Ethical Considerations in Health Care: Patient Care and Professionalism

Ethical Considerations in Health Care [WLOs: 1, 2] [CLOs: 1,
3, 5, 6]
Prior to beginning work on this discussion forum, read Chapters
10 and 11 in our textbook along with the instructor guidance.
Additionally, review the following: A Brief History of
Environmental Bioethics (Links to an external site.).
Medical ethics encompasses many situations. In this discussion,
you will explore one of the following ethical issues related to
the health care industry.
Below is the ethical issue you are assigned to complete in your
initial post.
Patient Care - neglect, disrespectful behaviors, lack of cultural
competence, failure to recognize or support patient autonomy,
biased care provisions, withholding pain management measures,
causing patient harm through intentional or unintentional
actions, etcetera.
· First letter of last name: A, E, J, M, Q, R
Professionalism - impaired worker, covering up mistakes,
practicing defensive medicine to avoid a malpractice lawsuit,
breaching patient confidentiality, cherry-picking patients (e.g.,
refusing to provide care to patients who have health conditions
that make the outcomes of procedures more challenging for the
doctor, such as obesity, diabetes, hypertension, or
cardiovascular conditions).
· First letter of last name: B, F, I, N, S, W
Financial - fraudulent billing practices, dropping insurers due to
low reimbursements or extended repayment periods, financial
kickbacks from pharmaceutical or assistive devices
manufacturers, prescribing or withholding treatments to meet an
organization’s budget.
· First letter of last name: C, G, K, O, T, Z, Y
Environmental Ethics - health care’s contribution to climate
change; improper disposal of waste materials causing air, water,
and soil pollution; lack of protection of the local and global

environment through improper use of materials.
· First letter of last name: D, H, L, P, U, V, Z
In your initial post, address the following:
· Create a brief example illustrating unethical behavior as it
relates to your assigned topic. The example can be either a
fictitious scenario or based on a real-world event.
· Discuss the steps you would take if you witnessed the
unethical behavior discussed above in your workplace.
· Explain the steps you would take if you were asked to
participate in the unethical practice addressed above.
· Describe how an organization’s strategic plan can address
unethical behaviors as it relates to your assigned topic.
Your initial post must be at least 250 words and must use a
minimum of two credible sources to support your discussion
content. The supporting resources can be the textbook as well as
the required or recommended resources provided in this course,
the University of Arizona Global Campus Library, or credible
websites.
The Scholarly, Peer-Reviewed, and Other Credible
Sources (Links to an external site.) table offers additional
guidance on appropriate source types. All referenced materials
must include citations and references in APA format. Please see
directions for including APA Style elements on these Writing
Center pages: APA: Citing Within Your Paper (Links to an
external site.) and APA: Formatting Your References
List (Links to an external site.).
Required Resources
Text
Spath, P. L., Abraham, S. C., & Mishek, J. H. (2022). Strategic
management for healthcare organizations (2nd ed.). Zovio.
· Chapter 10: Summary, Evaluation, and Benefits of the
Strategic Formulation Process
· Chapter 11: Ethics and Corporate Responsibility

· The full-text version of this ebook is available through the
Constellation suite accessed through your online classroom,
mobile app, or the Constellation (Links to an external
site.)Chapter 10 discusses generating a strategy and improving
existing strategies; and Chapter 11 discusses ethical behaviors,
ethical dilemmas and coping approaches, and corporate
responsibility for ethical behaviors. These chapters will assist
you in your Ethical Considerations in Health Care discussion,
the Week 5 Quiz, and the Organizational Evaluation final paper
this week.
Student Name: IWALOYE OLUSEYI.O
date: 10/11/2020
Client’s Medical Diagnosis: ACUTE PAIN DUE TO PAINS IN
THE JOINTS
STUDENT
INSTRUCTIONS:
In the space below, enter the subjective and objective data
gathered during your client assessment.
A
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Subjective Data Entry
Pain 5/10 in her joints. States that’s she hurts so much.
She cannot move from her bed to the chair.
Patient is moaning and crying.
“Patient states that the pain is severe”
Objective Data Entry

Vital signs:
BP 128/82
PULSE 78, apical
Respirations 16
Temperature 97.3
Need assistance with personal care, needs help to be moved
from the bed to the wheelchair. contusion of scalp.
TIME OUT!
Student Instructions: To be sure your client diagnostic
statement written below is accurate you need to review the
defining characteristics and related factors associated with the
nursing diagnosis and see how your client data match. Do you
have an accurate match or are additional data required, or does
another nursing diagnosis need to be investigated?
D
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CLIENT DIAGNOSTIC STATEMENT:
Nursing Diagnosis (per NANDA): Acute pain related to physical
mobility, bone deformities, and joint degeneration as evidenced
by reports of pain/discomfort, fatigue.
Definition of NANDA Dx: Un pleasant sensory and emotional
experience associated with actual or potential tissue damage, or

described in terms of such damage (international Association
for the study of pain); sudden or slow onset of any intensity
from mild to severe with an anticipated or predictable end, and
with a duration of less than 3 months.
Defining Characteristics of NANDA Dx:
Patient reports pain, guarding behavior, protecting body part,
facial mask of pain.
Reference: Denise Sullivan, MSN, ANP-BC and Maureen f.
Cooney, DPN, FNP-BC
_____________________________________________________
_____________________________________________________
_____
Related to Acute pain related to physical mobility, bone
deformities, and joint
degeneration.__________________________________________
_____________________________________________________
_____
As Evidenced By Reports of pain/discomfort, guarding body
part and facial mask of
pain._________________________________________________
_____________________________________________________
_________
P
L
A
N

