Instructions: 1. This is a leadership and managment assignment. Review case study. Answer questions. Write a summary and upload a copy.

2. Envision being the RN experiencing the situation and comment on how you would handle the situation. Post focusing on leadership and managment cricial thinking and strageties.

Nursing Now Case Study

Chapter 13: Health-Care Delivery Systems

Case Study

Katie is an advanced practice nurse who works in a busy neurosurgical unit in a large teaching health care center. She has become friends with several of the neurosurgeons who are nationally recognized for their skills. One day she is approached by an RN friend of hers, Ginger, who works with immigrants in a free clinic, on behalf of a patient who recently came to the United States from Costa Rica. The woman brought her twin sons who were born joined at the head. She approaches one of her physician friends about examining the twins for possible surgery. The physician agrees and after the exam, is very excited about the prospects of surgery to correct the defects and separate the twins. It would be a first-time cutting-edge surgery that he could get published in major medical journals and also gain international recognition for. Unfortunately, the patient will not be able to pay for the surgery.

The physician orders a number of image studies which appear to indicate that both infants should survive the surgery, but they will need intensive hospital care for several months after the surgery. They will also need long term outpatient rehabilitation and home care. Quite often, children who have severe neurological problems will have life time deficits including retardation and mobility issues.

After explaining the procedure to the Chief of Staff, the department expresses its interest in performing this ground-breaking surgery. The physician and several other surgeons offered to perform the surgery without pay, and the hospital, because of its status as a major teaching institution, agreed to provide post-operative inpatient care at no expense to the family. However, no one has come forth to pay for the care after the twins leave the ICU and for outpatient follow-up. Because the condition of the twins has been deteriorating, the physician schedules the surgery in two days’ time.

Questions

• Should the family’s ability to pay for long-term and home care for these children play a role in the physician’s decision about when and whether to perform the surgery?
• What should Katie include in the teaching plan for this family?
• If no funds are available for future care, should the surgeon operate? Where might the mother of the twins find additional funding?
• Is the surgeons’ and hospital’s willingness to forgo any payment purely altruistic? If not,

how might they leverage the media attention into funding the recovery of the twins?

• How do you feel about people from foreign countries coming to the US to receive advanced health care for free?
• Is there an issue of distributive justice in the use of scarce resources?