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Critical Thinking: The Case of the Missing Record

Critical Thinking Exercise 3

The Case of the Missing Record

Mary Dunn was a 65-year old woman who lived alone. Her husband had been dead for many years and her only daughter, Betty Dunn, was actively serving in the military overseas in Germany. Mary was the epitome of health. She ate right, never smoked, and exercised every day by walking three miles. Monday morning when she awoke she did not feel well. She was slightly nauseated and had severe heartburn. A couple of hours later, the pain was no better.She began to feel dizzy so she called her primary care physician, Dr. Nancy Morgan. Dr. Morgan told her to call 911, and that she would meet her at the hospital ER.

Mary was transported to Quinbery General Hospital. During her initial interview she informed the RN, Sarah Thompson, that she had a Living Will and a DNR order on file in her record.Dr. Morgan arrived at the ER and requested Mary s previous records.

Rachel Rivers, a 1st shift HIM clerk, received the call from the ER for Mrs. Dunns medical records. Rachel looked everywhere for the records, but was unable to locate them. While she was looking for the charts, John Roberts, another 1st shift HIM clerk, received another call from the ER requesting Mary s medical records. So, John joined the hunt for the missing records. They were nowhere to be found. Rachel went to Jonathan Smith, the HIM Director and informed him of the missing records. Dr. Morgan came to the HIM department, abruptly stating the urgency of the situation. She had called her office to see if there might be a DNR or living will in their physician records. Again, no paperwork was found.

Meanwhile, Dr. Morgan had the nursing staff contact the daughter to inform her of her mother s condition. It was suggested that she might take leave and come home as soon as possible since her mother was in critical condition and on life support measures. When Betty arrived home she searched her mother s house for a copy of the two missing documents. She too was unsuccessful. Betty had no idea who her mother s attorney was or whether she had even gone through an attorney to complete the documents. Betty was upset with the hospital s inability to locate her mother s medical records that contained the do not resuscitate order and the living will. The following day a feeding tube was inserted and Mary was no longer able to function at all on her own. Betty was faced with a difficult decision and had no idea what her mother s wishes were in her living will.

Critical Thinking Questions:

1. Communications: Define the problem in your own words.

2. Analysis: Compare and contrast the available solutions within this case study.

3. Problem Solving: Select one of the available solutions and defend it as you chosen solution.

4. Evaluation: Identify the weaknesses of your chosen solution.

5. Synthesis: Suggest ways to improve/strengthen your chosen solution.

6. Reflection: Reflect on your own thought process after completing the assignment.

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