1. Jameton (1984) says that for nurses to be less than competent is unethical. Discuss this…

1.       Jameton
(1984) says that for nurses to be less than competent is unethical. Discuss
this statement in terms of fidelity.

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2.       Read
the following hypothetical case and answer the questions that follow: Nels
Gruder is a 40 year-old disabled truck driver. He was injured several years ago
in a trucking accident. He subsequently has had back surgery but continues to
have severe pain. He has been seen by every local neurosurgeon and, for one
reason or another, is not pleased with the care he has gotten. Because of the
seriousness of his initial injuries, there is little doubt that Mr. Gruder has
chronic back pain. Even though the local emergency room policy of not
prescribing narcotic analgesics for chronic pain is clearly stated on signs in
the waiting area, Mr. Gruder comes there frequently complaining of severe back
pain. He reports a history of gastric ulcers and allergy to nonsteroidal
anti-inflammatory drugs (NSAIDs). The nurse practitioner who sees Mr. Gruder is
faced with a man who is in obvious pain. She wishes to help him relieve the
pain he is experiencing. At the same time she realizes that narcotic analgesia
is not appropriate for this type of problem, and is unable to prescribe NSAIDs
because of his reports of gastric ulcers and allergy. He says he has tried
exercises and a local pain clinic, neither of which was effective. He is aware
of the emergency room policy regarding narcotic analgesics for chronic pain,
but he comes there in desperation. He insists that his pain is relieved only by
narcotic analgesia

 

• What ethical
principles are involved? • Does the benefit of pain relief outweigh the harm
potentially caused by long-term narcotic analgesic use for this patient? •
Should Mr. Gruder’s perceived need for narcotic pain medications be honored
even though the nurse practitioner feels he has a problem with drug dependence?
• How does the nurse do what she thinks is right and yet respect
Mr. Gruder’s autonomy? • Is it important whether or not the nurse’s actions
please the patient?

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