Nursing Management Case Study Example

What facts have the most bearing on the ethical decision you must render in this case?

There are a couple of important facts in this case which includes nurses abusing their patient and the administration neglecting the complaints of the patient's family. On the other hand, the patient has a history of stroke which weakened one side of his body. Any mishandling could delay his recovery period and deteriorate his health condition. However, the placing of the secret camera in the patient's room is against most health care policies since it deprives the patients of their privacy.

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According to the claims brought out by the Dearborn family in Livonia Michigan, an 89-year old patient admitted to the nursing home was subjected to unethical treatment by the nurses in the unit. The patient who was brought to the nursing home after undergoing abdominal surgery to enhance his care and recovery process was allegedly abused by the nursing home nurses (Cwiek et al., 2018). According to the previous medical history of the patient, he was considered wheelchair bound due to his previous stroke which weakened one side of his body. After the patient complaining to his family members of the treatment he was going through, the hospital administrators refuted the claims (Cesario, 2018). However, the family deployed a secret camera in Younes room which captured several nurses physically and racially abusing Mr. Younes. A recording of over 100 video clips captured by the secret camera showed a particular nurse slapping the patient on the head, throwing up on the wheelchair and the bed and the camera captured one nurse praising Trump on the move to deport Asian Americans hence racially discriminating the patient (Langton, 2018).

According to the nursing ethics and code of conduct, nurses are poised at providing care to patients and advocate for their wellbeing in healthcare units. The recovery process of the patient was compromised owing to his treatment in the nursing home, as he was not accorded the necessary help and recovery conditions from the surgery and previous stroke suffered (Cesario, 2018). Regardless of the family members showing some concern, the nursing home administration did not take any initiative to address the issue at hand, therefore, allowed the nurses to extend their abuse to Mr. Younes. On the other hand, the nurses were inconsiderate of their duty as caregivers and as advocates for the patients and turned against their duty exposing the unfair patient treatment.

External or internal factors under consideration

The external factors to be considered include the legal obligation of the institution towards patient care and safety. Since the case was bound to the nursing home facility, setting up a secret camera in the patient's room infringed the privacy of the other patients in the neighboring rooms. Additionally, in the practice of nursing roles, adhering to the law is imperative in the delivery of efficient healthcare services. On the other hand, customer ethics is very critical in maintaining quality service delivery. Maintaining patient ethics fosters trust from patients which enhances long-term relationships between the patient and the institution of service delivery.

The organizational goals and best practices defined for adoption in line with establishing good patient care make up the internal factors aligned for consideration. As employees of a nursing home, nurses are tasked to embrace the definition of the organization's goals along with offering the best practices that reflect the best interests of the organization. Therefore, by offering dismal patient care and support to Mr. Younes, nurses failed to adhere to the goals of the organization by failing to embrace best patient care practices. Consequently, the organization's ethical climate is neglected.

Who are the claimants and in what way are you obligated to each of them?

The affected people, in this case, include the patient and his family members, therefore, making Mr. Younes and his family as the key claimants of the case. Fidelity, reparation, justice beneficence and non-injury are the obligations bound to the actions of the nurses. Fidelity entails the contract and promise made by the provision of care to the patient. Reparation refers to the wrong committed that needs attention to make it up. On the other hand, beneficence involves the ability to offer help to individuals in need and deserve help. Last but not least, non-injury refers to the ability to avoid unnecessary harm to an individual. Based on these obligations, it can be deduced Mr. Younes was not accorded the treatment he deserves.

According to the promise and contract of service delivery upheld by the institution, fidelity between the patient and the institution was breached. In this line, the patient expected delivery of quality care with consideration of adherence to fidelity linking the patient and the nursing home. With regards to reparation, Younes was physically and racially abused in person in his room by nurses during his stay at the facility seeking professional nursing care in his recovery from surgery. According to the family members reports, the patient's health continually deteriorated over the time that Younes was under the care of the nursing home. The health progress was against their expectations as they expected a swift recovery process for the 89-year old patient under the professional care of nurses (Huls et al., 2015). The institution stands liable for the actions of the nurses and therefore need to take full responsibility and offer a tangible resolution to the matter. His family members were also affected due to their confidence in the institution and its staffs to render expert and professional care to their father only to turn out a source of abuse to their father. The family members addressed the issue with concern and filed a lawsuit against the nursing home. Their patient was to be accorded with the best care that could aid his recovery process. On the contrary, the nursing was not obliged to abide by the beneficence call for extending help to someone in need and deserves care. In reference to nurses' obligation of non-injury which calls for avoidance of unnecessary harm, the patient was subjected to unnecessary harm by being thrown on the bed, wheelchair and physical harassment such as being slapped.

What are the ideals?

Ideals can be referred to as the values and behaviors based on the activities of the nurses in service delivery.

