The following story and questions are designed to stimulate critical thinking through class discussion or as a brief essay response. There are no right or wrong answers to these questions.  

Dr. Johnstone didn’t like what he saw. The x-rays of Gladys Gwynn’s hip showed a fracture of the femoral neck and severe osteoporosis of the hip. Mrs. Gwynn had been admitted to the orthopedic ward of Hamilton Hospital after a fall that morning at Sunny Meadows, an assisted-living facility. The accident had occurred when Sheri Smith, a new aide, lost her grip while helping Mrs. Gwynn in the shower.  A frail but alert and cheerful woman of 85, Mrs. Gwynn has osteoarthritis and osteoporosis that have forced her to rely on a walker. Although her finances were limited, she has been living at  Sunny Meadows since her husband’s death four years ago. Dr. Johnstone knew that she didn’t have any close relatives, and he did not think that she had signed a Health Care Power of  Attorney designating someone to help with medical decisions like this.  A total hip replacement would be the logical treatment for a younger patient because it could restore some of her lost mobility. However, for a frail patient like Mrs. Gwynn, internal fixation of the fracture might be the treatment of choice. This would repair the break but not improve her mobility.  Dr. Johnstone needs to make a decision soon, but he knows that Mrs. Gwynn is groggy from pain medication. With one more look at the x-ray, Dr. Johnstone sighs and walks toward  Mrs. Gwynn’s room.

Ehrlich, Ann. Medical Terminology for Health Professions, Spiral bound Version (p. 91). Cengage Learning. Kindle Edition. 

Discussion Topic 

1.  The recovery time for internal fixation surgery is shorter than that following a total hip replacement. The surgery is also less expensive and has a less strenuous recovery period; however, Mrs. Gwynn probably will not be able to walk again. Given the patient’s condition, and the limited dollars available for healthcare, which procedure should be performed?

2. Because the accident happened when Sheri Smith was helping Mrs. Gwynn, do you think Sheri should be responsible for the accident?  Since Sheri is an employee of Sunny Meadows, should the facility be held responsible?

3. Would you answer #2 differently if Mrs. Gwynn were your mother and she had very limited medical coverage?