Nursing - Mavis Case Study - Surgical Ward - Essay

Case study:
It is a busy morning on the surgical ward and one of the patients, Mavis, a 70-year-old retired nurse, has undergone a laparotomy for an acute bowel obstruction. She is the first-day post-op and her recovery so far has been uneventful with all vital signs being within normal limits. This morning, however, her vital signs have altered somewhat; her heart rate has increased to 92bpm, her blood pressure has decreased to 105/70; her temperature is 38.0 C, although she looks a little pale. She has not passed urine for nine hours although she has an IV infusion in situ. When you attend Mavis to take her vital signs, she seems quite confused, disorientated and anxious. Her condition is markedly different from the last time you attended to her, less than an hour ago when she seemed fine. Mavis informs you that she wishes to go home, as she is due to start work. She becomes frustrated and tells you aggressively to go away. You review her medication to determine if she has been given drugs that may have affected her behaviour and report your findings to the shift coordinator; then return to Mavis. Mavis, however, is not in her room andyou locate her in the visitors room. As you approach Mavis, you see her gown is open (and back to front), she has removed the dressing from her wound site, and is smearing faeces across her
abdomen and onto her surgical wound. Additionally, she has pulled out her IV cannula and is bleeding from the insertion site. You immediately close the door to give her privacy and attempt to cover her, with the intention of guiding her to the bathroom to attend to her hygiene needs, informing her that you need to help her to wash. Mavis refuses any assistance and states, I dont want a wash. You try to encourage her to accompany you to the bathroom but, she yells leave me alone and go away, dont touch me, I need to get home, or I will be late for work.

Assessment brief
The assessment brief is structured under the same headings as the marking rubric, please consider both documents carefully as you construct your essay.

Content
You need to consider:

• The legal and ethical concerns that the situation in the case study raises.
• The possible actions or inactions that could be taken and the implications of those actions.

You do not need to provide the right answers, what you will be assessed on is your ability to determine the implications of different actions or inactions from a legal and ethical perspective. Firstly, think of the possible courses of action (or inaction) that could be taken and then consider, do any ethical theories support (or not) the actions that you discuss? Which ethical principles, doctrines or concepts apply to the actions/inactions put forward and if so, how? Do any of the ethical principles conflict with each other or with the law? Which torts or other legal concerns apply to your suggested actions/inactions? Consider the Code of Conduct, Code of Ethics and RN Standards of Practice (2016), how do they apply to this situation?

Structure
Here you will be assessed on your ability to form a logical piece of work that contains an introduction, which should inform the reader of the main content of the essay. The main body of the essay should contain a logical and cohesive development of ideas and your ability to sustain logical arguments.

Application of critical thinking

You will be assessed on your ability to consider the implications of the suggested actions/inactions and the application of theory to practice. You will also be assessed on your ability to support the arguments you put forward with evidence from appropriate literature.

Assessment Guide for Essay

You must comply with the IHM assessment writing guidelines, follow these specific assessment instructions and use the IHM referencing guide to ensure all in-text and end-text references are correct.
There is no excuse for deviating from these guidelines as they are available through several links. If you are unsure about referencing, see your lecturer early in the course.