|
Practice in the Workplace
|
Get assignment help at
ozhelpassignment@gmail.com
|
|
The
assessment is centred on the case study which involves aspects of medical
negligence and violation of duty of care towards a patient. The case study
involves a patient in the emergency department who was being administered
Morphine via intravenous infusion post his operative procedure. Owing to his
pain medication, the patient had been vomiting intermittently throughout the
previous shift and it was now evening. On witnessing this scenario, Pamela (a
newly graduated registered nurse) requested a senior nurse, Jane also working
in the healthcare setting to review the patient’s analgesia. Listening to this,
Jane asked Pamela to cease Morphine and administer Metaclopramide instead.
Pamela pointed out that there was no written order to do the same and refused
to administer this medication without prior written order. Jane then proceeded
on to administer the medication herself and her actions resulted in severe
medical consequences for the patient.
In
context of this case study, the assessment first seeks to discuss legal aspects
such as duty of care towards the patient and negligence. Ethical considerations
in accordance with ANMC codes of practice and responsibilities of the
nurse-client and nurse-nurse relationship have also been highlighted in the
case study discussion.
A
duty of care has been imposed on all nursing professionals and healthcare
providers in Australia by law in all circumstances where this duty might be
reasonably foreseeable. Duty of care of nursing professionals suggests that
nurses have a legal responsibility to care for their patients and they must
avoid all actions and decisions which might harm their patients. Duty of care
of nursing professionals is not limited to situations where harm is caused as a
result of their actions but extends to situations where harm is the result of
not taking appropriate actions to benefit the patients in time (Young 2009). Furthermore,
responsibility has been equated to duty of care in law. In other words, the
legal implication of duty of care is applicable at all times ranging from tasks
involving bathing the patient to a complex surgical procedure. This can be
attributed to the fact that the possibility of causing harm intentionally or
unintentionally exists in every situation. In this context, each nursing
professional owes a legal liability to the patient by accepting to care for the
patient. Legal implications of duty of care also suggest that in case a nursing
professional fails to fulfil his or her duty of care towards a patient, nursing
actions might be punishable by law depending on the severity of nursing actions
and consequences for the patient. Individuals at the receiving end of these
nursing actions also have a legal right to contest such nursing actions in a
court of law (Weaver 2011).
In
context of this case study, it is evident that the duty of care has been
violated by Jane. Her decision of not seeking a written order for
administration of Metaclopramide resulted in the patient suffering from an
allergic reaction which had to be treated with the help of an immediate medical
intervention. Jane also did not take enough care to examine the patient’s past
medical history or listen to Pamela when she indicated that there is no written
order. Jane’s actions are in severe violation of duty of care of nursing
professionals and can be contested in a court of law.
Malpractice
and negligence are interchangeably used in Australian litigation with the only
difference being that malpractice is a specific kind and restricted form of
negligence (Turton 2009). Negligence
in nursing literature has been defined as a specific action or non action which
results in breach of standards of care and causes damages or results in
malpractice. Australian legislation however requires that the aspect of
negligence needs to be properly established before a case can be filed in a court
of law. In this context, four key elements of negligence have been defined by
the legislation. These elements comprise of duty, breach of duty, causation and
damages or injury. It has been suggested that all four elements of negligence
need to be present in an incidence before it is recognised in a court of law (Walker 2011).
All
four elements of negligence can be recognised in the provided case study. The
aspect of duty can be realised as Jane had agreed to oversee revision of
analgesia of the patient. Aspect of breach of duty can be realised as Jane
failed to comply with standards of nursing care, procedures and policies as
prescribed by the ANMC when she decided to proceed with administering
Metaclopramide without seeking a written order. Aspect of causation can be
realised by the fact that Jane’s decision led her to administer Metaclopramide
without a written order. Lastly, the aspect of damages can be realised by the
fact that Jane’s actions led to a severe allergic reaction which had to be controlled
by an immediate medical intervention. Thus, this case can be contested in a
court of law.
Scope
of practice of a nursing professional has been defined as the concerned nurse’s
ability to undertake medical decisions based on her/his knowledge, skills,
education, competence and lawful authority. In this case, Jane was an
experienced registered nurse. Her knowledge skills, competence and the lawful
authority in Australia made her eligible to administer intravenous medication.
