1. Bethel Ann Powers, R., PhD. (2003). Nursing Home Ethics : Everyday Issues Affecting Residents with Dementia. Springer Publishing Company.
2. Option 2: Order cleaning services and help
2.1. Mrs. Jenkins may still not accept
2.2. Moral compass would be uplifted knowing that something was done for patient.
2.2.1. "Beneficence, defines one’s duty to promote an individual’s good in some way" (Meyer, et al. 2020). This would be promoting a better good for Mrs. Jenkins.
2.3. Neighbors would be happy
2.4. Could prevent further infections from bacteria
3. Option 3: Leave Mrs. Jenkins and respect her wishes
3.1. Moral compass compromised
3.2. Could lead to further medical issues resulting from bacteria and infections
3.3. Neighbors at risk in unhealthy living situation
4. Ethical issues
4.1. 1. Leaving any patient dirty is not an act of good which goes against our code of ethics
4.2. 2. Knowing that the patient may come to future harm from the bacteria and uncleanliness
4.3. 3. Going against a patients wishes is also unethical as consent must always be obtained from a alert and orientated patient
4.4. "There are different ways to view autonomy of illness situations where patient's decisional capacities vary and where beneficence (acting in the patient's best interests) may in some instances be the greater moral good" (Powers, 2003).
4.4.1. In this case not getting Mrs. Jenkins the care she needs would not be in her best interest and so going against her wishes would be of good ethics.
5. Meyer, E. C., Carnevale, F. A., Lillehei, C., & Kurtz Uveges, M. (2020). Widening the Ethical Lens in Critical Care Settings. AACN Advanced Critical Care, 31(2), 210–220. https://doi-org.arbor.idm.oclc.org/10.4037/aacnacc2020265
6. Problem: Does not want to let the nurse clean up her and her living situation.
6.1. Housemates concerned with cleanliness- can lead to bugs, mold, etc.
6.2. Patient sitting in bacteria and dirt can cause infections.
7. Option 1: Stay and clean Mrs. Jenkins and her home
7.1. Would leave less time to spend with more critical patients later in the day.
7.1.1. "Nonmaleficence, is somewhat related to beneficence and defines one’s duties to refrain from causing deliberate harm, which itself is a stringent duty" (Meyer, et al. 2020). This would not be acting with nonmaleficence as the other patients who need more medical attention would be left with less time.
7.2. Would make neighbors happy
7.2.1. Mrs. Jenkins does not seem thrilled about the idea.
7.3. Self conscience would feel morally better about leaving Mrs. Jenkins
8. Solution: Spend a few minutes with Mrs. Jenkins reasoning with her to let you call a homemaker service that can come.
8.1. Check in with Mrs. Jenkins to see how she is doing after the homemaker services
8.1.1. Schedule possible follow-up with Mrs. Jenkins for regular homemaker services.
8.2. "Respect for patient autonomy, requires that individuals be supported when making self-determining decisions without being coerced" (Meyer, et al. 2020).
8.2.1. Reasoning with Mrs. Jenkins is not respecting her autonomy to make decisions.