Case Scenario: NURSING SCENARIO
During an evening shift, a patient with a potential diagnosis of avian flu is admitted to an acute medical unit in a large urban hospital. The emergency department nurse who facilitates this transfer indicates that they have been alerted to expect other suspected cases. The man is admitted and placed in isolation. Little information is available concerning his diagnosis, and the staff is concerned for their own safety and the safety of other patients. The unit manager has been involved in planning for such an event, but none of the staff on duty have received any education or information related to a suspected flu outbreak. The evening supervisor is called in to assist.
Ellie, a registered nurse (RN), is assigned to care for the patient. Ellie works part-time on the unit. She is a single parent of two school-aged children. Ellie also works as a casual employee in home care, which provides her with more flexible working hours and extra income. Currently, she does not work weekends, as child care is not available. Ellie is concerned about her health, the health of her children, and the implications that an outbreak will have on her work schedule. This evening, the unit is short-staffed and morale is low: one full-time RN called in sick, and again no replacement casual RNs were available. The unit manager has indicated that the unit is over budget for staff hours, and that staff must minimize their use of supplies to balance the budget. Moreover, overall reductions in the healthcare budget have resulted in bed closures throughout the hospital, and a consistent backlog of patients awaits placement in the Emergency Department. This case illustrates that health-care workers will confront situations where harm may come to them
- Is Ellie putting herself at risk by working in a facility with patients infected with influenza virus or other infectious diseases?
- Is Ellie putting her family at risk?
- Can Ellie trust that all measures will be taken to ensure her safety at work?
- Does Ellie have access to resources and information to address any questions or concerns that she may have regarding the risks she may face?
What values are at stake?
This case highlights the duty to provide care, stewardship, solidarity, reciprocity, trust/fidelity and accountability. Other values that could be considered include: evidence, equality/equity, social responsibility, liberty, and freedom.