NHS-FP4000: The Missing Needle Protector

 Case Summary

E.L Straight serves as Hopewell Hospital’s director of clinical services. He is concerned with Dr. Cutrite, the longest-serving staff at the facility. Although he was once considered an excellent general surgeon, he has deteriorated mentally and physically over the years. Thus, Straight considers reducing his privileges to enhance patients’ safety. However, he is yet to do so and Dr. Cutrite continues to work as a surgeon. For instance, the doctor operated on Mrs. Jameson but forgot a plastic needle protector in the client’s belly. However, Dr. Cutrite is not concerned about the error because he believes that the cap will not threaten the patient’s life. On the contrary, it will cause some minor discomfort. Similarly, Dr. Cutrite warns the operating room supervisor against notifying the patient about the incident, but the supervisor informs Mr. Straight about the error.  Mr. Straight considers sending the affected patient to surgery minus telling her the reason for the procedure. Instead, they were to lie to her that it was necessary to evaluate her deep sutures and incision. Therefore, she will not have a clue that they are searching for the needle cap. However, it was too late for Mr. Straight because the client had already been discharged.

Analysis of the Case Study Ethical Issues

Various ethical issues characterize the case study. First, Dr. Cutrite continues to serve as a surgeon despite his deteriorating mental and physical health status. Additionally, the Doctor forgets a plastic needle protector in the patient’s belly but does not inform her because he considers it non-life-threatening. The facility’s director of clinical services is willing to lie to the patient to have the needle protector removed (Capella University, 2018). Unfortunately, the patient had already been discharged. These stakeholders’ actions show that they violated the ethical principles of non-maleficence and beneficence that require healthcare workers to safeguard the patient’s interests rather than harming them. Therefore, they are supposed to disclose important information to the patient even if it may distress them. 

 However, the healthcare professionals hid vital details from the patient despite her right to know about the cap left in her belly due to the surgeon’s negligence. Nonetheless, the health professionals might have withheld the information to protect themselves from legal lawsuits that may damage the facility’s reputation and exert a financial burden on it.  Dr. Cutrite’s political influence prevented the Chief of Surgery and Mr. Straight from reprimanding or disciplining him (Capella University, 2018).  Therefore, the people involved or affected by the issue are the patient (Mrs. Jameson), Mr. Straight (Director of Clinical Services), The Chief of Surgery, Dr. Cutrite, and the operating room supervisor.

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Analyzing the Case Study using the Ethical Decision-Making Model

Three components characterize the ethical decision-making model, including ethical behavior, moral judgment, and moral awareness (Lincoln & Holmes, 2011). Moral awareness is the ability to identify an ethical issue in a situation. In contrast, moral judgment is the design of appropriate solutions to a moral issue (Lincoln & Holmes, 2011). Lastly, ethical behavior is the action taken by an individual when faced with an ethical dilemma. Unethical decisions result if the three components are not followed. For instance, despite Mr. Straight being aware of Dr. Cutrite’s deteriorating physical and mental health status, he continued to conduct surgery. As a result, he forgot a plastic needle protector on the patient’s belly and failed to inform her about it. He also warns the operating room supervisor against informing the patient about the incident (Capella University, 2018). The Chief of Surgery is informed about the incident but does not take any disciplinary action against Dr. Cutrite.  Mr. Straight, the Chief of Surgery, and Dr. Cutrite lack moral awareness.

 As per the moral judgment, Dr. Cutrite’s memory might be declining because of age. Also, Mr. Straight was afraid of taking disciplinary action against the Doctor because of his age and working experience. Similarly, the supervisor might have adhered to the facility’s policy of reporting errors to the executives. The involved parties’ actions in the case were attributable to their moral judgment of the situation. For instance, Dr. Cutrite’s actions to keep the surgery incident secret were to maintain his image as a brilliant surgeon and  avoid legal lawsuits against the facility. The operating supervisor was loyal to Dr. Cutrite and agreed not to inform the patient about the incident. However, he reported the matter to Mr. Straight because of the facility’s code of conduct.

Effective Communication Approaches in the Case Study

Effective communication is evident at Hopewell Hospital.  Junior employees are allowed to discuss sensitive issues with their seniors.  For instance, the operating room supervisor informed Mr. Straight about the medical malpractice and worked together to resolve the issue. However, communication ineffectiveness was also evident, specifically between the chief surgeon, the supervisor, and Dr. Cutrite. For instance, the Chief of Surgery was unaware of the medical malpractice at the facility. By the time the supervisor reported the issue to the Director of Clinical Services, the patient had already been discharged (Capella University, 2018). In this case, Hopewell hospital should design a standardized communication tool to facilitate communication effectiveness between healthcare workers and their colleagues and patients. Otherwise, communication breakdown at the facility may threaten the patient’s well-being and safety.

The Effectiveness of the Approaches Used to Solve the Ethical Issue in the Case Study

Hopewell’s health professionals took measures to safeguard the facility’s reputation and avoid legal lawsuits because of negligence. For instance, the hospital’s director of clinical services was ready to protect the facility’s reputation and Dr. Cutrite’s image by lying to the patient in order to remove the plastic needle protector from her belly. However, the patient had already left the hospital. Therefore, Mr. Straight sought advice from other professionals regarding the matter to ensure that the patient’s life would not be threatened because of the incident. The Chief of Surgery informed him that the surgery issue would not result in adverse consequences but minor discomfort. Thus, the case study provides significant lessons to healthcare providers. It highlights the importance of effective communication and collaboration between healthcare workers to resolve issues that may undermine the facility’s reputation and lead to expensive lawsuits.

Applying the Ethical Principles to Resolve the Case

The ethical principle of non-maleficence and beneficence requires health professionals not to harm the patient.  Hiding important information from Mrs. Jameson was unethical. Therefore, the facility should call the patient and inform her about the surgery issue and the need to have the needle cap removed from her belly. Additionally, the patient should be aware of the repercussions of refusing the corrective surgery to ensure an informed decision is made. Dr, Cutrite should be disciplined to avoid such mistakes from happening in the future. The patient should be made aware of the actions taken by the facility against the surgeon. The Director of Clinical Services should collaborate with his team to curb such errors from repeating. In summary, the case study underscores the importance of addressing ethical issues as soon as they resurface regardless of the repercussions. It also emphasizes the importance of effective communication among healthcare workers and taking disciplinary actions against those who violate the facility’s code of conduct.

References

Capella University (2018). NHS-FP4000 Exemplar Sample Ethical Case Study. Capella Website

Lincoln, S.H., & Holmes, E.K. (2011). Ethical decision making: A process influenced by moral intensity. Journal of Healthcare, Science and the Humanities, 1(1), 55-61.