CASE ANALYSIS

Was this patient harmed? Discuss your answer.

The patient was harmed in the sense that the student did not sustain the order of the
physician to have nothing by mouth. According to American Nurse's Association, the
registered nurse is individually responsible and accountable for maintaining
professional competence. The client was to have nothing by mouth. Naturally, the
student nurse is expected to be strictly monitoring and reinforcing the order to the
patient. This will include elaborating the possible complications that may happen as
explained by the physician that electrolyte might be loss by noncompliance of the
order of NPO and making sure that potential source of food and water within reach
are kept or hidden from the patient. The student nurse has not upheld the professional
competency in the situation given.

What was the benefit of the nothing by mouth order?

Usually, an order like nothing by mouth is instructed and advised for the reason that
patient is for surgery, for reduction of gastric secretions for abdominal pain and
preventing nausea and vomiting depending on the case of the patient.

In the case of this patient, the physician believed that electrolytes would be lost
through nasogastric suction if the patient were to ingest water and into the stomach.
The order was to prevent the possible complication that the patient could acquire.

Discuss whether the harm off thirst or the benefit of maintaining nothing by mouth
should take precedence?

According to Merriam-Webster, beneficence is the quality or state of doing or

producing good. It is the ethical principle of nursing that seeks to promote the
wellbeing and good to the health of the patient. On the latter, nonmaleficence is the
act of preventing and not doing harm or evil. Both principles combine as the
foundation of mortality (Albit, A., 2011). Therefore, aim of care is always benefitting
the patient with good and avoiding harm for patient. Maintaining nothing by mouth
prevents complication and aggrevation to condition of the patient and thus benefiting
to the patient's general wellbeing.

What other principles are relevant?

It is relevant to take into consideration the autonomy of the patient because the patient
has the right to self-governance. In this case, the patient was not restrained from his
freedom of drinking water. No one told him to drink water and nor was he encouraged
to do so. He was free of choice and decision to take the water and drink it because he
insisted to.
Why did the student experience such extreme distress?

The responsibility of the student to maintain nothing by mouth to the patient failed.
The student nurse was to watch out and to reinforce the patient during the shift. And
so, nonmaleficencie was not met. Even though it was the decision and action of the
patient to drink water, it is still separate to the student's responsibility of keeping the
patient out from harm and potential risk for health. The death of the patient caused
extreme distress to the student because regardless of all the effort to beneficence,
monitoring the IV, taking vital signs and the like, the student might have realized his
part of contributing to the decline and mortality of the patient instead.

Ma. Elyza Allene N. Paderanga

September 6, 2017
BSN 4 NA

Reference:

Christman,J. (2015). Autonomy in Moral and Political Philosophy. Retrieved from

https://plato.stanford.edu/entries/autonomy-moral/

(2011)."Nonmaleficence." Encyclopdia Britannica. Encyclopdia Britannica

Online. Web. Retrieved on September 4, 2017 at
https://www.britannica.com/topic/nonmaleficence

(2011). "Beneficence" Merriam-Webster Dictionary. Merriam-Webster Online. Web.

Retrieved on September 4, 2017 at https://www.merriam-
webster.com/dictionary/beneficence