Trying to be heard free essay sample

?The ethical problem in this case involves Joanna’s concerns with the patient complaint of abdominal pain going unaddressed. Despite the vital signs being within normal limits and no significant changes in readings, Joanna’s report of abdominal pain to the medical resident twice and the nurse supervisor’s went ignored. I believe that Joanna followed the nursing standards of practice; however, the case study does not give a lot of information into her assessment. One of the signs of abdominal aortic aneurysm is a pulsating bulge or a strong pulse in the abdomen. Joanna could have assessed the patient for this sign and symptom by assessing for a bulge in the abdomen or listening with a stethoscope for a loud pulse. Joanna could have also further investigated the location of pain. Was Mrs. Kelly exhibiting any back or flank pain? Lastly, I believe Joanna should have assessed for nausea or vomiting. We will write a custom essay sample on Trying to be heard or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page The institutional and professional constraints in this case involve communication between Joanna and the nurse supervisors and the medical resident. In the Journal Article â€Å"Can we Talk? † Miller (2013) discusses â€Å"Communication Principle #3: Know what you are talking about before you start talking† (p. 194). What this means is â€Å"You have got to be very familiar with the subject in order to have a good discussion when questions or conflicts arise† (Miller 2013, p. 194). I can understand why Joanna was brushed off by the medical resident and nurse supervisor. With vital signs within normal limits and a complaint of abdominal pain that could mean many issues and not necessarily life threatening. If Joanna would have approached the medical resident and nurse supervisor with a more thorough assessment as discussed above maybe the outcome would have been different. Professionally Joanna did what she could under her scope of practice. Under the circumstances presented in the case study, Joanna could have contacted the physician on call, described the situation and request an order for a computed tomography (CT) scan. A CT scan provides greater detail of the vital organs, blood vessels and other structures in the body. A CT scan could have detected the abdominal aortic aneurism. Joanna’s reactions resemble moral distress. Burkhardt and Nathaniel (2008) describe moral distress when â€Å"one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action† (p. 170). Joanna contacted the medical resident on two occasions and spoke with both her evening supervisor and the supervisor coming on to the morning shift. Joanna was ignored by all three parties. Joanna was aware of the moral problem, acknowledged her responsibility and made a judgment of the best action. Due to having to adhere to her scope of practice, she was constrained from taking the right action. Lastly, Joanna exhibited some of the physical reactions to moral distress which included â€Å"weeping, grief and sadness† (Burkhardt and Nathaniel 2008, p. 17). In reading an article â€Å"Understanding and Addressing Moral Distress† Epstein and Delgado (2010) provide great examples on how to deal with issues of moral distress in the workplace. I understand some of these steps would be a great start for Joanna to incorporate into her practice to prevent a similar situation happening in the future. These steps are â€Å"Speak up! Identify the problem, gather the facts, and voice your opinion. Be deliberate, know whom you need to speak with and know what you need to speak about. Focus on changes in the work environment, focusing on the work environment will be more productive than focusing on an individual patient. Remember, similar problems tend to occur over and over. It’s not usually the patient, but the system, that needs to change. Be accountable, sometimes, our actions are not quite right. Be ready to accept the consequences, should things not turn out the way you had planned† (Epstein Delgado 2010, para. 21).