Thinking Critically on Quality Improvement

Subject: Health Care
Type: Reflective Essay
Pages: 3
Word count: 922
Topics: Nursing, Medicine, Public Health
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The research paper analyzes the nursing dilemma pertaining to whether a person can treat themselves, their relatives, and other people close to them and do so professionally. Physicians may and have often found themselves in situations that require them to decide whether it is appropriate for them to offer treatment for family members, themselves or to other people close to them. Despite the fact that the physicians may have the best of the interest and intentions when providing medical services in this context, a review of available literature indicates that the close or personal relationships they have with these people has the potential to compromise the physician’s clinical and emotional objectivity. The quality of the care provided will be affected as the physician has been affected and thus not able to meet the standard of care required of them.

I attended a normal checkup at the Maryland Level Four health facility. An emergency was reported at the waiting area. A patient, an old man, had collapsed due to low insulin levels. As it would turn out, the patient was a relative to a nurse who served in the hospital. She was among the first ones to arrive at the incident and she quickly took the matters into her own hands to save the patient. She offered first aid services to the patient and she managed to save the situation. Citing laxity from the rest of the hospital staff, she decided to take it upon herself and attend to the old man. She was a niece to the old man and of course from her reactions, they were very close. Unfortunately, it would emerge later that the condition of the patient got no better. After several weeks of home care, the old man passed away. The AMA investigated the matter and found out that the nurse had no professional qualification nor did she have the exposure to handle patients with blood sugar related complications. 

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From the word “go,” the nurse did not tackle the matter with a professional perspective and she allowed her personal relationship with the patient (her uncle) affect her decisions. Several bioethical principles were breached in the process which led to serious actions being taken upon the nurse. As the closeness of the relationship between the doctors and their patients increases, equally the ethical issues involved in treating family and friends become increasingly problematic (Anyanwu, 2014). In this situation, the doctor is both the family member and the physician and they face numerous conflicts of interest as they undertake the dual roles. Due to emotional investment, it became easy for the physician to lose perspective and end up providing informal care which posed a risk to the life of the patient and ended up being detrimental in the long run (Anyanwu, 2014). This happened despite the fact that the physician saw herself as the best advocate for her relative. 

Issues of beneficence and non-maleficence are among the main morals raised in the situation. Beneficence demands that the care be provided in the best interests of the patient while non-maleficence demands that no harm should be inflicted to the patient in the process (Gold, 2014). However, in the process of caring for family members and friends, inappropriateness in the evaluations, testing and medication may arise. Maybe the physician got tempted to either underuse or overuse the test or the medications as the physician felt the pressure to provide service beyond the scope of her practice. 

A comprehensive background check into the matter was not conducted. The nurse barred the same by taking the matters by herself after she criticized her colleagues of not being mindful. The big wonder is the reason as to why she never felt the same of the rest of the patients if she was really a concerned professional. The ethical principles allow that a physician can only attend to their own relatives or friends until such a time when an alternative physician is available (Gold, 2014). There were many other doctors and spare nurses but she never gave way for them to attend to the patient. Her personal interest in the welfare of the patient which was professionally biased made her narrow down on her decision to keep her sick uncle home-ridden until the worst happened. Her actions obscured gathering of adequate information about the condition of the patient. Actually, she jumped into the conclusion that the patient suffered low blood sugar level based on her history with him. Even before the incident, she had had prescribed medication to the patient on several occasions and many of the times she did not make medical records that could help in the future. Most of the encounters with the patient were casual and informal and majorly from the homestead set up. The AMA pointed to her actions as ones that prevented thorough understanding of the matter and as ones that warranted legal pursuit. A further complication was to whether her family was ready to sue her for the loss of their beloved father. 

In order to prevent a similar occurrence in the future, professional bodies should adequately bring to the attention of their members the ethical requirements they should keep abreast within their daily practices (Gold, 2014). The consequences of failing to adhere to those ethical standards should be clearly brought to the attention of physicians as well. That way, the physicians will understand their role and the do’s and don’ts pertaining to their specific duties. 

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  1. Anyanwu, E. B., Abedi, H. O., & Onohwakpor, E. A. (2014). Ethical issues in treating self and family members. American Journal of Public Health Research, 2(3), 99-102.
  2. Gold, K. J., Goldman, E. B., Kamil, L. H., Walton, S., Burdette, T. G., & Moseley, K. L. (2014). No appointment necessary? Ethical challenges in treating friends and family. The New England Journal of Medicine, 371(13), 1254-8.
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