Legal and Professional Issues - Essay Example

? Legal and Professional Issues Legal and Professional Issues Introduction Professionalism and the law are major aspects in medical and nursing practice which must be given due consideration and regard by all medical professionals. This is necessary because it will safeguard the safety of patients and at the same time prevents the health care professionals from the legal consequences that would emanate from the disregard of the law. The training of nurses and other health care providers is aimed at making them aware of the legal and professional framework within which their practice should be based. This paper presents four case scenarios which illustrate various aspects of legal and professional conduct of nurses and health care providers as pertains to the use of medications, research and care of patients. The case scenarios are analysed in line with the legal provisions that are stipulated by the Australian Department of Health and regulators in Victoria. The analysis of the case scenarios includes a reflection of the ethical and professional issues that are being presented and what should have been done to avoid various forms of misconduct on the part of health care providers. Case 1 Case scenario 1 presents a situation where Nurse M has violated the law that prohibits the use of controlled medications without a prescription. According to the Department of Health, Victoria (2012), drugs that are controlled must be used only with a prescription from a physician or a doctor. This means that Nurse M has violated the legal framework as provided by the Department of Health. The law requires that the nurse is reported to the relevant authorities in accordance to the legal procedures that are ascribed by the department. This is to be backed by convincing pieces of evidence which would be used to determine the legal provisions in nursing care that have been violated by the nurse. In health care education, nurses and other health care practitioners are presented with relevant information and data in addition to guidelines within which they should base their professional practice (DeWolf, Bosek & Savage, 2007). These guidelines include the use of medication and ensuring that the safety of patient is safeguarded. In this regard therefore it is argued that Nurse M disregarded the provisions of nursing training as demonstrated by the non-professional conduct in the use of medicine. In this case, Nurse M has also violated the standards of professional practice by taking controlled medication without permission. This is provided by the legal framework which protects medication within the hospital environment from theft and possible misuse or abuse of such drugs (Forrester & Griffiths, 2010). In this sense therefore, Nurse M has violated more than one count of the legal provisions in professional practice. Therefore both professional and legal considerations have to be put in mind in deciding upon the course of action against the nurse. Nurse M is obliged to take professional responsibility for her actions. According to the Nursing and Midwifery Board of Australia (2012), nurses are obliged to conduct and practice nursing with professionalism and adherence to the laws which govern the practice and profession of nursing. The actions that Nurse M engages in are compromising to the care of patients. This is against the Code of Professional Conduct for Nurses in Australia. The code of conduct mandates nurses to practice in line with the standards of professionalism as defined within the broader health system (Nursing and Midwifery Board of Australia, 2012). Since Nurse M denies her misconduct, taking action against her is a challenge which requires that evidence must be produced so that any form of doubt is removed before her actions can be measured in line with the provisions of the law. This case reflects a dilemma within the nursing profession where nurses are faced with hard decisions of responsibility. This is demonstrated by the fact that Nurse M is a single mother who is in need for her job. However, a disregard of the provisions of the law should be avoided regardless of the situation of the health care provider who violates the legal and professional framework of conduct. In this case Nurse M is to be reported after comprehensive consideration of all professional, legal and ethical frameworks which govern care. The Code of Professional Conduct for Nurses in Australia further stipulates that nurses who experience or witness unlawful conduct by their co-workers or colleagues have a responsibility of reporting such cases to the relevant authorities within the hospital. This is aimed at safeguarding the lives of those who would be put in danger for such unlawful or professional conduct (Nursing and Midwifery Board of Australia, 2012). The dilemma within Nurse M’s conduct requires that she is made aware about the seriousness of her misconduct and how it would lead to the loss of her job. Depending on the circumstances of the misconduct and the readiness of nurse M to admit to her actions, she would be reported to the management and face the board for evaluation of her violation of legal and professional requirements for proper action. Case 2 The Department of Health, in conjunction with the Human Research Ethics Committee of Australia stipulates that requires that the approval