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Running head: MORAL DILEMMAS AND ETHICAL DECISIONS1Moral Dilemmas and Ethical DecisionsShaleta S. BoydCapella UniversityNursing Research and InformaticsMoral Dilemmas and Ethical DecisionsDecember, 2018
MORAL DILEMMAS AND ETHICAL DECISIONS2Moral Dilemmas and Ethical DecisionsProviding healthcare in an emergency room is often met with moral and ethical challenges. Emergency department (ED) nurses have to deal with the ethical issues of triaging patients with time constraints in the wake of overcrowding. This presentation will review the triage procedures in a recent incident involving two patients, one of which faced multiple disparities. There will be an explanation of healthcare policies that direct triage care in an emergency situation. Then there will be a review of the impact healthcare disparities has on treatment decisions. Also, an identification of policies that directs care for the uninsured, and how that affects the triage process. The presentation will also discuss the moral and ethical challenges nurses face with following hospital protocol. Finally, there will be recommendations for evidence-based strategies that should be utilized for managing care provided to patients with healthcare disparities.Healthcare Policies and ProtocolsThere are protocols and policies in place in the ED that steers triage care in emergencies when there are insufficient resources available to deal with issues of overcrowding. There are triage guidelines that score patients in the ED based on several categories that determines urgency[Aac11]. Studies have indicated that five-level triage systems, such as Manchester triage system, have proven to be more effective and reliable, than the initial three level systems that were used (Aacharya et al., 2011). These systems are used to sort patients into categories to determine the priority in which patients are treated. In the case of Frank Jeffers and Brent Damascus, the triage nurse should have used the triage guidelines and ethical principles to determine who needed help first. This decision is based
MORAL DILEMMAS AND ETHICAL DECISIONS3on protocols of the Emergency Severity Index (ESI), which is used to determine which patient needs to be treated immediately based on their health rather than social status. The triage systems

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