| Ms. Robertson, a 78 year old is
hospitalized after a hip fracture. A speech-language
consultation is requested because her physician is
concerned about her cognitive abilities. The evaluation is
conducted by Scott, a student clinician. He observes mild
cognitive deficits, but also notes that Ms. Robertson
coughs immediately after taking sips of water and that she
has a wet voice quality for several minutes after drinking.
From the medical record, Scott notes that she had pneumonia
on admission to the hospital and has been treated for
pneumonia at least three times in the past 9-months.
Scott discusses his observations with his supervisor. He
recommends a "bedside" swallowing evaluation and
possible videofluoroscopic swallow examination. His
supervisor suggests that she coughs because she is
recovering from pneumonia. Furthermore, they were consulted
for a cognitive assessment, thus his observations about her
swallowing are inappropriate to include in his report.
Scott is concerned about the patient, but unsure of his
role as a student and questions how to interpret his own
observations.
Questions to consider
:
1. Does the Code of Ethics provide guidance in this
case?
2. What is the role of a student in advocating for
patients and handling disagreements with a supervisor?
3. What approaches could Scott take to continue the
discussion with the supervisor?
|
Responses:
Annotated Bibliography
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