Aburu, 81, with a history of cerebral vascular accidents, was hospitalized as an outpatient for a surgical procedure to incise and drain a skin lesion on his chest. After the procedure, he returned to the long-term care facility with sterile packing in the partially sutured incision site. The packing was to remain for 3 days, then be removed, and the wound covered with a dry dressing. The risk of complications for this type of surgery was considered quite low, and both the nursing home administrator and the attending surgeon saw no reason why the patient could not be adequately cared for in the nursing home immediately after surgery. A pproximately 5 hours after Mr. Aburu returned to the nursing home, blood was observed at the incision site. He was transferred back to the acute care hospital, where he died the following day. E vidence at trial showed that for the 5 hours that Mr. Aburu was at the nursing home, several licensed and unlicensed personnel attended to him. At lunchtime, two aides escorted Mr. Aburu to the dining room; lunch was about 3 hours after his return to the
nursing home. None of the personnel examined his dressing until an aide noticed that he was bleeding though his bed sheets. Shortly after discovering the bleeding, the patient was transferred by ambulance to the hospital. His family has filed a lawsuit for the wrongful death of their father, alleging that the care given to the patient after surgery fell below the acceptable standards of care.
- What should the standards of care be for such a patient?
- Even though the nursing care plan did not specify that the wound should be checked hourly, how should the prudent nurse have acted?
- Should the lawsuit center primarily on the surgeon for allowing this patient to be sent back to the nursing home for post- operative care rather than insisting he be kept for 24 hours in an acute care facility post-operatively?
- How would you decide this case?
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