N
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G
TIME OUT!
The desired outcome must meet criteria to be accurate. The
outcome must be specific, realistic, measurable, and include a
time frame fcompletion. Does the action verb describe the
client’s behavior to be evaluated? Can the outcome be used in
the evaluation step of the nursing process to measure the
client’s response to the nursing interventions listed below?
Short-Term Goal #1: Patient will report relieved/controlled pain
on a scale of less than 2 in 24hours.
Interventions for Goal 1:
Rationales for Interventions:
1. Consider reports of pain, noting location and intensity (scale
of 0-10). Note precipitation factors and non-verbal pain cue.
Favorable in determining pain management needs and
effectiveness of the program.
Patient may report pain in the fingers, hips, knees, lower lumber
spine, and cervical vertebrae. Pain is usually provoked by
activity and relieved by rest; joint pain and aching may also be
present when the patient is at rest.
Pain may manifest as an ache, progressing to sharp pain when
the affected area is brought to full weight-bearing or a full
range of motion (ROM). The patient may experience sharp,
painful muscle spasms and paresthesias.

Reference: Ackley, B.J., Ladwig, G.B., Msn, R.N., Makic,
M.B.F., Martinez-Kratz, M., & Zanotti, M. (2019). Nursing
Diagnosis Handbook E-Book: An Evidence-Based Guide to
planning care. Mosby
2. Recommend or provide a firm mattress or bed-board, small
pillow. Elevate linens with bed cradle as needed.
Soft and sagging mattress, large pillows prevent maintenance of
proper body alignment, placing stress on affected joints.
Elevation of bed linens reduces pressure on inflamed or painful
joints.
Flexion of the joints may reduce muscle spasms and other
discomforts.
Decreases pressure on fragile tissues to reduce risks of
immobility and development of decubitus.
3.suggest patient assume a position of comfort while in bed or
sitting in a chair. Promote bed rest as indicated. Place and
monitor use of pillows, sandbags, trochanter rolls, splints,
braces. Use adaptive equipment (such as cane, walker) as
indicated.
In severe disease or acute exacerbation, total bedrest may be
necessary (until objective and subjective improvements are
noted) to limit pain or injury to joint.
These aids assist in ambulation and reduce joint stress.
Relieves pressure on tissues and promotes circulation.
Facilitates self care and patient’s independence. Proper transfer

techniques prevent shearing abrasions of the skin.
Rests painful joints and maintains a neutral position.
Note: use of splints can decrease pain and may reduce damage
to the joint; however, prolonged inactivity can result in loss of
joint mobility and function.
Promotes joint stability (reducing risk of injury) and maintains
proper joint position and body alignment, minimizing
contractures.
Short-Term Goal #2: In 2 days, patient will appear relaxed, able
to sleep/rest and participate in activities appropriately.
Interventions for Goal 2:
1. Encourage frequent changes of position every 2 to 4 four
hours. Assist the patient to move in bed, supporting affected
joints above and below, avoiding jerky movements.
Prevents general fatigue and joint stiffness. Stabilizes joint,
decreasing joint movement and associated pain.
Muscle spasms may result from poor body alignment, resulting
in increased discomfort.

2. Monitor the duration, not the intensity, of morning stiffness.
Duration more accurately reflects the disease’s severity.
The patient may find coping with a progressive, debilitating
disease difficult.
3. Provide gentle massage.
Promotes relaxation and reduces muscle tension.
Long-Term Goal #1: on a daily basis, patient will incorporate
relaxation skills and diversional activities into the pain control

program.
Interventions for Long-Term Goal 1:
1. Encourage the use of stress management technique such as
progressive relaxation and feedback, visualization, guided
imagery, self-hypnosis, and controlled breathing. Provide
Therapeutic Touch.
Promotes relaxation, provides a sense of control and may
enhance coping abilities.
2. Involve in diversional activities appropriate for individual
situation.
Refocuses attention, provides stimulation and enhance self-
esteem and feelings of general well-being.
3. Medicate before planned activities and exercises as indicated.
Promotes relaxation, reduces muscle tension and muscle
spasms, facilitating participation in therapy.

Exercise is necessary to maintain joint mobility, but patients
may be reluctant to participate in exercise if they are in too
much pain.
E
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TIME OUT!
Do your interventions assist in achieving the desired outcome?
Do your interventions address further monitoring of the client’s
response to your interventions and to the achievement of the
desired outcome? Are qualifiers: when, how, amount, time, and
frequency used? Is the focus of the action’s verb on the nurse’s

actions and not on the client? Do your rationales provide
sufficient reason and directions?
What was your client’s response to the interventions?
The patient responded appropriately to the interventions.
Was the desired outcome achieved? If no, what revisions to
either the desired outcome or interventions would you make?
Goal 1: Met
Give supporting data: Patient described satisfactory pain control
at a level less than 1 to 2 on a rating scale of 0/10 pain 8hours
after she was placed on a firm mattress.
Goal 2: Met
Give supporting data: Changing of position helped the patient
stabilizes joint, decreasing joint movement and associated pain.
Goal 3: Met
Give supporting data: Patient displays improved well -being
such as baseline levels for pulse, BP, respirations, and relaxed
muscle tone/body posture.
If any of your goals were “Not Met” or “Partially Met” explain
why:_________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
____________________________
In your opinion, how could your plan of care be revised or
improved to help the patient achieve a better outcome?

D
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Documentation Focus: Now that you have completed the
evaluation, the next step is to document your care and the
client’s response. Document all of your interventions,
including the time and date that the intervention was performed,
in your nurse notes. Be sure to include your patient’s response
to the intervention.
Reassessment Data:
Pain 0 out 10
Relaxation and mobility
Relieve morning stiffness

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