Ethics

Question 1

Burnout

Answer 1

• Acknowledge the Issue: Recognize the seriousness of the nurse’s complaint. Aggression in the workplace, especially in critical care settings, can affect team dynamics and patient safety.
• Assess the Resident: Understand the context of the behavior. Determine if it’s an isolated incident or part of a pattern. Evaluate for signs of burnout, stress, or other personal issues.
• Provide Support: Offer resources for mental health and stress management. This could include counseling services, peer support, or wellness programs.
• Educate About Burnout: Discuss the symptoms and consequences of burnout. Emphasize the importance of self-care and seeking help when needed.
• Foster a Supportive Environment: Encourage open communication and a non-punitive culture where staff feel safe to express concerns and seek help.
• Mentorship and Supervision: Ensure the resident has adequate mentorship and supervision. Regular feedback and support are crucial in training programs.
• Review Workload and Responsibilities: Assess if workload is contributing to stress. Make adjustments if necessary to ensure a balanced workload.
• Develop Coping Strategies: Teach stress management techniques, such as mindfulness, time management, and setting professional boundaries.
• Address the Incident: Discuss the specific incident with the resident. Understand their perspective, provide constructive feedback, and discuss ways to handle similar situations in the future.
• Follow-Up: Monitor the resident’s progress and well-being. Regular check-ins to ensure they are utilizing available resources and coping effectively.

Question 2

End of life care

Answer 2

• Symptom management (pain, dyspnea, nausea)
• Emotional and psychological support
• Palliative sedation if needed
• Advance care planning discussions
• Family and caregiver support
• Respect for patient’s cultural and spiritual beliefs
• Hospice care referral
• Grief counseling for family and caregivers
• Ethical considerations (withdrawal of life-sustaining treatments)
• Legal aspects (living wills, healthcare proxy)

Question 3

Medical error

Answer 3

Addressing the Complication:
- Monitor for signs of potential complications
- Provide immediate treatment for any complications that arise.

Transparency with the Patient:
- Inform the patient about the medication error promptly.
- Explain the nature of the error, the potential risks, and the steps being taken to manage it.
- Apologize and maintain open, honest communication.

Debriefing with the Nurse:
- Approach the nurse in a non-judgmental, supportive manner.
- Discuss the error to understand how it occurred and how similar incidents can be prevented.
- Emphasize learning and improvement rather than blame.

Reporting and Sentinel Event Analysis:
- Report the incident as per hospital protocol, recognizing it as a potential sentinel event.
- Engage in a root cause analysis to understand systemic issues contributing to the error.

Preventative Measures:
- Review and reinforce medication administration protocols.
- Encourage a culture of safety where staff feel empowered to double-check and verify orders, especially with high-risk drugs.
- Consider system improvements such as clearer labeling, dose alerts, and ongoing staff education.