7/27/2019 Ethical Aspect.docx Ncm 107

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Ethical Aspect

1.Summary: breaking confidentiality to a colleague

Rebecca Fein and Sarah Goldman were staff nurses on the night shift in a pediatric surgical unit.

One night, as they neared the completion of their work, Miss Fein noted that a 6y/o diabetic patient

recovering from minor surgery looked very pale and was perspiring. When she was unable to awaken

the patient, she notified her colleague and best friend, Miss Goldman, together they tested the patients

blood sugar. The child was extremely hypoglycaemic. She called the resident and assisted her in

stabilizing the patient. The child recovered and was discharged home two days later.

The next day, Miss Fein reviewed the incident, stating how surprised she was to find the child

hypoglycaemic. Miss Goldman finally admitted that it was her fault. She had mistakenly given the child

too much insulin. She had not gone back to check on the child and realized her mistake only when Miss

Fein found the child unresponsive.

Miss Fein was surprised and asked her friend and asked her friend whether she had completedan incident report or notified the childs physician afterward. Miss Goldman said she had decided not to

report the mistake because it would create an inquiry and undoubtedly make trouble for her. She was

being reviewed for promotion to the next step in the clinical ladder program of the nursing division and

feared that the incident would prevent her promotion and financial benefit it would bring. She asked

Miss Fein not to report it either as a friend, and that it would be unethical for her to do anything about

the mistake. After all, it was just a mistake, and the patient recovered.

2. The ethical principles that were violated are nonmaleficence and confidentiality. These involve the

drug error with respect to the diabetic child, it is clear that the patient suffered harm from Miss

Goldmans mistake. Miss Goldman uses their friendship as the basis for a duty to keep the informationin confidence. If the information doesnt keep in confidence, harm likely will occur to Miss Goldman.

Nurses have responsibility to safeguard patients from incompetent and unethical care provided by other

members of health care team. Conflicting loyalties are involved when mistakes that cause patient harm

are made by personal friends, but the obligation to protect patients from harm overrides any claims to

friendship between colleagues.

3. The nurses code of Ethics suggest that the nurse promotes, advocates for, and strives to protect the

health, safety, and rights of the patients. This provision in the nurses code of Ethics was being violated.

theres no reporting or charting was done about the medication error.