You are a perinatal unit coordinator at a large teaching hospital. In addition to your management responsibilities, you have been asked to fi ll in as a member of the hospital promotion committee, which reviews petitions from clinicians for a step-level promotion on the clinical specialist ladder. You believe that you could learn a great deal on this committee and could be an objective and contributing member. The committee has been convened to select the annual winner of the Outstanding Clinical Specialist Award. In reviewing the applicant fi les, you find that one fi le from a perinatal clinical specialist contains many overstatements and several misrepresentations. You know for a fact that this clinician did not accomplish all that she has listed, because she is a friend and close colleague. She did not, however, know that you would be a member of this committee and thus would be aware of this deception. When the entire committee met, several members commented on this clinician’s impressive fi le. Although you were able to dissuade them covertly from further considering her nomination, you are left with many uneasy feelings and some anger and sadness. You recognize that she did not receive the nomination and thus there is little real danger regarding the deceptions in the fi le being used inappropriately at this time. However, you will not be on this committee next year, and if she were to submit an erroneous fi le again, she could be highly considered for the award. You also recognize that even with the best of intentions and the most therapeutic of communication techniques, confronting your friend with her deception will cause her to lose face and will probably result in an unsalvageable friendship. Even if you do confront her, there is little you can do to stop her from doing the same in future nomination processes other than formally reporting her conduct. ASSIGNMENT:  Determine what you will do. Do the potential costs outweigh the potential benefits? Be realistic about your actions.

 

You are a surgical nurse at Memorial Hospital. At 4 pm, you receive a patient from the recovery room who has had a total hip replacement. You note that the hip dressings are saturated with blood but are aware that total hip replacements frequently have some postoperative oozing from the wound. There is an order on the chart to reinforce the dressing as needed, and you do so. When you next check the dressing at 6 pm, you find the reinforcements saturated and drainage on the bed linen. You call the physician and tell her that you believe the patient is bleeding too heavily. The physician reassures you that the amount of bleeding you have described is not excessive but encourages you to continue to monitor the patient closely. You recheck the patient’s dressings at 7 pm and 8 pm. You again call the physician and tell her that the bleeding still looks too heavy. She again reassures you and tells you to continue to watch the patient closely. At 10 pm, the patient’s blood pressure becomes nonpalpable, and she goes into shock. You summon the doctor, and she comes immediately. ASSIGNMENT:  What are the legal ramifications of this case? Using the components of professional negligence outlined in Table 5.3, determine who in this case is guilty of malpractice. Justify your answer. At what point in the scenario should each character have altered his or her actions to reduce the probability of a negative outcome?