Legal Aspects in Nursing - Case Study Example

? Legal aspects of nursing Introduction Legal aspects in nursing: case study In this case, a nurse was working in a critical care unit, but suspicion later began as she was diverting narcotics for her personal use. The Acute care hospital had recently installed computerized medicine cabinet that could enhance the tracking and monitoring of the narcotic distribution process. Nurses had the duty to manually document the patient details, time, route and dosage on paper based medical administration record (MAR). Later, discrepancies were noted in the electronic data and hand written records. The nurse was unable to make a reasonable explanation and was later suspended by the supervisor. On trial, other nurses stated that they frequently made paper records during breaks or at end of shift, often when they could hardly remember the dosages administered to patients. In addition, nurses would electronically sign for narcotics and prepare IV drip bags in advance of when needed and discard the same when no longer required or when physicians changed orders. In addition, nurses deviated from physicians order for an IM injection by thus electing to provide medication by an IV route. In addition, the hospital lacked a clear policy on when nurses such as preceptor and mentee, both had a responsibility for patient care. The suspended nurse also admitted that she recorded the data long after administration and in some cases in the following day (Guido, 2009). Legal aspects in nursing provide the framework for establishing the acceptable care to the client and outline the responsibilities of the nurses. The law in nursing also outlines the boundaries in independent actions of nursing and provides for the standards of nursing practice. Nursing law ensures that nurses obtain the informed consent of the patients before any treatment and provide information to the clients on any condition that requires diagnosis and also the benefits and risks of the alternative modes of treatment (Guido, 2009). In the above case, the facility has sufficient evidence to suspend the nurse from employment. The nurse is liable since she testified that she recorded their paper documents at the end of the shifts or even the following day. According to legal framework, the nurse must carry out the physician orders unless she reasonably believes that there is an error. The nurse must seek a clarification from the physician or immediate supervisor; otherwise she is liable for any harm experienced by the patient. If nurses are requested to float to another unit, the nurse must have the capacity and experience to carry out the duties since one is held liable for the same standards of care as those other nurses working regularly in that unit. In addition, the nurse is liable for not reporting unsafe nursing practice such as theft of narcotics in the facility (Guido, 2009). Surprisingly, the facility had allowed nurses to sign for narcotics electronically and prepare IV drips in advance and discard the same IV bags when not needed by the physicians. The evidence of other nurses is critical in determining the outcome of this case since other nurses did not follow the legal procedure in medical documentation. The nurses clarified that they had deviated from physician’s order for an IM injection, thus choosing to provide medication by IV route. Finally, the organisation lacked a standard procedure and policy framework for paper records when a preceptor and a mentee were involved. The testimony other nurses would impact on the outcome of the case. For instance, the testimony proves the negligence of the hospital facility in safeguarding the safety of patients since not policies that outline the working relationship of a preceptor and mentee and who should record the narcotics usage. The institutions should first preview the paper record documentation of all nurses and review the authority of each personnel in the organisation. The institution should also review the nurse-patient relationship before the court of law (Guido, 2009). If I were the judge, I would rule guilty in case of the suspended nurse. There are numerous principles of patient safety that are involved in the above case. For instance, the nurses are expected to provide safe and compassionate health care to all the nurses and promote the well being of all patients. Nurses are also expected to respect the informed consent of the patients and utilize their due diligence in decision making. The principle of accountability requires nurses to bear responsibility for patient health care and promote collaborative relationships in the organisation. The nurses working in this unit are negligent for delaying medication documentation. Registered nurses are expected to document accurately and timely and include additional details like the name of medication, the dosage, the frequency and prescriber’s name and signatures. If the organisation was to consider the roots causes of the situation, several ethical principles must be considered. One of the ethical principles that should be considered is Nonmaleficence principle that aims at avoiding harm and reporting unsafe nursing practices such as exposure to chemically impaired nurses (Guido, 2009). In the above case went to trial, the charges would be negligent nursing practice in medical documentation since there is a breach of the duty of care. From the details of the case, there is evidence of malpractice since the standards of care in nursing practice have been breached such as the professional standards and scope of nurse practice. Some of the charges will include failure to document, incomplete paper documentation and improper documentation. The kind of court that would hear the case is State trial court since such courts have jurisdiction over medical malpractices. However, if the case involves the government acting through a Veteran’s administration health facility or federal funded clinics, the case should be filled at federal district court for hearing (Guido, 2009). If this case did go for a trial, the defendants in the case would be the concerned nurse and the hospital. The plaintiff would be any patient who has suffered harm from the malpractice. In the above case, both the nurse and the health facility would be liable for any damages suffered by the patients. I believe that the nurse would be liable for not following the professional standards of care that require nurses to report any unsafe nursing practices and to accurately document the patient records. The court would find the nurse and health facility guilt of medical malpractice and injury to patients. The health facility would also be liable for not implementing administration policies that outline the responsibilities of different personnel. The State Board of nursing should be involved in the case since it is responsible for issuing guidelines and administrative regulations in nursing practice. The board also advises on registration requirements and participates in licensure, disciplinary and policy development. The State Board of nursing has the legal mandate to enforce the laws that govern nursing practice in the jurisdiction. The State Board of nursing will conduct the hearings and prosecute nurses for the violations of the standard nursing practice. The organisational policy and procedures manual in patient drug administration should be changed. From the case, there is no formal policy for documenting narcotics when a preceptor and mentee are involved. In addition, there is not formal procedure for authorization of the IV route and medical orders form the physicians. The new policy and procedure should provide the timeframe for paper record documentation of the physician orders, the criteria for routing and authorization of narcotics documentation. Some of the stakeholders that need to be included in the changes include the nurses, supervisors, unit heads and physicians (Guido, 2009). References: Guido, G.W. (2009). Legal and ethical issues in nursing. London. Pearson. Read More