Nursing Intervention for Absconding Patients: Strategies and Ethical Issues

Running Head: NURSING INTERVENTION
NURSING INTERVENTION
Name of the Student
Name of the University
Authors Note

NURSING INTERVENTION1
Driscoll’s cycle of reflection mainly consists of three steps. The description of the event
followed by analysis and proposed actions of the event. In this case, Shelley is a 27 year old
female who has been admitted in a busy medical ward of a regional hospital for three days. She
was admitted for getting diagnosed with left lower lobe pneumonia. She is also suffering from
Acquired Brain Injury (ABI) from a fall from her horse 18 months earlier. She has a tendency to
wander into other patient’s rooms and abscond from the hospital.
There are many important strategies that I should adopt to prevent my patient from
absconding or wandering about in other patient’s room. She needs to accept the medications so
that she feels less anxious and her health improves. I should devote my time to the patient for
establishing strong therapeutic relationships with her. She needs person centered care that is
culturally responsive (Berg, Rørtveit and Aase 2017). I should engage her in communication and
other entertaining activities like indoor games so that she can participate and make her mind
busy. She needs to deviate her thoughts from those that makes her anxious. She needs
deontological care. Her mother is away to see her brother for three weeks and has not visited her
since she got hospitalized. This is one of the main reasons for her arousing anxiety. Since Shelly
is 27 years old she needs more care and I should try to make her feel comfortable in the hospital
surroundings, try to reduce her feeling of restriction within the hospital premises.
There are many ethical and legal issues which a nurse needs to face while dealing with
such wandering and absconding patients. It is the right of the patient to get acknowledged of the
type of treatment he or she is receiving with informed consent. If violated it leads to disclosure of
the confidentiality of the patient and involuntary treatment and autonomy disruption. In my case,
Shelley’s mother is away from her. She is not in a state to give the consent on her own for her
treatment. Additionally, her mother is also not present for consent approval or permission for

NURSING INTERVENTION2
starting of new medications. This hampers the autonomy of ethics. Ethics refers to a form of
conduct by the nurses towards her patient (Bipeta 2019). Shelley’s condition is very critical and I
need to violate my code of conduct and force her in bed so that she does not absconds and harms
any other patients or herself. Her actions has forced the hospital community to apply a closed
setting on Shelley but this had adverse effects on her. She grew more intolerable and started to
behave abruptly. She has been ordered for a regular dose of sedative medication to commence
but she is so violent that is nearly impossible for applying a minimal dose. As a nurse I feel that
family centered care must be approached and a consent from her mother should be taken for
application of these drugs on her. It is also essential to persuade her mother to visit her as soon as
possible as she gets anxious from her absence in hospital. Her presence would have definitely
impacted her positively and she would have responded in a calm and quiet manner.
There are many ways in which the absconding behavior of the patient can be prevented.
There needs to be a smooth relationship between the patient and the health care professional.
This will promote the beneficence of ethical principle. The first step includes asking the patient
about how she wants herself to be addressed. I should also describe my reason of my presence
with her and the explanation of my role towards her. The purpose of my caring should also be
cleared. I should let her question me and clear her doubts regarding the assessment procedure.
This will decrease her feelings of anxiety and uncertainty and uncomfortableness. I should
devote quality time with her and listen to her with patience and respond to her (Gu 2015). I
should be able to visualize her perspective of life and support her, highlight her strengths and
motivate her. This deontological approach is very crucial for her health. I should be aware of
making and keeping my patient in comfort zone within that private hospital environment. Shelley
is independent of her daily activities and living style and I should consider that get connected.