Reference no: EM133852043

Question

The Visiting Nurse and the Obstinate Patient: Limits on the Right to Nursing Care

Mr. Jeff Williams, a staff nurse with Home Care Services at the county health department, was preparing to visit Mr. Rufus Chisholm, a 59-year-old patient with emphysema who was recently discharged from the hospital after suffering pneumonia. Well known to the health department, Mr. Chisholm was unemployed as a result of a farming accident several years ago and was essentially homebound. Hypertensive as well as overweight, he was also a heavy cigarette smoker of long duration despite his decreased lung function. Mr. Williams's reason for visiting him today was to assess Mr. Chisholm's medication use-if there were any side effects, and how effective the medications were in clearing his lung congestion from the pneumonia. As Mr. Williams parked his car in front of his patient's house, he could see Mr. Chisholm sitting on the front porch smoking a cigarette. He experienced a flash of anger as he wondered why he continually tried to teach Mr. Chisholm the reasons for not smoking and why he took the time out from his busy home care schedule to follow up on Mr. Chisholm's health. This patient certainly did not seem to care about his own health, at least not to the extent that he would give up smoking. Identifying Ethical Conflicts 29 During the home visit, it was determined that Mr. Chisholm had discontinued the use of his antibiotic before the full course of treatment was completed and that he was not taking his expectorant and bronchodilator medication on a regular basis. In addition, his blood pressure was 210/114, and he coughed almost continuously. Although his lung sounds were improved, Mr. Chisholm said he tired easily and had no appetite. He politely listened to Mr. Williams's concerns about his respiratory function and the continued use of his medications, but he did not seem to be taking any responsibility for his health status. Mr. Williams told Mr. Chisholm that he would visit him again in 3 days.

Discuss to what extent Mr. Williams was obligated as a nurse to provide care to patients who took no personal responsibility for their health. Is there any limit to the amount of nursing care a non-cooperative patient could expect from a community health service.