For me. - Caring, compassion, and empathy

Any patient in a healthcare institution should be accorded with the best care as well as due respect regardless of his position. The role of the medical practitioners is to provide medical attention and quality patient care service (Huls et al., 2015). In this case, Mr. Younes expected to be treated with decency, respect and accorded all the services entitled to him. Additionally, the nurses are tasked with the responsibility of patient safety and protections. Therefore, they were expected to protect Mr. Younes from any mistreatment rather than contributing in inflicting pain on the same patient.

For the client/organization/profession.

Client - Fairness, care, and empathy

Any patient deserves good care, respect, and fair treatment. At the same time, any medical practitioner has the mandate to accord any patient the desired medical attention without any bias and discrimination. Working towards providing the best medical conditions to patients should be the driving force for all medical staffs. In this case, Mr. Younes deserved a better treatment, about his medical condition, care needed and his position in the society. At 89 years, it would have been recommendable for the nurse to treat him with care and respect to accord him a faster recovery rate.

Organization - Patient privacy, efficiency, and quality

In nursing homes, patients expect an ample environment such helpful, friendly and caring nurses dedicated to addressing the particular patient requirements such as support, cleaning, basic therapy and personal help in walking and feeding. Additionally, the efficiency of service delivery impacts the quality of care given. Therefore, the organization should focus on enhancing efficiency in service delivery.

The facility's administration needs to take a strong stand in addressing the complains raised by the family members. The administration taking a keen insight into the complains brought on board by different clients in their facilities is a sign of dedication to offering quality and standard healthcare services to their patients. The institution also expects to its policies to be adhered to effectively. In order to protect patient's privacy, use of cameras along with other video and voice recording devices are discouraged.

Profession - Respect and fairness.

Nursing is a multifaceted profession which entails nurses working under their license and therefore rendering them independent in dispatching their services. However, nurses are guided by the nursing ethics and code of conduct of the institutions in dispensing their services. Nurses are expected to serve as the ambassadors for the patients to the hospital administration, doctors, friends, and family as well as other relevant stakeholders. Their duty entails ensuring patient safety as well as protection. Therefore, the key role of nurses is to offer evidence-based holistic patient care. Therefore, nurses should embrace tolerance, respect for others and fairness in their service delivery.

Do any of these ideals conflict? In what order would you honor them?

There is a conflict between the patient's need for care and patient privacy. A patient may be in an undergoing abuse from the medical staffs and to come up with tangible evidence on patient care, patient privacy needs to be breached by using secret cameras in the patient's room. In this case, a patient's privacy will come last so that it provides room for verifying the alleged abuse.

Among the evident ideals from the case, the patient' need for care should be honored first (Poirier et al., 2015). Medical facilities should prioritize the needs of the patient about the provision of medical care. Therefore, medical practitioners should take a deep insight into the medical condition of the patient and facilitate the required care as per their analysis. This goes hand in hand with professional care which is enhanced by medical practitioners. Nurses bear the responsibility of establishing a conducive environment for the recovery of the patient. In facilitating patient care services, nurses should adhere to the nursing ethics and code of conduct that guide them in their practicing of the profession. The institution's policy is among the most affected area in this context. Use of secret cameras is against the nursing home's policy, and therefore, other patient's privacy in the institution was infringed by the installation of the hidden camera in the room. However, in breaching the institution's policy, the unethical practices of the nurses serving Mr. Younes were brought out uprooting some of the possible habits of the nurses in handling patients.

What are your options, and which would be favored by each affected party?

• Taking legal action
• Firing the nurses who engaged in the act
• Settling the issue with the hospital administration

Taking legal action.

This will be highly be considered by the patient owing to the physical and racial abuse subjected to by the nurses. According to the footage of the secret camera, Younes was thrown on bed and wheelchair and at some time had to groan with pain which resulted in him being slapped on the head to stop making noise. This was harsh and owing to the fact that the patient was very old, weakened by a stroke on one side of the body and had undergone abdominal surgery which he was recovering from. Bringing the perpetrators to justice would serve as a lesson to other nurses in the institution with regards to the quality and sensitivity of patient care.

Firing the nurses.

The institution would prefer to fire the nurses to put an end to patient abuse in the facility. Additionally, the nurses tainted the reputation of the institution going against the nursing ethics as well as the institution's code of ethics. On addressing the patient's need for care, the nurses failed to take care of the patient denying him water, abusing him and failing to fulfill some of the basic care entitled to the patient.

Talking the issue with the institution's administration.

In the best interest of the institution and nurses, they would wish to address the issue between the family with the institution's administration. This implies the nurses will be suspended but retained back on duty on completion of their suspension. Additionally, the information will not spread to the public and hence protect the institution's reputation. However, this will serve as a cover-up instead of facing legal charges.

Which options could cause harm to any claimant?

Talking the issue with the nursing home administration is most likely going to harm the patient if he opted to remain in the facility. On the contrary, taking legal action is most likely going to cost the institution resources in compensation of the patient. Additionally, the organization stands chances of being understaffed before they fill the gap left by the nurses.