There has been a car accident and the driver if the car was brought to PRU. She has been stabilized in the emergency department; however, transferring her to another facility 40 miles to ICU away would not be appropriate in her health status for her injuries would not sustain life.
Case
There has been a car accident and the driver if the car was brought to PRU. She has been stabilized in the emergency department; however, transferring her to another facility 40 miles to ICU away would not be appropriate in her health status for her injuries would not sustain life.
The patient has to be placed in ICU in the next 1-2 hours. The night supervisory gains composure and describes the status of patients occupying the 4 ICU beds.
Patient A- A 59 year old female, comatose, stroke victim who had been in ICU for 33 days; uncertain prognosis; retired, with no family
Patient B- 2- week old premature male, has Down’s syndrome and has been in ICU since birth; hospital has brought a legal action to permit surgery to repair a duodenal atresia, a procedure the parents had not permitted; family in adjacent city.
Patient C- 35 year old male who underwent emergency appendectomy, developed severe wound infection and septicemia, source of infection is unknown; because of previous anaphylactic shock in reaction to antibiotics; requires ICU care; bachelor; aged mother in city.
Patient D- 13 year old female undergoing chemotherapy for leukemia with an experimental drug; has been in remission three times in the past; close monitoring of the experimental protocol and potential reaction to drug requires ICU care; family in city.
New Patient- 24 year old patient; college honor student in physics. scholarship winner; pregnant; engaged; no family known.
The supervisor ended the brief description by asking, “What should I do?”
You are the superviser and you have to make a decision. (continued on next page) – each question followed must be answered.
Describe your facility
Describe your staff
Explain any legal or ethical issues of the situation
Explain your management style/theory
Discuss cultural issues that the situation presents
Explain budgetary plans or concerns
Explain credentialing or accreditation issues the situation presents
Describe your response to the situation
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