You are among several RNs, MDs and Therapists meeting to discuss how to take care of your Covid-19 patients while also taking care of yourself and your family. Is our loyalty to our families or to our patients? To our colleagues or to ourselves? What are all the risks, benefits and burdens to be weighed […]
An 80-year-old Asian woman is hospitalized with weight loss, generalized weakness and a pulmonary mass. Work-up reveals that she has pulmonary tuberculosis. Her family approaches the physician and asks that the patient not be told, stating that in her upbringing in mainland China tuberculosis was considered fatal and to tell her would be like giving […]
During a visit to her family physician, a 35-year-old woman discloses that she suffers from anorexia nervosa. She complains of fatigue, dizziness, depression, headaches, irregular menses and environmental allergies. Each day, she uses 15 to 60 laxatives, exercises for several hours and eats a salad or half a sandwich. At 5’2″, she weighs 88 pounds. […]
Dr Jordan is treating Mr. Reynolds for prostate cancer. Mr. Reynolds seemed to be in remission for several months. He is now having some symptoms related to his cancer history. Dr Jordan wants to admit Mr. Reynolds to begin aggressive diagnostics and, if needed, treatment. Given the current pandemic situation, What are Dr Jordan’s reasonable […]
A 32-year-old woman was admitted to the Trauma Intensive Care Unit following a motor vehicle accident; she had multiple injuries and fractures, with several complications which continued to develop over the first couple weeks. The patient rapidly developed Adult Respiratory Distress Syndrome, was on a ventilator, and was continuously sedated. Shortly after the patient’s admission, […]
Joe is a 62-year-old man who just had a needle biopsy of the pancreas showing adenocarcinoma. You run into his brother in the hall, and he begs you not to tell Joe because the knowledge would kill him even faster. The family made it clear that, if the team went against the family’s instructions not […]
Your patient has been suffering from chronic low back pain for many years now. She voices her frustration with the various treatment modalities that her physician has been trying and says her friend had recommended a homeopath. How do you respond to your patient’s request to consult with a homeopath? What if you disagree with […]
A 60-year-old man has a heart attack and is admitted to the medical floor with a very poor prognosis. He asks that you not share any of his medical information with his wife as he does not think she will be able to take it. His wife catches you in the hall and asks about […]
An elderly patient with irreversible respiratory disease is in the intensive care unit where repeated efforts to wean him from ventilatory support have been unsuccessful. There is general agreement among the health care team that he could not survive outside of an intensive care setting. The patient has requested antibiotics should he develop an infection […]
A 5-year-old presents to the emergency department. She was diagnosed with pyelonephritis by her physician yesterday, treated with an intramuscular injection of antibiotic and sent home on an oral antibiotic. She is vomiting today and unable to keep the antibiotic down. As you prepare to admit her, you feel she should have been admitted yesterday. […]
Camille M. Renella, RN, CME, LNC
Clinical Medical Ethicist/Legal Nurse Consultant
Institute of Medicine Chicago (IOMC) Fellow
Executive Director