Weekly Assignment

As the manager, what would you advise Michelle to do? What about the resident?

 As a manager, I would advise Michelle to calmly ask Greg ( patient) why he is against the nurse drawing the blood culture. Greg could have had reasons why he was against the nurse drawing the blood culture. Firstly, maybe Greg had had an unpleasant experience while the nurse initially drew a blood culture during his leukaemia treatment that subjected him to excessive pain. Also, Greg could have refused a blood culture because his health has deteriorated and perhaps thinks that further tests at Alaska Rural Health Services will not help. He could also be distressed because his previous experience at the hospital was unpleasant, and he is not ready to face the same with Michelle.

 I would also advise Michelle to offer Greg patient education. Patient education will involve informing Greg of the importance of drawing a culture to his health. A blood culture test will help the nurses find if Greg has bacteremia or any other life-threatening condition deteriorating his health. Also, it could help the nurses to determine the kind of treatment to administer to Greg. Patient education could also help Greg to understand the consequences of not taking the prescribed medication.

To the resident

I would advise the resident to refer to the ethical codes. The physician is breaking the professional ethical codes of a physician as outlined by the American medical association (Riddick, 2003). Firstly, the physician is displaying unprofessional behaviour by shouting at Michelle instead of collaborating with her to design Greg’s best care plan.

 I would advise the resident to respect the patient’s rights. The patient has a right to free consent and should not be forced to take certain medications without their consent.

I  also would advise the resident to respect other health professionals. The resident shouted and yelled at Michelle to forcefully draw blood culture from Greg, which is unprofessional. Instead, the resident should collaborate with Michelle and explain the importance of drawing a blood culture to Greg.

Are there other issues at play? Are there issues of diversity, communication, or power being demonstrated in this scenario?

 The scenario addresses several issues. Firstly, there might be an issue of communication breakdown between Michelle and the resident. After Michelle informs the resident that Greg has refused a blood culture, the resident shouts at Michelle to perform his job without the patient’s free consent. The resident could have taken his time to understand the issue and collaborate with Michelle to devise a suitable care plan for Greg, whose health has deteriorated.

Also, unethical issues are evident in the case. The resident acts unprofessionally after Michelle consults him. He raises his voice and yells at Michelle to draw a blood culture against Greg’s will. As a physician, the resident should respect the patients’ rights and avoid acting forcefully against their will.

Diversity issues are also evident in the case. The resident fails to recognize that patients are diverse, and each requires person-centred care to be provided without judgements. The resident should be mindful of his language and understand why Greg refuses a blood culture without judging him. The resident says,” I do not care what he says,” which illustrates that he is judgmental and unconcerned about Greg’s feelings.

 The issue of autonomy is also evident in the scenario. Patients should be granted the right to be free-spirited and act based on their values and interests. The resident would have respected Greg’s actions in refusing a blood culture, and instead of forcing Michelle to draw the blood culture forcefully, he should explain calmly to the patient why it was necessary for his treatment. Also, patient’s
What are your recommendations for addressing this issue? Substantiate your recommendations using appropriate substantive support and literature.

The issue addressed in the scenario is the patient’s defiance of the recommended treatment. Greg refuses the nurse to draw a blood culture, and she is forced to seek assistance from the resident and the manager at the hospital. The issue of defiance to medication is common among children, especially those suffering from terminal illnesses. In children, defiance to treatment is called oppositional defiant disorder(ODD), usually associated with issues with the self-control of emotions and behaviours (Matthys & Lochman, 2017). Patients decline medication due to various reasons such as lack of enough information concerning the treatment and fear that the treatment may fail to work. When this occurs, I recommend several tips to encounter defiance to treatment.

Firstly, the patient should be educated on the outcomes of noncompliance with medication. Educating the patient enables him/her to understand the negative outcomes that may arise when they continue neglecting the medication. For example, cataract patients should be educated on using non-steroidal inflammatory drugs to prevent oedema (Smick et al., 2007). In this case, Greg can be informed that a blood culture will enable Michelle and other health practitioners to identify the best care plan to administer to him. Patient education enables the nurses and other staff involved in the treatment to be on the same page on ensuring the patient are informed on the procedures of care meant to enhance their speedy recovery.

Moreover, the patients can be provided with standardized instructions on how the nurses will undertake a blood culture. Treatment instructions help a patient fully understand how the treatment will be undertaken and make inquiries in case of any clarifications. The treatment is further undertaken with the patient consent as they clearly understand the importance of the treatment.

References

Matthys, W., & Lochman, J. (2017). Oppositional defiant disorder and conduct disorder in childhood. Wiley Blackwell.

Riddick, F. (2003). The Code of Medical Ethics of the American Medical Association. The Ochsner Journal, 5(2), 6-10. Retrieved 26 April 2022, from.

Smick, K., Ficco, C., & Ga, A. (2007). Solve Compliance Defiance. Optometricmanagement.com. Retrieved 26 April 2022, from https://www.optometricmanagement.com/issues/2007/march-2007/solve-compliance-defiance.