On a recent exam, one question was answered incorrectly by 28 out of 30 students in our class, yet our professor remains adamant. Here it is:
"A man who has a profuse, purulent urethral discharge with painful urination is seen at the sexually transmitted disease (STD) clinic. Which information will be most important for the nurse to obtain?"
A.) The date of his last sexual activity
B.) A prior history of STDs
C.) When the symptoms began
D.) The names of recent sexual partner
The class majority was an even split between B and C. Apparently the right answer was D. This was rationalized as a community health choice; a prioritization of preventing the spread of this STD. It's not that the other actions won't be performed, just that this one is the *most important.*
Funnily, this was the first answer I crossed off, for sounding absurdley wrong. To me, this seems to be an ethical decision to place "the good of the many" above his, at least initially. I can't wrap my mind around focusing on everyone else while this man is my patient. Note, this question doesn't state I'm a community health nurse, or someone else who may place a much greater emphasis on the epidemiological aspects of his visit.
I'm very curious to hear some opinions on this! Thanks
"C" would have been my answer as well. An answer of "D," one would also have to further take in consideration the question of "HIPPA" privacy issues as well. . . However, in the original question as it was posed; it was "not" asking what the ethical implications of the line of questioning; rather it was a question of prioritization of care. Addressing the "public health" question as implied, is secondary to addressing the immediate concern for initiating treatment as needed.
I couldn't answer the question first, but when you said 'D' is correct I rationalized it my self. Under HIPPA, we should not reveal patients' medical information. I think, however, the public health outweights it. STD is transmitted by personal contacts and thus there are chances that other people may get infected. My point is that preventing the disease for the public is more important than treating a patient's STD which is not critical at the moment. And again, the question indicates what is most important.
If I took this test, I might as well answer “c” as I would prioritize first the health of my client, but if we really are to analyze the stem question, what’s being asked is the “most important” information that we should get, and “d” really is the answer for that