However, such medication could only be provided after a written order in this
context has been issued by the treating physician. Jane in accordance with
scope of her practice did not have the authority to decide on the patient’s
medication and proceed on to administer the same without consultation (Pulcini et al 2010).
Code
of conduct for nursing practice in Australia suggests that nursing
professionals practice in a competent and safe manner. In other words, nurses
are personally accountable for provision of safe nursing care. Further, it has
also been suggested that all nursing professionals need to understand that
undertaking actions which do not fall within their scope of practice might harm
the patient. Code of conduct also suggests that all nursing professionals are
required to practice and conduct themselves in accordance with laws which are
relevant to their profession. Both these codes of conduct have been violated in
this case scenario. Jane can be held accountable for the fact that she needed
to deliver safe nursing care to the patient and should not have taken a
decision which had the potential to harm the patient. Another code of conduct
which might be considered violated in this case study involves an element of
trust. Code of conduct for nursing professionals in Australia suggests that
nurses act in a manner so as to build and enhance the community’s trust in the
profession. Jane’s actions can certainly be considered in direct violation of
this code of conduct (ANMC 2009).
Further,
codes of ethics for nursing professionals as provided by ANMC suggest that all
nursing professionals are required to fulfil the responsibility and
accountability of their inherent roles. It has been suggested that nurses are
morally autonomous professionals and thus are completely accountable for their
decision making in a clinical setting. Further, codes of ethics as provided by
ANMC are suggestive of the fact that nursing professionals need to make a
positive contribution to the healthcare setting by collaborating with each
other and respecting everyone’s opinion in the healthcare setting. These codes
of ethics have also been violated in this case study. As an autonomous
professional, Jane should have been completely aware of the consequences that
her decision might have on her patient. Thus, it can be argued that she did not
fulfil the aspects of responsibility and accountability inherent in her role. Also,
she did not respect Pamela’s opinion when she indicated the absence of a
written order and proceeded on to administer the medication. In this context,
it can be argues that Jane’s actions were not ethical in nature (ANMC 2009).
Further
expanding on the ethical aspect of this case study, it can be concluded that
the ethical principles of beneficence and non-malfeasance have been violated. The
ethical principle of beneficence states that all healthcare professionals
should seek to benefit their patients and the community by their decisions and
nursing actions. In this context, nursing professionals should clearly evaluate
their potential benefits for the patient. This ethical principle has been
violated as Jane failed to speculate and evaluate the fact that her decision
might lead to serious consequences for the patient. She also did not speculate
that her decision to administer the medication had the potential to harm her
patient (Harrowing et al 2010).
The
ethical principle of non-malfeasance is closely related to the principle of
beneficence and suggests that all nursing actions which have a potential to
harm the patient should not be undertaken. This principle suggests that health
and safety of patients is paramount and no nursing action should be undertaken
to compromise care. Bearing similarity with the principle of beneficence, this
ethical principle has also been violated in this case study. Jane’s decision to
administer Metaclopramide without a prior written order or consultation of the
patient’s prior medical history harmed the patient and resulted in a severe
allergic reaction. This decision and following action was undertaken despite
its potential to cause harm (Goethals
et al 2010).
Proceeding
with discussion on this case study, several nurse-client and nurse-nurse
relationship responsibilities have been suggested in literature. In context of
nurse-client relationships, it has been suggested that the relationship needs
to be therapeutic in nature. Additionally, it has also been suggested that the
needs of the client need to be placed first and nursing professionals are
responsible for maintaining components of trust, respect, professional
intimacy, empathy and power. Further, nursing professionals are responsible for
ensuring that they maintain a professional relationship with the client and
seek to provide a holistic care to their patients (Fronek et al 2009).
Analysing
this aspect in context of the present case study, it can be argued that Jane
was unable to fulfil her responsibility in the relationship. Her actions would
certainly serve to breakdown the trust the patient would have had in his
healthcare professionals. It can also be argued that Jane misused her power
over the care provision system and performed procedures she was not supposed
to.
