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Case Study – Unit 4 The ethical discernment model described by Slosar (2004) and developed for use at Ascension Health will assist us as we analyze this case. It reminds us that discernment engages our spirituality, intellect, imagination, intuition, and beliefs. It is decision-making that reaches into the heart of our beliefs about God, creation, others, and ourselves. It therefore requires structured time for reflection and prayer from the beginning and throughout the process. All states’ laws require reporting when suspected abuse has occurred, and forensic examination is a part of collecting evidence. The presence of a sexual assault nurse examiner (SANE) and a pediatrician skilled in sexual abuse examinations indicates that strict protocol was followed. The child is described as a resident of “a very rural part” of a western state; therefore, conducting the examination as detailed spared the child and family the added stress of extensive travel. According to Foster and Whitworth (2005), telemedicine offers proficient consultations, immediate evaluations, and eliminates transporting the patient to a facility hundreds of miles away. It gives them access to the best possible care, with the least inconvenience and has been shown to be very beneficial in rural areas (Wesson & Kupperschmidt, 2013). This patient in particular needs a nurse with therapeutic communication skills to establish and maintain the trusting nurse/patient relationship so vital to her recovery. When a child experiences abuse, in addition to hurt and anger, the victim has their sense of right and wrong challenged. Whether psychological, physical, sexual, or emotional abuse, the victim may believe they deserve what they are going through. This causes low s... ... middle of paper ... ...005). The role of nurses in telemedicine and child abuse. CIN: Computers, Informatics, Nursing, 23(3). pp. 127-131. Retrieved from http://www.medscape.com/viewarticle/506916_7 Grace, P. J. (2014). Nursing ethics and professional responsibility in advanced practice. (2nd ed.). Burlington, MA: Jones and Bartlett. Kangasniemi, M., Vaismoradi, M., Jasper, M., & Turunen, H. (2013). Ethical issues in patient safety: implications for nursing management. Nursing Ethics 20(8); 904-916. doi: 10.1177/0969733013484488 Slosar, J. P. (2004). Ethical decisions in health care. Health Progress. pp. 38-43. Retrieved from http://www.chausa.org/publications/health-progress/article/january-february-2004/ethical-decisions-in-health-care Wesson, J., & Kupperschmidt, B. (2013). Rural trauma telemedicine. Journal Of Trauma Nursing, 20(4), pp. 199-202. doi:10.1097/JTN.0000000000000012