Journal reflection regarding ethical considerations

Assignment Objective:
To provide a private, journal reflection regarding ethical considerations and strategies you would implement when caring for Hannah who has an eating disorder.

Case Study:
Review the following case study (Case study is also in Appendix A, page 329 in Butts & Rich textbook):
Hannah, aged 13 years, overheard some of her friends in the hall at school talking about her big build and weight. Hannah was devastated! According to the family physician and her family, she was a normal weight and size for a girl her age. She looked at herself in the mirror many times, each time with more and more disgust. She began receiving harassing instant messages from people she did not recognize. These remarks by her friends bothered her so much that Hannah began thinking about how she could lose weight. She was terrified at what her classmates thought about her, and she thought of not fitting in or losing her friends.

Over the course of a few days, she became so obsessed with her weight that she began visiting various Ana websites, such as Thin Intentions Forever and Ana Boot Camp. She found great comfort in knowing that many girls her age were having similar feelings about themselves.

The websites and people commenting on blogs encouraged her to lose weight. Hannah first began cutting out all desserts, all milk products, and all fats from her diet. Later, she progressed to eating only green salads, tiny servings of meat, and water. She increased her exercise to at least 1 hour of full aerobics every day. She lost considerable weight.

Everyone mentioned her weight loss to her, which encouraged her to continue. Not knowing Hannah’s secret, her parents appeared proud of her new healthy eating pattern and exercise program, and therefore, they did not worry until later when people started commenting on her extreme weight loss and unhealthy appearance.

Hannah discovered she could not stop her new eating and exercise ritual, nor did she want to. A couple of Hannah’s friends discussed their concern with Hannah’s mother. Her mother took her to the family physician. After the physician diagnosed her with anorexia nervosa, the nurse provided them with resources for recovery and support.

Instructions:
1.  Review the content and statistics related to eating disorders, trust, and limits of confidentiality in the chapter. Then, search websites such as Ana Boot Camp and Thin Intentions, as well as those websites that provide recovery guidelines and support for anorexia nervosa.

2.  Create a journal entry and answer the following questions (this journal entry is private).  Within your journal entry, provide a reference list for Text and websites reviewed.

Adolescents engaging in risky behaviors tend to keep it hidden from others as long as possible. As a school nurse, what strategies would you implement to monitor signs of eating disorders?

Explore the limits of confidentiality for an adolescent. As a school nurse, what ethical considerations would you face?

What online information did you discover about the recovery and support site? How would you incorporate some of the information in your strategies?

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