Instructions: 1. This is a leadership and management 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 management critical thinking and strategies.

Chapter 25: Integrative Health Practices

Lasandra first visited the very busy Woman’s Free Clinic in a large metropolitan city when she was 24 years old and 8 weeks pregnant. This was the first child for her and her husband

Benito, who had recently arrived from a small central American country and spoke very little English. LaKisha, the nurse midwife who volunteered at the clinic two days a week, performed the initial assessment and ultrasound which showed a normal fetus at 8 weeks gestation. She spoke to the couple in Spanish, although the dialect was different from what the couple spoke in their small rural town.

The couple expressed a high level of fear that the child might be born with downsyndrome since one of Benito’s brothers had the condition. However, when it was explained to them that there was a 1 in 500 chance that an amniocentesis could result in a miscarriage, they opted not to undergo the procedure. They were assured by the nurse midwife that there was a

99.9% chance that the child would not have any form of mental disability.

Lasandra missed several of her follow up appointments at the clinic, but showed up for her six month appointment. A repeat ultrasound was performed and it was reported to the couple that the fetus was doing well and was completely normal.

The baby, Jana, was delivered by a normal vaginal birth at full term at a local hospital by the nurse midwife, however the child was born with only one leg, and no arms. The deformities obviously were not the fault of LaKisha, but Jana’s parents accused her of negligence and malpractice for not properly detecting the birth defects when she performed the ultrasounds. The parents stated that they would have aborted their daughter if they had known she would only have one limb.

LaKisha argued that she was not to blame. The parents refused the amniocentesis which would have clearly shown the genetic markers that were indicative of a condition that could cause a defect in the limbs. Also, the parents were concerned about a mental disability and Jana appeared to have normal mental development and showed no signs of any mental disability.

Questions

• What key legal principles are involved in this case?
• Do you agree with the parents or with the nurse midwife? Why?
• What is the standard of care that a health care provider such as a nurse midwife should be held to in evaluating a pregnant patient?
• Are all the key elements for a malpractice suit present in this case study? What was the harm that resulted directly from LaKisha’s actions?
• Was there any contributory harm by the parents? What was it?
• What ethical principles are involved with this case?