggie tell Dr. West that he can go ahead with the surgery and she will make the adjustments to provide care for this patient?
2. What ethical obligations does Maggie have to the patient?
3. How about her obligations to Dr. West and the hospital?

Answer 1

1.No Maggie cant tell Dr.west to go ahead with the surgery because the patient need one on one care for 24 hours after surgery.As said above the hospital is short staffed on weekend and Maggie only managed to provide sufficient coverage fro the eight patients.And the hospital cannot provide a personal 24 hour care to Mrs.p.

2.The ethical obligation to the patient is mostly care which the nurse can provide.Maggie should be able to provide care to Mrs.p and if she agrees Dr.west to do surgery then she can't provide the care which is required for Mrs.p.

3.A nurse obligation mostly resides with the patients and their care.She may have obligation to the doctor and the hospital but the obligation to the patient is more.Nurse responsibility is mostly towards patients.And if she agrees for surgery then she can't provide the care which is required for the patients.So patient obligation override other obligations they may have.