Also
according to nursing literature, nurse-nurse relationships are based on mutual
understanding and respect for each other and for the profession. Primary
responsibility of this relationship consists of respecting each other’s opinion
and honouring each other’s expertise in the healthcare setting. Furthermore,
responsibilities of this relationship include reminding each other of their moral
and ethical responsibilities and not letting mistakes happen. Discussing this
aspect in context of this case, it can be argued that these responsibilities
have not been fulfilled. Jane did not honour Pamela’s opinion and her expertise
when she tried to suggest that a written order is missing. Pamela also was not
assertive of her opinion. She merely stated that she is not willing to
administer Metaclopramide without a prior written order but did not stop Jane
from doing the same (Hughes &
Fitzpatrick 2010).
In
conclusion, analysis of this case study is suggestive of several violations
with regard to ANMC codes of ethics, professional code of conduct, ethical
principles of practice and responsibilities of relationships which exist
between a nurse and her client as well as between two nursing professionals.
Legal aspects of the incident can also be drawn as all key elements of medical
negligence can be identified in the case study. Lastly, it can also be said
that duty of care of nursing professionals has been violated by Jane in the
case study and this incident would serve to decrease the amount of trust
patients and the community has on nursing professionals.
References
Fronek, P., Kendall, M., Ungerer, G., Malt, J.,
Eugarde, E., & Geraghty, T, 2009, ‘Towards healthy professional-client
relationships: The value of an inter-professional training course’, Journal of Interprofessional Care, vol 23, no 1, pp 16-29, viewed
05 September 2013, via PubMed < http://www.ncbi.nlm.nih.gov/pubmed/19142780>
Goethals, S., Gastmans, C., & de Casterlé,
B. D, 2010, ‘Nurses’ ethical reasoning and behaviour: A literature review’, International Journal of Nursing Studies, vol 47, no 5, pp 635-650, viewed
05 September 2013, via PubMed < http://www.ncbi.nlm.nih.gov/pubmed/20096413>
Harrowing, J. N., Mill, J., Spiers, J., Kulig,
J., & Kipp, W, 2010, ‘Culture, context and community: ethical
considerations for global nursing research’, International nursing review, vol 57, no 1, pp 70-77, viewed
05 September 2013, via PubMed< http://www.ncbi.nlm.nih.gov/pubmed/20487477>
Hughes, B., & Fitzpatrick, J. J, 2010, ‘Nurse-physician
collaboration in an acute care community hospital’, Journal of interprofessional care, vol 24, no 6, pp 625-632,
viewed 05 September 2013, via PubMed <
http://www.ncbi.nlm.nih.gov/pubmed/20807034>
Nursing, A., & Council, M, 2009, Code of
ethics for nurses in Australia, ANMC,
R CN, Canberra < http://www.contemporarynurse.com/archives/vol/26/issue/2/article/509/>
Pulcini, J., Jelic, M., Gul, R., & Loke, A.
Y, 2010, ‘An international survey on advanced practice nursing education,
practice, and regulation’, Journal
of Nursing Scholarship, vol 42,
no 1, pp 31-39, viewed 05 September 2013, via PubMed <
http://www.ncbi.nlm.nih.gov/pubmed/20487184>
Turton, G, 2009, ‘Factual and legal
causation-their relation to negligence in nursing’, British Journal of Nursing, vol 18, no 13, pp 825-827,
viewed 05 September 2013, via EbscoHost <
http://connection.ebscohost.com/c/articles/43022166/factual-legal-causation-their-relation-negligence-nursing>
Walker, R, 2011, ‘Elements of negligence and
malpractice’, The Nurse
Practitioner, vol 36,
no 5, pp 9-11, viewed 05 September 2013, via NursePractitioner <
http://journals.lww.com/tnpj/Citation/2011/05000/Elements_of_negligence_and_malpractice.4.aspx>
Weaver, D, 2011, ‘Introduction to duty of care
in health and social care’, Nursing and Residential Care, Vol 13, no 5, pp 214, viewed 05
September 2013, via InterNurse < http://www.internurse.com/cgi-bin/go.pl/library/contents.html?uid=4000;journal_uid=13>
Young, A, 2009, ‘Review: the legal duty of care
for nurses and other health professionals’, Journal
of Clinical Nursing, Vol 18,
no 22, pp 3071-3078, viewed 05 September 2013, via PubMed <
http://www.ncbi.nlm.nih.gov/pubmed/19825113>
Nice Blog!!! If you are looking for Assignment writing Experts Help Australia, then you can contact at Complete Assignment Services. We are having the best writers who can help in their best way to grade up. This helps us to create the best quality assignments on the time.
ReplyDelete