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Nurse's Ethical Dilema Essay

991 words - 4 pages

In this paper, I will discuss the ethical dilemma faced by a nurse who is caring for an eight month old patient, who reports with his mother to the emergency room with a suspicious fracture. The mother provides a plausible story, and the physician knows the family and does not suspect abuse. I will discuss the action I would take in order to provide the appropriate care for this patient.
As a registered professional nurse, I feel the only approach to the case is to report the injury to Department of Family and Child’s Services (DFACS) for their investigation. When a report is made, DFACS will complete an investigation and make the ultimate decision if abuse or neglect was the cause of ...view middle of the document...

Three indicators of abuse or maltreatment include physical, child behavioral and parent behavioral indicators (Henderson, 2013). These indicators should not be considered in isolation but should be considered along with the child’s condition in the context with overall physical appearance and behavior; however, it is conceivable that a single indicator may be consistent with abuse or neglect (Henderson, 2013). Considerations of abuse are raised by injuries to both sides of the body and/or to soft tissues, injuries with a specific pattern or injuries that do not fit the explanation, delays in presentation for care, and/or untreated injuries in multiple stages of healing (Henderson, 2013).
It would be helpful to check the patient’s record for previous unexplained injuries or history of frequent visits to the emergency room or physician’s office. Any burns or patterns of bruising during the examination would warrant further investigation. Other signs of physical abuse I would monitor for include signs of pain where there is not visible injury and lack of reaction to pain. I would also note any emotional signs of physical abuse, which include passive, withdrawn or emotionless behavior, and fear when seeing parents. Any symptoms noted on exam should include this in the report to DFACS. Since the physical signs of abuse are often visible, most cases of abuse are recognized by a healthcare provider (Padera, 2009). These signs may be noted at routine appointments or while providing acute care.
The ethical principle of non-maleficence and beneficence are addressed with this case. The ethical principle of non-maleficence helps to ensure that healthcare providers do not harm to their patients. If I did not report this case to DFACS for investigation and the abuse continued causing any harm to the patient, this would be an ethical violation of non-maleficence on the part of the nurse. The ethical principle of beneficence ensures...

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