Assignment name: Written Assignment Option 7, week 10, Conflict of Interest Case
Assignment name: Written Assignment Option 7, week 10, Conflict of Interest Case Analysis
Points for the assignment: 10
This writing assignment invites you to identify the ethical challenges and conflicts of interest experienced by a pediatric nurse practitioner. Describe how you would respond to these challenges and justify your Reponses.
Read the case study below for analysis.
In a 5-6-page paper, identify and prioritize at least four ethical challenges in the case. If you were Kathy’s provider, how would you respond to each challenge identified? What justifies your responses?
Case for Analysis
Prepared by Sarah B. Vittone DB, MSN, MA, RN
Assistant Professor, School of Nursing and Health Studies
You are working prn at a large internal medicine practice associated with a community hospital. You have 5 years of experience as an FNP and 10 years as an RN. You work full time in a busy Hispanic clinic for the urban poor but “moonlight” to earn money for a badly needed winter vacation.
A 15-year-old girl, Kathy, a known asthmatic, is accompanied by her mother to be seen for a sore throat. She has obvious signs of flu-like symptoms. Her mother requests a throat culture for strep, which the daughter has had in the past year. Kathy has a cough with an expiratory wheeze but does not appear short of breath. She has a history of asthma but does not have her albuterol inhaler with her, and her mother says they only use it when really necessary. You set up an albuterol nebulizer. The mother then requests a chest X-ray. You do not feel this is appropriate at this point but could refer her to the MD you are partnered with today in the practice. This MD is just out of residency and commonly overprescribes medications and orders unnecessary diagnostic tests. In further discussion with the mother, you find out that Kathy is a member of an Irish dance squad traveling to Ontario later this week on tour, but she cannot travel if she is diagnosed with flu. While the mother agrees that her daughter is sick at this point, she asks you to sign a form that her daughter is not contagious and that she is clear to go on tour. The tour leaves in five days. The practice is not testing for flu unless the patient’s insurance will cover it
or unless it is deemed necessary for treatment. The mother comments that, while her deductible has not been met yet this year, her company would pay for the chest X-ray. You have also been told by the practice manager that statistics are kept regarding the number of diagnostic and laboratory tests ordered by each practitioner and your numbers are low. You’ve been told your numbers need to improve.
While you wait to see how Kathy responds to the nebulizer treatment and continue your exam, you notice that she has a small, possibly new, tattoo of the Irish flag at her bra line. When you ask her about it, she states, “My mother would kill me if she knew about this. You can’t tell her.” The wound appears inflamed and is draining slightly, leading you to believe it is infected and requires antibiotics. Kathy indicates she would take antibiotics, but she doesn’t want her mother to know and she would need a way to get them. When you share this story with your FNP colleague, he tells you there are samples in the “poor closet” that you could give her. He says, “What’s the worst that could happen? She has no allergies, and this will get treated. She could come back for a pulmonary check, so you could see the wound.”
What happens next?