“Nurses are often placed in situations where they are expected to be agents for patients, physicians, and the organization simultaneously, all of which may have conflicting needs, wants, and goals.” Marquis, p. 84.

     You are the evening shift charge nurse of the postanesthesia care unit (PACU).  You have just admitted a 32-year-old woman who 2 hours ago was thrown from a Jeep in which she was a passenger.  She was rushed to the emergency department and subsequently to surgery, where cranial burr holes were completed and an intracranial monitor was placed.  No further cranial exploration was attempted because the patient sustained extensive and massive neurologic damage. She will probably not survive your shift.  The plan is to hold her in the PACU for 1 hour and, if she is till alive, transfer her to the intensive care unit (ICU). 

     Shortly after receiving the patent, you are approached by the evening house supervisor, who says that the patient’s sister is pleading to be allowed into the PACU.  Normally, visitors are not allowed into the PACU when patients are being held there only temporarily, but occasionally exceptions are made.  Tonight, the PACU is empty except for this patient.  You decide to ben the rules and allow the young woman’s sister to come in.  The visiting sister is near collapse; it is obvious that she had been the driver of the Jeep.  As the visitor continues to speak to the comatose patient, her behavior and words make you begin to wonder if she is indeed the sister. 

     Within 15 minutes, the house supervisor return and states, “I have made a terrible mistake.  The patient’s family just arrived, and they say that the visitor we just allowed into the PACU is not a member of the family, but it’s the patient’s lover.  They are very angry and demand that this woman not be allowed to see the patient. 

     You approach the visitor and confront her in a kindly manner regarding the information that you have just received.  She looks at you with tears streaming down her face ans says, “Yes, it is true.  Mary and I have been together for 6 years.  Her family disowned her because of it, but we were everything to each other.  She has been my life, and I have been hers.  Please, please let me stay.  I will never see her again.  I know the family will not allow me to attend the funeral.  I need to say my goodbyes.  Please let me stay.  It is not fair that they have the legal right to be family when I have been the one to love and care for Mary.”

Instructions:

1. You must decide what to do.  Recognize that your own value system will play a part in your decision.  
   1. List several alternatives that are available to you.
   2. Identify which ethical frameworks or principles most affected your decision making.  
2. Decide whether this could cause you “moral distress” if you were the nurse taking care of this patient.  Elaborate on why this is the case…
3. Answer the questions as thoroughly and concisely as possible.
   1. Be sure to reference any works that you utilize in answering the questions (Be sure that references are in APA format).