of patients is sought before they are involved in any research. This is supposed to take place under the processes of informed consent (Department of Health, 2012). The case of Patient X illustrates the use of medical records to perform a research without her consent. This demonstrates that Dr W violates the legal provisions of doing medical research as stipulated by the Department of Health of Australia. Since the patient agreed to take part in the research, her consent could have been obtained before any of her personal medical data would be used for the research. This case scenario also reflects professional misconduct in the use of patent records. According to the provisions of the Department of Health, the confidentiality and privacy of patient record must be upheld by all medical professionals. This means that the record of the patients must not be disclosed for research or other purposes without approval from the patient. In addition, security of patient data should be ensured by all medical professionals as part of their professional obligation (Department of Health, 2012). In this case, Dr W violates this professional obligation by taking patient data at home for the research which predisposes the data to possible unauthorized access and use by a third party without the awareness of the patient. The medical record management within this case demonstrates a case of professional misconduct. The medical records officer should not have provided the patient data to Dr W without the consent of the patent. In addition, the health record management failed to safeguard the rights of patients for privacy of personal data through disclosure that was not consented. In addition, the impatience that Dr W demonstrates is not in line with the requirements for appropriate professional conduct. Moreover, Dr W assumed that since Patient X agreed to take part in the research, personal data would be used further without the okay of the patient. This case further shows the failure of the head of the ward to prevent the use of patient data which violates the legal framework and the standards for professional practice. Any form of misconduct or violation of the legal provisions as pertaining to medical research must be reported to the relevant authorities for a course of action (Johnstone, 2009). Case 3 In Australian nursing provisions, the establishment of a mutual and useful client-nurse relationship is therapeutic and professional. The nurse’s effort to create a comfortable relationship with patient Q was in accordance with the Australian health care regulations. Excellent nurse-patient relationship in the cases under study therefore played an exceptionally essential role in ensuring the clients’ healthcare needs were granted the first priority by the concerned health practitioner. According to the existing regulations, nurse-patient relationship should be specifically designed to meet the patient’s health needs while accomplishing the nurse personal aspirations. According to the Australian nursing regulations, the nurse is obligated to establish and maintain boundaries in a nurse-patients relation irrespective of the patients’ behavior and health condition (Forrester & Griffiths, 2010). The nurse-patient relationship should however be based on several factors as explicated by the law. As per the case under study, the relationship was based on mutual trust and respect. Due to the vulnerability of the client, trust between the nurse and client is essential. The prevailing trust between the client and nurse in the cases under study can to some extent be linked with the proposed offer. Reciprocated respect in a nurse-patient relationship helps in the recognition of dignity and worth of the client irrespective of the client’s personal attribute, nature of the health problem and social-economic status (Beach, Roter, Larson, Levinson, Ford & Frankel, 2004). In reference to the Australian nursing regulations, the relationship between the client and the nurses should as well be based on professional intimacy. Professional intimacy is essential in defining the nature of services to the client. In this case, professional intimacy involves provision of social, spiritual, and psychological elements as defined in the Australian healthcare plan (Smith, Taylor, Keys, & Gornto, 1997). Empathy is important in necessitating effective healthcare service delivery. In nursing provision, empathy entails the establishment of an appropriate emotional distance between the client and nurse that facilitates appropriate and objective professional response. Additionally, nurse-client relationship should be based on an unequal power. In this kind of relationship, nurses have more power than the patient (Simon & Izben, 1999). The nurses always have more authority in the health care service delivery compared to the client. However, the Australian law indicates that, nurses should use the power conferred on them in a caring manner to facilitate effective service delivery. The misuse of power for personal gain is highly condemned. With reference to the Australian nursing regulations, some behaviors are unacceptable in a nurse-client relationship as it can violate nurse professional standards. Some of these unacceptable behaviors include: acceptance of rewards and gifts, verbal abuse, neglect as well as financial and emotional abuse. Therefore, in the