NURS 3004 Assignment 1 (1500 words)

Choose either Case study A or Case study B for the assignment

Case study A

Mr Lam is 30 years old and suffers from metastatic bone cancer. He has frequently attended the
oncology unit over the past six months, initially for chemotherapy, but he is now likely to die soon.
Mr Lam is popular with the nursing staff who have gotten to know him well.
In recent days his condition has deteriorated significantly, and he has been moaning in pain and
distress. Cancerous growths in his spine are causing him intense pain while metastases in his brain
stem threaten death. The goal of Mr Lam’s nursing care is now to keep him as comfortable as
possible, so he has been prescribed a continuous infusion pump containing morphine. The rate of
infusion can be varied by nursing staff but not by the patient.
Finally, Mr Lam pleads to the nurses to do something about the pain, saying ‘Please, just make it
stop’. A review of his chart shows that the rate of morphine can still be increased; however, nurses
note that when he falls asleep his respiratory rate drops and they are concerned that any increase in
dose may result in respiratory depression. When he wakes up, he is still clearly in pain with the
morphine providing inadequate relief. One of the nursing staff says, ‘We’ve got to do something, it’s
inhumane to leave him like this’.

Case study B

Ann is a night duty nurse in a local hospital. Over the past couple of weeks, she has been working a
series of double shifts as several the nursing staff have been absent due to illness. In addition to the
long working hours, Ann also cares for her disabled son and elderly mother at home and is usually
extremely fatigued when she arrives for her shift. One evening during a particularly busy shift, Ann
accidently administers the wrong medication to one patient, Bob. After realizing her mistake, Ann
immediately checks Bob’s medical history and is certain Bob won’t suffer any adverse reaction from
her error. Bob is a particularly anxious patient and has previously been given incorrect medication. On
that occasion he suffered no adverse reaction to the medication. However, he was so upset after
hearing of the error that he decided to initiate legal action against the RN concerned. Ann discusses
the matter with a colleague who suggests that, given Bob’s history, it is probably in Bob’s best
interests if he is not told of the error as knowing about the error will only exacerbate his anxiety. The
colleague adds, ‘We’re doing the best we can here. You just made a mistake.’

Sample Solution to Case Study B

Scenarios taken from (and adapted);
McDonald, F., & Then, S. (2019) Ethics, law & health care: a guide for nurses and midwives (2nd ed.)
(p. 180 & p. 270). Red Globe Press.