A nurse manager is leading a discussion about ethical dilemmas. Which of the following situations should the nurse manager include as an example of an ethical dilemma?

a. "I am not sure how I will pay for all the therapy I will need":

"I am not sure how I will pay for all the therapy I will need":This statement expresses a concern about financial matters related to medical expenses and therapy costs. It is relevant for social services or a financial counselor, not an occupational therapist.This indicates a need for assistance with financial planning and resources, possibly involving a social worker or a financial advisor, rather than an OT.

b. "I hope I can adjust to using crutches while I am recovering":

"I hope I can adjust to using crutches while I am recovering":This statement reflects a concern with mobility and the use of assistive devices, such as crutches, during recovery. While this is an important aspect of rehabilitation, it is typically within the scope of physical therapy (PT) rather than occupational therapy.Physical therapists specialize in improving mobility, strength, and the proper use of mobility aids. Therefore, this would be more relevant for a PT referral.

c. "I just don’t think I can handle looking at my leg":
This statement indicates emotional distress and difficulty in accepting the physical changes after the amputation. This is an important issue, but it suggests a need for psychological support rather than OT intervention.This would be more appropriate for a referral to a mental health professional or counselor to address emotional and psychological concerns related to body image and adjustment.

d. "I am worried about taking care of my toddler":

This statement highlights a concern about the client's ability to manage daily tasks and care for a dependent (in this case, a toddler) at home after the surgery. Occupational therapists specialize in helping clients adapt to daily living activities and manage home responsibilities effectively despite physical limitations.

a. Review current literature regarding client falls:

This option involves conducting a review of existing research and literature on client falls. Reviewing current literature can provide valuable insights into evidence-based practices and interventions for fall prevention. However, conducting a literature review typically follows problem identification and is part of the process of developing an evidence-based approach to addressing the issue.

b. Implement a fall prevention plan:

Implementing a fall prevention plan involves putting in place strategies and interventions aimed at reducing the risk of falls among clients. While implementing a fall prevention plan is an essential step in addressing the issue, it should be based on a thorough assessment of clients at risk for falls (which comes before planning interventions) to ensure that interventions are targeted and effective.

c. Identify clients who are at risk for falls:

This is the most appropriate first step in the quality improvement process. Identifying clients who are at risk for falls allows healthcare providers to focus interventions on those who are most vulnerable. It involves conducting comprehensive assessments, considering factors such as age, mobility, cognitive status, medications, and history of falls, to determine individual risk levels.

d. Notify staff of the increased fall rate:

While communication with staff about the increased fall rate is important for raising awareness and promoting a culture of safety, it should not be the first action taken in the quality improvement process. Before notifying staff, it's essential to identify clients at risk for falls and develop targeted interventions to address the issue effectively.