Ethical concerns

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 A 47-year-old man with Ulcerative Colitis has been admitted to the emergency room with an extreme abdominal pain.  He explains that he has not taken his medications for the last few months and does not have any medical or prescription insurance. 

A 47-year-old man with Ulcerative Colitis has been admitted to the emergency room with an extreme abdominal pain.  He explains that he has not taken his medications for the last few months and does not have any medical or prescription insurance.

1. What necessary information would need to be obtained about the patient through health assessments and diagnostic tests?

2. Consider how you would respond as an advanced practice nurse. Review evidence-based practice guidelines and ethical considerations applicable to the scenarios you selected.

 Write a detailed one-page narrative (not a formal paper) explaining the health assessment information required for a diagnosis of your selected patient (include the scenario number). Explain how you would respond to the scenario as an advanced practice nurse using evidence-based practice guidelines and applying ethical considerations. Justify your response using at least three different references from current evidence-based literature.

RUBRIC FOR GRADING

Write a detailed 1-page narrative (not a formal paper) addressing the following:·  Explain the health assessment information required for a diagnosis of your selected patient (include the scenario number). The response clearly, accurately, and thoroughly explains detailed health assessment information required to diagnose the selected patient, with correct scenario number included.

Explain how you would respond to the scenario as an advanced practice nurse using evidence-based practice guidelines and applying ethical considerations. Justify your response using at least three different references from current evidence-based literature. The response clearly, accurately, and thoroughly explains detailed evidence-based practice guidelines and ethical considerations applied by an advanced practice nurse in responding to the scenario, with clear, accurate, and thorough justification using three or more different references from current evidence-based literature.

Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria. Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.

Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation. Uses correct grammar, spelling, and punctuation with no errors.

Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list. Uses correct APA format with no errors.

Ethics Week 11

Sara Moss

Walden University

NURS 6512

Dr. Delgado

February 09, 2023

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Introduction

This case is a 47-year-old man with Ulcerative Colitis has been admitted to the

emergency room with an extreme abdominal pain. He explains that he has not taken

his medications for the last few months and does not have any medical or prescription

insurance. There is a lot of information left out of this case that would be beneficial to

know. Proper information can help develop the best care possible for the individual

patient. Understanding histories, cultures, and reasons why decision are being made

can help a professional guide a patient to a better outcome, as well as develop a better

collaboration (Back et al., 2020).

Questions

For this patient I would want to know how he culturally identifies. I would want to know

his medical history, and how long he has been diagnosed with colitis. I would want to know the

patient’s diet, lifestyle, substance consumption, support, and history of disease processes.

Understanding the patient’s culture could help understand the patient’s beliefs with the healthcare

system, diet, and how the patient may believe in treatment. The medical history, diet, and

background social history are obvious in understanding what factors may be contributing or not,

and if there are any co-morbid factors with the colitis. Understanding the length of the diagnosis

can also provide insight into potential cellular changes, length of medication, and other factors

(Ball et al., 2019).

I would want to understand what prompted the patient to stop the medication. If it was a

financial thing understanding how we can better address that or find a medication the patient can

afford. If it is another reason finding out if education, or supplements, or working with the

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patient to identify the best care and understanding. Maybe the diagnosis is new, the patient

started feeling better and simply quit because he was unaware of the long-term need. I would

like to know when the medical insurance quit and why. Maybe the two started simultaneously

which would again allow to address financial concerns. Possibly the patient is in between jobs

or chose not to have health insurance. Working with the patient to overcome financial burden is

important.

Addressing the situation

Responding to the patient openly is extremely important. It is important to understand

that patient care involves dealing with a human and an individual. Despite that each human may

have the exact same medical diagnosis, not each human should be treated identically. So

humanizing the patient and provided patient centered care by proper interview techniques and

managing the patient with treatments that work for the patient and the disease process, getting

the patient’s buy-in, and making adjustments to yourself as a professional to have that

collaborative relationship (Vaeza et al., 2020).

Financial concerns are usually one of the most driving factors in healthcare. Healthcare

in the United States is expensive and affording healthcare even with private insurance can be

difficult for patients. Patients, like this one, that may have just lost their health insurance for

whatever reason, may no longer be able to afford prescriptions. Addressing this issue by

identifying the best low-cost generic prescription options would be important. Helping the

patient identify resources for financial help, insurance, and lower cost care is important (Teisberg

et al., 2020).

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Effective communication is highly important. Respectful and effective communication

can help drive a good relationship with a patient that can create opportunities for situations to

improve their health. Maybe this patient is not ready for this diagnosis, maybe this patient wants

to try home treatment, maybe the patient is not well educated on the diagnosis, or maybe the

patient does not care currently to be chronically treated. Meeting the patient where they are at

and providing educational opportunities in a non-judgmental fashion will allow the patient to

process the situation and feel comfortable when questions arise. Leaving the door open and

being respectful can drastically benefit the relationship with the patient (Varkey, 2021).

Conclusion

With every patient interaction it is important to provide the patient with a thorough

assessment, diagnosis, and understanding. Integrating the patient’s personal, cultural, and

religious beliefs into their care can be tricky, but it is a job of a provider to do that while keeping

a trusting relationship. Constant reminder of the fact the care is a partnership is important when

communicating with a patient. There are a variety of reasons a patient may choose not to

medicate, or have insurance, and maybe it is not a choice. Helping the patient navigate those

situations and being a place of trust and transparency will go a long way.

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References

Back, A., Tulsky, J. A., & Arnold, R. M. (2020). Communication skills in the age of COVID-

19. Annals of internal medicine, 172(11), 759-760. https://doi.org/10.7326/M20-1376

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to

physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier

Mosby.

Teisberg, E., Wallace, S., & O’Hara, S. (2020). Defining and implementing value-based health

care: a strategic framework. Academic Medicine, 95(5), 682.

https://doi.org/10.1097/ACM. 0000000000003122

Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical

Principles and Practice, 30(1), 17-28. https://doi.org/10.1159/000509119

Vaeza, N. N., Delgado, M. C. M., & La Calle, G. H. (2020). Humanizing intensive care: toward a

human-centered care ICU model. Critical Care Medicine, 48(3), 385-390.

https://doi.org/10.1097/CCM. 0000000000004191

Tuddenham, S., Hamill, M. M., & Ghanem, K. G. (2022). Diagnosis and treatment of sexually

transmitted infections: a review. Jama, 327(2), 161-172.

https://doi.org/10.1001/jama.2021.23487

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