cases under study, any plan or attempt to give personal number to the client is legally and professionally unacceptable. The law only allows for rewards that are given to a group of nurses with a therapeutic intent (Rushton, Armstrong, and McEnhill, 1996). The nurse in the cases under study should reject the outing offer as it might compromise the nurse professional obligations. Additionally, the acceptance of the offer may develop a sense of commitment and lead to favoritism in service delivery. The offer may be presumed by other nurses to be a special treatment, creating resentment between the involved nurse and other health professionals. The offers may as well be a pressure for the nurse to offer extra care services to the patient. In this case therefore, the acceptance of the offer is likely to subsisting relationship between the client and the nurse. This will however depend on the intention and perception of the offer (DeWolf & Savage, 2007). However, there are some ethical, legal and ethical issues that may arise on the decision to either accept or reject the offer. This is due to the fact that, the Australian nursing provisions clearly stipulate exceptional cases where the gift should be accepted. According to the existing law, gifts should be given in group context and if the offer is intended for health care service delivery. in the case under study, the nurse should only accept the offer when it is given to all members of staff in the hospital and if it is for therapeutic purposes. The offers should as well be a therapeutic plan to the client but not for other purposes. Case 4 As per the existing laws, all adults are presumed to have the ability to decide on whether to accept or reject healthcare services. Since Mr. D was an adult, the law allows him to make a decision on whether to get treatment or not. However, before making such a decision, the nurse should be made to understand the effect and nature of the decision (Johnstone, 2009). According to the Australian law, the nurse under study ought not to assume that the patient lacks the capacity to make decision purely because of his age, behavior, appearance, belief or by the fact that the clients decision contradicts with the practitioner’s decision. Health practitioner should have worked on the legal presumption that, any adult patient has the capability to make a decision on whether to accept or decline healthcare service except when clinical examination confirms the client’s incapability to make substantive decisions (Health Association of Canada, 1999). Therefore, immediate action to treat Mr. D was professionally and legally unacceptable. Instead, the emergency practitioners could have undertaken appropriate assessment and provide relevant documentation on the client’s clinical examination. However, by considering the main role of nurses to improve the health status of their clients, failure to provide the required and appropriate health care services to the client was likely to create professional and legal confusion (College of Nurses of Ontario, 2006). On the other hand, due to the client’s fluctuating capability, it was extremely intricate to examine whether the client under study had the capability of making accurate decision. The client seemed not to understand the impact of his medical condition. Therefore, according to the Canadian law, the medical practitioner has the responsibility of making decision on behalf of the client. However, consultation with other health practitioners such as neurologist, psychiatrist and geriatricians was exceptionally essential in this case. Additionally, due to conflicting interest between the patient and his son, health practitioner could have requested the son to fill the consent form (Canadian Nurses Association, 2002). Moreover, the reliance on the son’s account of his father’s health status was legally acceptable. Seeking views from people who understand the client’s health condition is appropriate and in accordance with the Australian legal and professional requirements Conclusion Total compliance with the existing professional and legal requirements is incredibly valuable to necessitate the prosperity of the global health system. This is due to the fact that, the existing regulations are reasonably decisive in facilitating harmonious and mutual teamwork between health professionals and clients. The cases under study have significantly helped in explaining the legal and professional confusions that emerge due to the existence of diverse conflicting legal and professional requirements. The confusion as a result complicates the work and operation of all professionals in the health system. Moreover, the Canadian nursing and health care regulations are intended to ensure that, the health status of the entire country is significantly improved. Professional health practitioners are as a result expected to understand and totally comply with the existing legal requirements. Compliance with the existing regulations is intended to minimize legal and professional confusion and conflicts in service delivery. To necessitate quality service delivery, the involved stakeholders in the health sector ought to address the existing disparity between clients’ rights and the roles and responsibilities of health practitioners References Beach, M., et al. (2004). 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