Mary Lewis Personality: Story Of One Patient

The story of Mary Lewis began at her home where she is currently having physical therapy to recover from a narrated fall as indicated by her medical documentation. Mary is being treated by Tawyla Roberts at her home. Tawylw Roberts is a physical therapist in a community care agency name Marion Home Care Agency. Tawya patients includes both adults and children, in most cases elder adults. Tawyla provided physical therapy on a weekly basis for Miss Mary for some time and became relatively close to her. The have built a thrusting relationship.

Mary and Tawyla met when Mary was being discharged from the hospital and was informed that she will need additional physical therapy treatments after discharge. The Marion Home Care Agency was part of the healthcare system and provided such services, hence Tawyla was assigned to Mary. Tawyla like all other therapist that work for Marion Home Care are thought and are required to enter all treatment, progression, and patient information into the system. The system is a computerized medical record program connecting a few hospitals and homecare agencies along with the providers. The system allows providers to see what is going on with their patient. For example, when Tawyla would finish a session of therapy with Mary, her treatment, her progress, and recommendation would be recorded. With all information accurately documented Mary’s surgeons, physicians, and nurses can track her progress as necessary without phone calls or physically visiting the provider’s location. All caregivers were able to communicate efficiently virtually.

As Mary and Tawyla carry on with their normal conversation and therapy one day Mary all of a sudden decided she wanted to confess something to Tawyla. Mary ask that Tawyla keep the confession confidential. She even asked Tawyla to promise, however, Tawyla did not agreed to anything. After the confession Mary also regretted her confession. The confession was that Mary did not tell the truth when she was at the hospital as to how she got injured. The providers did not dig into her story and proceeded to treatment. According to Mary she did not ended up at the hospital because of a fall but because of a push from her husband. Her husband is an older gentleman who suffers from Alzheimer and it seems to be getting much more severe with time. Mary confessed that she did not tell the truth because she did not want to be separated from her husband at any cost.

Mary believes and accepted that her husband is ill and in his normal senses he would never do anything to hurt her. She is so concerned about his well being and keeping him safe at home she did not even told her daughter about the resent situation of him pushing her and his increasing physical aggressive behavior. Tawyla listened carefully to Mary’s concern but she did not make any promises to keep the confession a secret. After treatment Tawyla must log all her treatment into her laptop to update the medical record and documentation. At this point Tawyla was somewhat nervous and unsure what to do with the information she received from Mary.

It could be considered that if Tawyla does not document the situation it will continue and perhaps the next time it could be fatal. On the other hand, if she does document the situation Mary’s husband can be separated and sent to a medical institute for treatment. This would break all trust with Mary as she had mentioned that she never want to be without her husband. If Tawyla reports, her conversation of the physical violence in Mary’s home it will definitely trigger an investigation considering other social worker such as Michael White is suspicious of Mary’s husband’s behavior. The parties involved in Mary’s situation are numerous care givers including Mark White the social worker who have access to all her medical documentations. However, the primary parties involved are Mary, Tawyla, and Mary’s husband.

The ethical dilemma here is whether or not to Tawyla should document the private conversation she had with Mary. Despite Mary regretting and asking Tawyla to keep the information private. As Tawyla contemplate what to do, a few questions must come to mind. Questions like, what will happen if the information is documented and then exposed causing Mary’s husband be removed from their home? How will their relationship change in reference to trusting and honesty? The trust and relationship will most likely be destroyed. What if Tawyla decides to ignore the confession and never document it, pretended it never occurred. Maybe the next time he loses control it will be a much serious injury or possible death.

If the physical aggressiveness continues and Mary ends up in the hospital again and then decided that she and her husband needs help and mention to the care givers that she told Tawyla about the previous incident. Tawyla could be in a devasting situation because she could have prevented this from reoccurring by reporting it. After all physical therapist like all other medical care givers have a moral, ethical, and legal obligation to protect their patients. Even if that means they must break that trusting relationship, however, to decrease trust is like harming one’s patient. The duty of Tawyla is to protect Mary. The Ethical dilemma comes down to keep the secret and hope that it never happened again, in which case it will happen again because of rapid progression of the disease or to report it and protect Mary from further harm even though she’ll be disappointed and probably hurt from being separated from her husband.