Critique ethical issues Assignment
Critique ethical issues Assignment
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Deliverable 3 Ethics in Triage.
Competency
Critique ethical issues in current nursing practice.
Scenario
You are the nurse manager of a small, four-bed emergency department. Your department received seven patients involved in a mass casualty shooting at a local grocery store two days ago. A brief overview of each client is provided below.
Pregnant female: 32-years-old, 36 weeks gestation. Presentation to the ED: alert and oriented x 3, respiratory rate at 25 breaths/minute, radial pulses palpable, complaining of abdominal pain after being trampled during the event. Triaged as green. Course of treatment in the ED: Extensive resources (human and non-human) were used to assess the fetus. Both the patient and fetus survived and were discharged 24 hours later.
Caucasian female: 45-year-old suspected shooter. Presentation to the ED: gunshot wound to the right chest, unconscious, shallow breathing at 8 breaths/minute, thready radial pulse. Triaged as red. Course of treatment in the ED: Patient was being aggressively treated, but argument ensued between staff members upon discovering that she was the suspected perpetrator. Care of her was abandoned upon arrival of other patients, and she did not survive.
Caucasian female: 52-years-old, HIV positive. Presentation to the ED: gunshot wound to the right leg, confused, respirations shallow at 40 breaths/minute, no palpable radial pulse. Triaged as red. Course of treatment in the ED: Aggressive treatment of the individual, including first access to the OR. She is stable and recovering in the ICU. Upon realization that this patient was HIV positive, there is much anxiety amongst the ED staff related to potential exposure with the large blood loss the patient experiences.
African American male: 45-year-old Iraqi war veteran, history of PTSD, allegedly shot the perpetrator. Presentation to the ED: No visible physical injuries, hyperventilating at 45 breaths/minute, light-headed, palpable pulse. Triaged as green. Course of treatment in the ED: Patient was observed by ED nursing staff for several hours and was released to police for questioning regarding the event.
Hispanic male child: 6 years-old. Presentation to the ED: gunshot wound to the abdomen, unconscious, no spontaneous respirations, radial pulse not palpable. Triaged as red. Course of treatment in the ED: Extensive treatment was provided, including bag-mask ventilation, intubation, wound care, cardiac monitoring, and blood transfusions. The patient did not survive.
Hispanic female: 29-years-old, mother to the 6 year-old patient. Presentation to the ED: open fracture to left leg, hysterically screaming for her child, climbing out of gurney, palpable radial pulse, respirations at 40 breaths per minute. Triaged as yellow. Course of treatment in the ED: Wound care and stabilization of fractured leg after administration of a sedative. She was the second patient to the OR. The client was kept separated from her child during the incident and was not informed of his death until the following day. She is stable and recovering on the medical/surgical unit.
Migrant Spanish-speaking male: age unknown, appears to be in his 50s. Presentation to the ED: lethargic, unable to communicate verbally due to language barrier, was pointing to and holding his head, laceration noted to the forehead, respirations at 30 breaths/minutes, palpable radial pulse. Triaged as green. Course of treatment in the ED: wound care to the laceration and monitored by nursing staff for several hours, at which time he suddenly became unresponsive. A CT scan revealed a subdural hematoma, and he is in a vegetative state. No attempts were made to find a Spanish-speaking individual to assist in assessing the confusion or pain when he was still conscious.
Instructions
The Chief Nursing Administrator of your facility has requested a post-action report focusing on the triaging and outcomes of these 7 patients. The post-action report should include:
An evaluation of the triaging of each patientWas the triaging appropriate or not, and what was the associated rationale? Use evidence/resources to support your evaluation.
Was there evidence that personal beliefs, values, and ethics affected the health care providers’ approach to triaging the patients?
An explanation of the treatment of each patient, and a judgement of whether or not the treatment was futile.
The outcome of each patient.How can the outcome be associated with the triage category, the provider’s personal ethics, and subsequent treatment provided?
Any corrective actions that will occur as a result of the event.Include ethical considerations in your corrective actions.
Resources
For assistance on fatality management, please visit the Emergency Preparedness page
For assistance on creating an after-action report, please visit please visit the Rasmussen College Answerspage
You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.
Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.
Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.
The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

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