SCENARIO SUMMARY:
62 yo stroke patient whose insurance only covers a 3 night stay at the hospital.
According to the insurance company, they recommend discharging her today. The patient’s nurse and healthcare team say she isn’t ready for discharge and still has to undergo rehab and physical therapy to relearn many basic daily movements.
This patient has no one to take care of her at home because her daughter works full time.
Others argue that 1-2 additional nights in the hospital aren’t going to solve these issues.
Also, if the hospital is overpacked, she is at risk of infection. If she stays longer, she has to pay out of pocket.
The healthcare team is conflicted on what to do and ultimately decide to discharge the patient.
This episode raises important questions about the ethical responsibilities of healthcare professionals. Even though Joan’s condition had not fully stabilized, a shortage of available beds, the hospital’s policy, and insurance algorithms appear to have dictated her care. What potential consequences and ethical dilemmas do you observe in this scenario? What ethical frameworks or guidelines should healthcare team members and their organizations follow when facing this situation?
In Addition, address ONLY three (3) of the following questions:
What emotions and/or internal conflict did you feel when you watched this episode?
How did your personal and professional background impact your feelings about Joan’s situation?
Do you feel that the administrators’ and practitioners’ responses were reasonable or typical?
How can healthcare team members balance the need to provide quality care with resource constraints?
Which ethical decision-making model might provide a systematic way to evaluate this ethical dilemma?
