Jane is a client exhibiting medication management challenges due to the COVID-19 pandemic. She is old and lives with a mentally-challenged grandson in Honolulu. She suffers from a terminal heart disorder that depends on prescriptive drugs. Her life and ability to manage medication before COVID-19 were stable due to the open interactions she managed to have. Attending a local community center’s events, for example, allowed her to experience a vigorous social life that stabilized her condition. Going to choir practices every evening allowed her to visit the pharmacy. Moreover, meeting friends after the service reminded her to take her evening medications. However, the emergence of COVID-19 led to the disruption of Jane’s routine, and she is now struggling with medication management. Her health is also declining, and she lives significantly far from the health care facility.
Bioethical Decision-Making Model
Defining the Dilemma
Jane exhibits medication management challenges due to the present-day pandemic. She has for a long while dependent on her active social life to accomplish her heart disorder meds. Jane now lives an isolated life due to the COVID-19 safety protocols exposing her to the problems she is experiencing. Taking her back to the normal past is not possible. Having heart issues makes her more vulnerable to COVID-19 due to the already compromised body immunity. Jane’s situation requires significant considerations, such as taking her to home care or utilizing technology to assist her. She lives with a mentally-challenged grandson, coupled with the emerging need to reduce the patient’s in-home care, which implies the difficulty in using the approach to help her. Better still, paying frequent visitations to the hospital is impossible due to her location and curfews. Arranging a conference call for her to rekindle her social life remains the only viable solution, which still depends on the availability of a smartphone.
Medical Facts Identification
Jane’s heart condition is critical, demanding a close watch of her treatment. She has stayed with the illness for about six years now, which she managed effectively before COVID-19. She also has diabetes and takes blood glucose management drugs daily. The patient acquires her drugs from a nearby pharmacy, mostly weekly or monthly. Jane freely and readily acquired her drugs before COVID-19 and managed to keep track of the meds through her interactions. Currently, the patient is forced to remain in her house, making her forget to take the drugs often. Buying drugs from the pharmacy is also not as easy as before. She is meant to sleep without taking the meds even when remembering to do so. Failing to take the drugs as prescribed exposes her to health deterioration that affects her performance and physical ability. Jane has personal and Medicaid health insurance that covers her medication, with the grandchild, featured as a beneficiary of the two covers.
Jane is eighty years Caucasian and lives with her thirteen years grandson. She is a former employee of the U.S. postal corporation, where she retired twenty years ago. Jane was once married but divorced after ten years of marriage. Her only child, a daughter, passed on about four years ago, leaving Jane with one grandson, Thom, with who they live together. Thom attends a special school in Honolulu, leaving Jane alone most of the time. Jane and Thom understand and cherish each other significantly. Therefore, the two live in an owned house and do not pay rent. Jane has a car and used to employ a house help before her economic condition went down. She is the family’s breadwinner and survives on the savings and pension accrued during her working days. The surviving relatives live far, with the closest brother living in Canada with his family. The brother pays frequent visits and renders Jane financial aid whenever needed for such.
The U.S. exhibits health policies that purpose to make the country a healthy nation by improving the management of terminal illnesses like heart disorders. The nation’s policy on advancing healthcare access is also committed to having all citizens get health insurance to get the necessary medical care that they may have (Shi & Singh, 2019). The U.S. medical fraternity also anticipates employing research-based best practices to alleviate the extent of terminal conditions. The demand that all registered medics help patients in need of special care also affects the current situation involving Jane and her grandson.
Items Requiring Clarification
Several items require clarification for Jane to get the necessary aid. Examples of such aspects include her ability to cater to drug expenses both in the short and long run. Other concerns require clarification touch on whether she has a smartphone and knows how to use it to join conference calls. The availability of reliable internet signals at Jane’s home also poses noteworthy concerns that need unraveling to develop an appropriate intervention.
Decision Makers Identification
Jane has a sound mind and is capable of making her decisions. The patient’s memory is also intact and is highly informed about what is happening around her health issues. She maintains a calm personality and loves seeking all the necessary information before deciding on an aspect. In addition, Jane can relate to and easily trusts people; the situation makes it easy for inventions to work with ease on her.
Review of the Underlying Ethical Principles
Several ethical principles inform the current healthcare intervention endeavor. Doctrines include autonomy, beneficence, non-maleficence, justice, fidelity, and veracity (Levine-Ariff & Groh, 1990). Autonomy touches on the need to grant Jane the ability to operate independently, while beneficence and non-maleficence demand that interventions cause more good than harm. Justice further demands the promotion of fairness to all, while fidelity and veracity require confidentiality and integrity (Tai, 2021). These moral principles are necessary for Jane’s situation and inform the intervention process.
There exist at least two possible intervention alternatives for Jane’s case. Such include taking her to a home care facility or using technology to re-activate her life and medication management. The former intervention faces constraints like reducing people in-home care facilities due to the COVID-19 threat while offering effective patient care services. Using conference calls is, thus, the best alternative due to cost-effectiveness and fewer inconveniences.
Frequent checks on Jane’s health and treatment management will be necessary follow-up activities for the intervention. The inquiry would be done through phone calls and visits to very her situation. Jane currently experiences deteriorating health due to taking her meds as prescribed. The intervention’s success stands to improve her health, thus, proving successful within a short duration. This will allow the nurse to have a clear record of her treatment progress.
The Nursing Advocacy in the Clinical Setting and the Nurse Role as a Patient Advocate
The intervention involves the arrangement of conference calls by the advocate during different times of the day. The advocate will confirm the patient’s medications and dosages to help track them. The advocate will also research local pharmacies and advise Jane about their opening hours and delivery selections. The counselor will arrange for the client to maintain a stock of medicines requiring a longer time to refill because of the pandemic. The advocate will regularly check in with Jane to offer medication reminders and inquire about other needs, as Sipes (2018) advised. The intervention will also use make use phone alarms to notify her when the time for medicines is due.
Levine-Ariff, J. & Groh, D.H. (1990). Creating an ethical environment. Nurse managers’ bookshelf a quarterly series: 2:1. Baltimore, Maryland: Williams & Wilkins. 41-61.
Shi, L., & Singh, D. A. (2019). Delivering health care in America: A systems approach. Jones & Bartlett Learning.
Sipes, C. (2018). Application of nursing informatics: Competencies, skills, and decision-making. Springer Publishing.
Tai, M. (2021). Harmonizing bioethics: Global ways in integrating people and values. Zürich LIT-Verlag.