Ethical Dilemma in Nursing Practice Individual Occupational Therapy Assignment

Assignment Task

Autonomy

Mr Wong had admission to Coronary Care Unit following multiple discharges for repeated concerns of angina with a normal electrocardiogram (ECG) and blood test. This admission the treatment plan included a basic blood test, Electrocardiogram and continuous heart monitoring. Chest X-ray, Computerised tomography (CT scan), and Coronary catheterisation (angiogram) was also part of the investigation. The patient had a good night sleep, and the next day doctors informed their plan of care to Mr Wong. Mr Wong was familiar with all the test due to repeated admissions which provided negative results prompting for early discharge. However, this admission the plan was for coronary angiography as it has a pivotal role in the assessment of a patient's Coronary Heart Disease (CHD). Angiogram is the gold standard test for ruling out CHD and carries small but definite mortality (1 in 1400). Mr Wong was not happy with the suggestion despite being informed of the potential consequences he refused to proceed for an angiogram, as he does not prefer invasive surgical intervention. This displeases June who is the allocated nurse for the morning shift. June sees Mr Wong's son Mr Chen visiting his father. For the benefit of Mr Wong, June contacts Mr Chen and tells him the suggestions of the team, the proposed treatment plan and Mr Wong’s refusal to the plan. Mr Chen does not make any comment during the day regarding his father's plan; therefore, it becomes evident to June that he does not understand the consequence to his father's decision either. June’s shift ends for the day, and she remains restless because she did not get enough time to render additional information or educate both the father and the son together. Consequently, June seeks help from a colleague she sees over the corridor walking towards the ward. She mentions regarding Mr Wong 's refusal for an angiogram, further states how illiterate he is being unaware of the benefits of angiogram and lacks insight in regards with his health condition. This conversation was overheard by a passer (visitor to patient) makes a complaint to the charge nurse.

Later this example was used for educational purposes making known the consequences of privacy breach, ethical principle, values, code of conduct, legislation when dealing with ethical dilemmas during their clinical practice by the consent of June.

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