Florence Nightingale once said, “apprehension, uncertainty, waiting, expectation, fear of surprise, do a patient more harm than any exertion.” Nurses face ethical dilemmas daily while caring for patients and patients’ families, and while working in a multidisciplinary environment. Many ethical dilemmas faced by a nurse are often difficult to resolve, which often times, leads nurses to withhold care due to the conflicting values of self, of patients’ values, and employers values and expectations of its employees. It is of the essence that nurses recognize this dilemma and resolve it without delay to preclude compromise of patient’s care and wellbeing. But this is not always an easy fix as in the case study of nurse PT and her ethical dilemma during the H1N1 pandemic in Ontario (CNA, August 2008)
Ontarians had one thing on their minds back in April 2009....the influenza A virus subtype H1N1, or swine flu. On June 11, 2009, the World Health Organization (WHO) affirmed a global pandemic, with over 8000 confirmed cases in Ontario alone, and 95 confirmed deaths by November 26, 2009 (Wikipedia, 2011). A pandemic is an astonishing event that sometimes compels nurses to go above and beyond their duty to provide care to their ailing patients. With their duty to provide care, many nurses were faced with grappling ethical dilemmas, as in the case of nurse PT who was ambivalent between her need to work for financial means, her accountability to her patient and employer, and her uncertainties that she may become infected and will than transmit the disease to her children.
Nurse PT cared for many patients infected with the H1N1 virus, but most memorable was a four year old girl name CR. CR was brought to the ER by her parents in July 2009. CR was very sick and had a fever of 41.3C, vomiting, diarrhea, sore throat, headache, low blood pressure, pallor skin tone, and shortness of breath. CR was admitted and intervention was applied quickly, such as administering the antiviral medication called Tamiflu and had a complete blood count (CBC) done. When the blood test came back, it confirmed CR was infected with the H1N1 virus. CR continued her medication therapy and was isolated in her own room.
During the care of CR, nurse PT noticed CR’s mother also looking very sickly. She was coughing and had difficulty breathing. Nurse PT asked CR’s mother if is she is feeling ok? CR’s mother expressed to nurse PT that she has a cough, has muscle aches, and is having difficult time breathing. The mother also told nurse PT she has an autoimmune disease called Lupus, in which her body’s immune system attacks her body tissues. After assessing her vitals, nurse PT confirmed the mother indeed was sick and had the same symptoms as her daughter. The mother was admitted, was placed in isolation, had a CBC test done, which later confirmed the diagnosis of H1N1, and was given antiviral therapy. Within 24 hours, both mother and daughter’s health deteriorated drastically. The mother...