|Type of Project||Essay/Research Paper|
A Nagging Uneasiness Discussion Paper
You are a nurse on a pediatric unit. One of your patients is a 15-month-old girl with a diagnosis of failure to thrive. The mother says that the child is emotional, cries a lot, and does not like to be held. You have been taking care of the child for 2 days since her admission, and she has smiled and been receptive to being held by you.
She has also eaten well. There is something about the child’s reaction to the mother’s boyfriend that bothers you. The child appears to draw away from him when he visits. The mother is very young and seems to be rather immature but appears to care for the child.
This is the second hospital admission for this child. Although you were not on duty for the first admission 6 weeks ago, you check the records and see that the child was admitted with the same diagnosis. While you are on duty today, the child’s father calls and asks about her condition.
He lives several hundred miles away and requests that the child be hospitalized until the weekend (it is Wednesday) so that he can “check things out.” He tells you that he believes the child is mistreated. He says he is also concerned about his ex-wife’s 4-year-old child from another marriage and is attempting to gain custody
of that child in addition to his own child. From what little the father said, you are aware that the divorce was bitter and that the mother has full custody.
Because of Health Insurance Portability and Accountability Act, you tell the father that you cannot provide any information about the child.
You talk with the physician at length. He says that after the last hospitalization, he requested that the community health agency and Child Protective Services call on the family.
Their subsequent report to him was that the 4-year-old child appeared happy and well and that the 15-month-old child appeared clean, although somewhat underweight.
There was no evidence to suggest child abuse. However, the community health agency plans to continue following the children. He says that the mother has been good about keeping doctor appointments and has kept the children’s immunizations up to date.
The pediatrician proceeds to write an order for discharge. He says that although he also feels somewhat uneasy, continued hospitalization is not justified, and Medicaid will not pay for additional days. He also says that he will follow up once again with Child Protective Services to make another visit.
When the mother and her boyfriend come to take the baby home, the baby clings to you and refuses to go to the boyfriend. She also seems reluctant to go to the mother. All during the discharge, you are extremely uneasy. When you see the car drive away, you feel very sad.
After returning to the unit, you talk with your supervisor, who listens carefully and questions you at length. Finally, she says, “It seems as if you have nothing concrete on which to act and are only experiencing feelings.
I think you would be risking a lot of trouble for yourself and the hospital if you acted rashly at this time. Accusing people with no evidence and making them go through a traumatic experience is something I would hesitate to do.”
You leave the supervisor’s office still troubled. She did not tell you that you must do nothing, but you believe that she would disapprove of further action on your part.
The doctor also felt strongly that there was no reason to do more than was already being done. The child will be followed by community health nurses. Perhaps, the ex-husband was just trying to make trouble for his ex-wife and her new boyfriend.
You would certainly not want anyone to have reported you or created problems regarding your own children. You remember how often your 5-year-old bruised himself when he was that age. You go about your duties and try to shake off your feeling. What should you do?
Solve the case in small groups by using the traditional problem-solving process. Identify the problem and several alternative solutions to solve this ethical dilemma. What should you do and why? What are the risks? How does your value system play a part in your decision? Justify your solution. After completing this assignment, solve the second part of this assignment below.
Assume that this was a real case. Twenty-four hours after the child’s discharge, she is readmitted with critical head trauma. Police reports indicate that the child suffered multiple skull fractures after being thrown up against the wall by her mother’s boyfriend. The child is not expected to live. Does knowing the outcome
change how you would have solved the case? Does the outcome influence how you feel about the quality of your group’s problem solving?
|Excellent||The essay demonstrates exemplary comprehension of the relevant content by thoroughly as well as correctly discussing the relevant information; identifying as well as explaining all of the 3 fundamental aspects; using correct terminology; describing the reasoning next to key points/claims; as well as substantiating points with several accurate as well as illuminating examples, as necessary or useful. There are no gaps in the necessary answer.|
|Good||Scholarly sources that are credible are employed to successfully support statements that are, as the most part, clear as well as fairly expressed. With just a few minor inaccuracies, APA 6th Edition is utilized. There are a few small typos in the references and/or citations. There is some reliance on dubious sources.|
|Satisfactory||Because of certain improper terminology and/or confusing wording, the work is frequently confused and difficult to understand; thoughts may be disjointed, meandering, and/or repetitious. a lack of structure; and/or grammatical, spelling, and punctuation mistakes.|
|Poor||The essay demonstrates a lack of understanding of the related documents by failing to address or improperly addressing the relevant; failing to identify or incorrectly trying to explain key concepts/ideas; ignoring as well as incorrectly attempting to explain key points/claims as well as the rationale behind them; and/or inaccurately or improperly using terminology.|
|No Response||Essay displays great writing abilities, such as a clear as well as thought-provoking thesis, suitable and effective organization, vibrant and persuasive supporting materials, good diction as well as sentence skills, and faultless or almost perfect mechanics, such as spelling and grammar. The essay flawlessly achieves the assignment’s objectives.|
|Quality of Response||Because of its intelligent growth and mature manner, this study merits attention. It provides a compelling analysis of or reaction to the text, expanding on that response using well-chosen examples and arguments. The sixth paper demonstrates that its author can typically use appropriate words, employ advanced phrases successfully, and adhere to written English rules.|
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A Nagging Uneasiness Discussion Paper
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