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Ethical Issues

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Posted over 4 years ago

 

I'm doing a paper on Ethical issues and Nursing.  I need some good topics.  The only things I can think of is abortion and assisted sucide half my class is doing topics on this, I would like to do something different.  Any suggestions of topics?  I'm new to the nursing and not sure of what qualifies as ethical issues and what would make a good paper. 


MICHELE
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How would you deal with a parnoid sch. pt that came into the ED having halluncinations. Would you put them in 4 point restaints and observe considering all the laws for mental health. Hand cuff them to a bed and have security watch them. Shut the door on the room and lock while the hit the door with their hands. Give them Haldol 10 mg, Benadryl 50 Ativan 2mg IM and observe until you can get then transfered to Mental hospital. Write about that.

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What about the issue where a person has an Advanced Directive indicating "No heroic measures" and a signed DNR order. They are coding and the spouce is screaming for you to save her husband.... Would the age of the coding patient affect how you feel about the situation...


What if you were in the ER when a 14 year old boy/girl was brought in after being hit by a car at a lower speed. They are bleeding badly and are shock from loos of blood. Mom is there and as you are about to tell them about their childs condition and blood loss she informs you that she is a Jehovah's Witness and you are not to use blood products of any kind when treating her son/daughter. What do you do??? About 15 min later dad arrives tells you that his wife is in a cult from the dark ages and he wants his child saved at any cost... what do you do???

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What about the ethical and legal ramifications associated with CAM (complementary and alternative medicine)? 


Paula

"If you have built castles in the air, your work need not be lost; that is where they should be. Now put the foundations under them" - Henry David Thoreau

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One idea and something you may come across in the nursing profession is the issue of blood transfusions, some patients you encounter do not accept blood transfusions, what does a nurse do when you have a patient that is having surgery and the patient does not sign the blood consent. you can contact your local kingdom hall of jehovah's witnessess and they would be willing to give you more information concerning this issue.   hope that helps.

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Hi All,


I worked in Pediatric Oncology, including Bone Marrow Transplantation for 18 years.  Many of our young patients were transfused with Platelets, PRBC's or other blood products quite often and in many patients transfusions were daily!!  I've worked with a handful of Jehowva (sorry, not spelled right) Witness families and we could get a court order at any time, day or night, for blood transfusions.  Most of the parents were relieved because the court order took it out of their hands, after they have done everything to prevent the transfusions.   We will try to accomadate as much as we can.  We would let their  H&H go lower than other patients as long as they were asymptomatic and we would cover the blood bag and tubing as much as possible.  If a patient is 18 and over, that's a different story! 

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What do you do when you have a resident of a nursing home that is a signed dnr that now elects to have surgery.  The surgery null n voids the dnr so what do you do, how do you approach, what do you say?

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Thanks everyone this is very helpful!!


MICHELE
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derf says ...



What do you do when you have a resident of a nursing home that is a signed dnr that now elects to have surgery.  The surgery null n voids the dnr so what do you do, how do you approach, what do you say?


The funny thing about a DNR is that it is only good for as long as a person wants it to be.  If conscous and the person changes their mind: No DNR!   After the procedure ask the patient again if he is DNR or full  code. I would then refer for a psych consule.


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kstiltner1 says ...



How would you deal with a parnoid sch. pt that came into the ED having halluncinations. Would you put them in 4 point restaints and observe considering all the laws for mental health. Hand cuff them to a bed and have security watch them. Shut the door on the room and lock while the hit the door with their hands. Give them Haldol 10 mg, Benadryl 50 Ativan 2mg IM and observe until you can get then transfered to Mental hospital. Write about that.


First of all the big issue with this situation is: It depends. Is the pt violent? Is he/she hurting themselves or others? Also as far as medications that would depend on the doctors orders for that pt. Allergies, side effects from previous meds. Why would a person add to the parnoid thoughts by restaraints if they are not needed.  I cannot answer this question unless I have more information.