Ethical Dilemma: Online poll

[ltmurray3]

Hi everyone,
As part of my final year physiotherapy coursework, I need to justify what an appropriate response to a complex patient situation should be. I thought it would be interesting to conduct an online poll as to what people think the appropriate course of action should be when presented with the following scenario:
‘You are asked to see a 44 year old male with generalised weakness and de-conditioning admitted to hospital. He has a history of substance abuse and 4/7 ago he fell and post-discharge from a Detox unit he fell and sustained #NOF. Now in hospital, he has been initially resistant to Physio Rx. Nurses say he is uncooperative and abusive. He says they don’t provide him with his medication and are too rushed to help with washing etc. He lives on the street. What are his rights and are there any ethical or professional issues here that you could address to give him the best treatment and also help the staff?’
First of all, has anyone experienced a similar situation themselves whilst practicing as a physiotherapist.
Secondly, which course of action from the available choices would you take as a physiotherapist when dealing with this patient.


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[physiobob]

I think the problem here is that you need to ask an individual yes/no for each option as many might do more than one thing. hence they would not want to vote on a single solution? p.s. Not sure I would choose any of the above as the main first step, perhaps a conference meeting with all involved to discuss the issues and then a discussion with my head of dept who should be able to offer some sound advice on what we can hope to achieve with the resource we have and therefore match accordingly, varying that match as the situation changes..

[Fyzzio]

Hi, I completely agree.

I generally found the question rather confusing:
What are the patients rights? - that is rather clear: there is a patient code of rights; in NZ that is done by the Health and Disability Commission. In Australia, you have got the Australian Charter of Healthcare Rights.
Are there any ethical of professional issues? - I presume, you are talking about a patient's difficult behaviour and refusal of treatment as well as staff's refusal to provide cares. Both are in their full rights here (check the Codes of Ethics for Nurses and Physios - both exist for Australia).
Have I ever experienced a similar situation? - well, my answer would be: about once a month.
Course of action: Could vote for "Raise issue with nurse unit manager", but that is not the course of action to deal with the problem, just the first step. So I won't put my vote in. You have also let out the option to contact your Line Manager or Supervisor to discuss the problem and course of action.

My course of action would be to set up a team meeting including the patient and his advocates. But then again, I am in a position to do so and have a professional role with an obligation to manage situations like that. Other Physios will not necessarily have that.

Cheers, Fyzzio

[ltmurray3]

Thanks for the feedback! I've posted a new thread with the suggested changes.