A) One Small Cut that Killed
Dr. Contadina is a primary care physician in a Metropolitan area at a large, not-for-profit, integrated health care system. On average, she sees several patients a day from a variety of backgrounds who come in with an assortment of conditions, injuries, and ailments.
One day, a patient comes to see her complaining of ankle pain on his right leg. The patient is a farmer and says that he fell while he was taking care of his chickens in the chicken coup. He has some cuts and bruises on either leg, complains of a swollen right ankle, but appears to be fine otherwise. Dr. Contadina instructs him to purchase an air cast at a pharmacy along with some ibuprofen and to take it easy. Dr. Contadina returns to seeing other patients and Joe goes home.
Three days later Joe is admitted to the emergency room. He has low blood pressure, a fever, extreme shaking, an irregular heartbeat, and is very agitated. After removal of the air cast, the nurses notice a cut that has become infected on his left leg (the other leg with the swollen ankle). Joe’s condition continues to worsen, and he eventually goes into septic shock. After two days in the ICU, Joe dies of complete organ failure.
The family wants answers, and so far all they know is that he came in with one small cut and suddenly died. The hospital is pressuring Dr. Contadina to apologize in hopes of mitigating some legal trouble. Dr. Contadina is afraid that if she admits that there was any chance she made a mistake, that she’ll be in bigger trouble- both legally and professionally. She is very afraid of what her colleagues and patients will think if she admits that she made an error.
- Does this scenario deal with moral, ethical, and/ or legal conduct?
- What is the nurse’s ethical role in this case?
- Describe an unsafe, illegal, and/or unethical practice you have witnessed in your personal life, nursing or student practice.
- What made it unsafe, illegal, and/ or unethical compared to the expected professional standards for practice?
- What resources are/were available to resolve the issue?
Please be sure to use citations to support your point of view. Then reference them at the end. For more grading specifics, please refer to the rubric.
1. What theory best describes your organization’s approach to external influences on care delivery, Systems (with open or closed) or Chaos or another?
2. State what your workplace's mission, vision, & philosophy (values) are.
3. What themes or unity do you see between these statements? (i.e. What do they have in common?)
3b Does your workplace culture reflect these concepts? Why or why not? How do you see them being enacted (or not)?
3c. Does your health care setting (the unit where you work) interpret these statements differently than other settings within the organization? (i.e. Are the statements broad enough to fit all circumstances?) Elaborate.
4. Find an organizational chart from your facility.
4a. What type of operational structure exists at your organization? (For example, is it Functional? a Service line? a Matrix? Flat? etc...)
4b. Describe it to defend your interpretation of the structure.
5. Do you feel your organization could benefit from a different operational strategy?
5b. why or why not?