Managing Health Care

Address the following situation in a minimum of 500 words with at least one citation supporting your position.

You are a CEO, and Chief of Medicine, of Good Samaritan General Hospital. After acknowledging a knock on your office door a nurse enters and introduces himself/herself as a charge registered nurse in post-partum with more than 30 years of experience including multiple honors for clinical excellence.  

 He/She quickly informs you that he/she and a hospitalist Ob/Gyn physician significantly disagree on a patient’s immediate discharge.  You argue that the patient after delivering a baby the day before via caesarian section has developed a fever and the beginnings of lower abdominal distention with a drop in in her hematocrit.  You are seriously concerned she may have an internal bleed.  

The Physician vehemently disagrees, informs you he did the surgery and in no way is there an internal bleed. The Physician has firmly instructed you as the patient’s nurse to discharge her immediately with the caveat that the patient should self-diagnose and return to the hospital if her situation gets worse.  

You argue, to no avail, that the woman is a single parent with no one at home to care for her and that she doesn’t have the skills or resources by herself to determine if she is gravely ill until it would be too late. The Nurse explains to the CEO he/she has refused to send the patient home on the basis of safety and patient-centered care concerns. The Physician warns he will place charges of insubordination to the nursing board of registration if the nurse does not comply. As CEO and Chief of Medicine, the ball is in your court what would you say and do?

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