The ethical principal showcased in this case presentation was beneficence. The nurses were not thinking beneficially of the resident in any aspect of their practice. A professional nurse would not consider leaving a floor with only three nursing assistants to care for 100 patients. The nursing assistants do not have the authority to manage a floor, the license to ensure patient care, nor do they possess the required knowledge to assess patients or delegate tasks. The institutional constraint would be the state of severe understaffing. For a facility of one hundred patients to be cared for by only three nurses significantly lowers the standard of care. According to a chart in the Journal of Scholarly Nursing (2010), Ohio standards are to have a ratio of one licensed nurse to every fifteen direct care patients in a nursing home facility (p 91).
This presentation, even with the ten additional nursing assistants, was still understaffed with these standards. Although understaffed, the nurses are culpable because the patient was not thoroughly assessed. As a part of the scope and standard of nursing, an assessment would have revealed the need for a focused assessment. The focused assessment would have directed the nurses to signs and symptoms of the bowel obstruction, or led to further investigation. Provision Six is associated with the presentation in that it is essentially concentrating on ethical decision making in the workplace. Stated in Provision Six (2010), “Professional nurses make decisions that significantly affect the lives of others on a daily basis” (p.72). The nurses caring for Loren Richards should have used Provision Six in deciding when to take a break.
There are several characteristics I would have changed about the presentation. Firstly, none of the nurses voiced the aversion for the short staffing. I feel strongly about this being a issue and would have mentioned something to management or the director of nursing. Secondly, the amount of professionals taking a break at the same time was exceptionally unethical. Scattering breaks throughout the shift would have been a more superior decision. Finally, pain is the fifth vital sign and when a patient is complaining, it is a nursing standard to assess. To add vomiting to his signs, and no action was taken, is complete contrary to my nursing practice.
Harrington, C., Choiniere, J., Goldmann, M., Jacobsen, F., Lloyd, L., McGregor, M., & … Szebehely, M. (2012). Nursing Home Staffing Standards and Staffing Levels in Six Countries. Journal Of Nursing Scholarship, 44(1), 88-98. doi:http://dx.doi.org.proxy.library.ohiou.edu/10.1111/j.1547-5069.2011.01430.x Olson, L. (2010). Provision Six. In Guide to the Code of Ethics for Nurses (p. 72). Silver Spring , Maryland: nursesbooks.org.
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