Case Study for ODP - Essay Example

Background Information On the 25th March 2014, a 15-year-old patient, Mary, walked into the hospital where I was attached, as a nursing practitioner, to seek medication on her rapidly deteriorating health. She underwent the regular examinations to determine the nature of her sickness and immediately the doctors arrived at a conclusion that Mary needed to be taken to the theater for a minor operation on her left hand, besides further medical attention. Upon closer observations, I noticed that Mary was a very anxious young girl. Although she had been accompanied by her mother, Mrs. Silvestre, to theatre for an insignificant surgery guided by a local mentor, she stayed restless the entire period of the admission process. My mentor, Dr. Hughes, supervised me as I took Mary and Mrs. Silvestre through the theater admission procedures. After sometime, Mrs. Hughes resolved to speedily nip to the lavatory in the process so as to get back, and relocate the patient into theatre. He left me to complete the remaining procedures and prepare the patient for admission. During this time, I observed that the agreement form had been contracted by Mary and a comment added to the notes that Mary thought she was pregnant. I proceeded to confirm this comment setting Mary free for theater admission after completing all required procedures. After transferring Mary into theatre, my mentor attempted to supplement a cannula in Mary’s hand. To my utter amazement, Mary was startled by a sharp pain inflicted upon her by the inserted cannula. She immediately withdrew her hand resulting in the cannula becoming dislodged with some blood spillage. I privately ask Dr. Hughes why such a unique occurrence was taking place, and she quickly confessed that she had not really attempted a cannula procedure unsupervised before. I concluded that she must have forgotten to follow certain necessary procedures resulting into the pain experienced by the patient and consequently, the blood spillage upon withdrawal. Introduction Operating department practitioners (ODPs) have a huge role to play in seeing forth the liberation of patients from the anguish of various diseases. The situations to which operating department practitioners are often exposed as health care professionals are sometimes so complex and demanding including serious issues of health and wellbeing of various patients (MacDonald Sohn & Ellis, 2010). It is for this reason that nursing practitioners have to be well informed of their duties and mandates to enable them execute their duties in an ethical and acceptable manner while maintaining their professional understanding in different areas of specialization. The philosophy of ethics is a fundamental requirement to all nursing practitioners. The term ‘ethics’ implies an illustration of how ODPs should behave themselves or determine what they are required to do while interacting with and giving care assistance to patients. Perhaps Beauchamp & Childress, (2009) contributions into this matter can shade more light in informing decision making process in line with a close observance of the ethical issues underlying the practitioners’ behaviour during care giving process. Due to the different settings upon which ODPs are subjected and the necessary philosophical assumptions that have to be made in order to reach at an appropriate procedure in every circumstance, ODPs are often involved in various circumstances of patients’ lives (Rogers & Ballantyne, 2010). The case study illustrated above shows a general breach of the necessary requirements that the nurses in question needed to comply with before handing the pertinent issues relating to the patient’s health and care giving. All nurses are required to strictly adhere to all theoretical and regulatory measures set to inform their decision-making procedures. Total compliance to these set rules and regulatory frameworks have been advocated by several writers and regulatory bodies (Murray, Gruppen, Catton, Hays & Woolliscroft, 2000). A breach of these rules often results into serious problems that can cost the lives of the respective patients; hence, violating the intent by the practitioner. This paper is an illustration of the ethical issues to be considered by ODP in order to ensure that their missions are successful in every aspect. The guiding principles under the HCPC have been used to inform the various arguments illustrated in this paper in order to enhance the ODPs understanding of their roles and requirements based on the case study illustrated above. The study has also drawn from various ethical theories used to inform decision-making by nursing practitioners. Various legislative laws and other regulatory frameworks have been laid down by various nations and health related bodies to help ODPs execute their mandates efficiently without infringing on the patients’ rights. However, Mason (2005) arguments are concurrent with that provided by other scholars stating that the ultimate need of all patients is recovery from their respective illnesses. However, in the process of ensuring the provision of such care to the needy patients, they need to be respected. The ethical provisions illustrated herein are in support of this idea highlighting that the patients, as customers in the health sector must have the overall say and, therefore, care givers must seek and adhered to their conscience. According to Vanlaere & Gastmans, (2011) only the patients’ own words should be used to make relevant judgments concerning their sicknesses. It is for this reason that a clear conscience is often sought for before care givers embark the provision of care to patients. The nursing board has provided an acute definition on the scope of nursing practice taking into consideration the responsibilities of the individual nurses. Among the key considerations in their definition include the assessment of clients, synthesis and analysis of data, and the application of nursing principles and the related therapeutic procedures required at every stage. In cases where the ODPs are not certain of the obligatory phases to be engaged in order to ensure successful implementation of nursing requirements, the board provides room for consultation and collaboration with other caregivers, as well as community resources in order to make conclusive decisions (Bryant, 2013). The regulations set for safe practice puts all ODPs in charge of the patients’ data and ensuring that the information provided therein is right and reflects the patients’ feelings and true status. Failure to closely scrutinise the content of the information provided in order to make a safe decision was a great mistake that certainly recapitulated in the later stages. Furthermore, the protection of patient’s data is backed by the data protection laws such as the United States Privacy Act and the Health Insurance Portability and Accountability Act, both of which are concerned with the security of data collected about patients, the mode of handling of the data and transmission of the personal data in modes such as electronic. These acts are essential to this case study in the sense that they provide a directive to the ODPs on how to handle the data collected from patients under their care. Debates have arisen on the person that should be authorised to sign a consent form before any theatrical operation is conducted. Some experts have argued that both the patient and the accompanying persons should append their signatures on the form as a form of legality. However, a great deal of literature has been on the basis of the patients’ conditions. According to Guttman & Salmon (2004), discord arises in ensuring uniformity in the legal procedures during the caregiving process. Most countries have left the signing of the consent form entirely to the accompanying persons. The international regulations on nursing practice are aligned with the view that all consent forms should be signed by the accompanying persons. The ODP has gone ahead to give details on the accompanying persons authorised to sign consent forms. It is the sole mandate of the accompanying persons to give their consents guaranteeing the physicians the authority to operate on the patient. Contrary to this normalcy, and in line with the set regulations, the consent form in this case was signed by the patient without the involvement of the person in charge. Besides, the irregularity noticed on the consent form, the ODP guidelines advices all ODP mentors to seek clarifications on the sections that are not clear to them from other experts, especially their mentors. According to Beauchamp & Childress, (2009), every practitioner is allocated a mentor that is in charge of the activities undertaken by them. ODPs are not authorized to make decisions not approved by their mentors. During the period when student nurses are attached to any health providing unit, they are suppose to execute every activity under strict supervision of the mentors. Questions have been raised on the legalities behind ODPs acting in the absence of their mentors. For instance, Fraser & Matthews, (2008) has argued that the ODPs should be allowed by laws to act in the absence of their mentors in case of emergencies. For instance, in some cases, the mentors may be committed with other affairs and the ODP is the only person available, especially in care centers where the number of nurses is low compared to that of patients streaming in for medication (Gastmans, 2002). On the other hand, ODPs are prohibited from acting on any emergency as they are prone to make serious mistakes in the course of exercising their duties. Goldie, Schwartz, McConnachie & Morrison (2002) draw their arguments from a wide array of cases where ODPs have been allowed to carry out the legalities during patients’ admission to theaters. They cite several cases where grievous mistakes had been committed that were against the laws and ethical requirements. According to Simpson et al., (2002) theatrical enrolments are considered emergent issues; hence, call for fast action by the persons involved. Some scholars give leverage for ODPs to act on emergencies only under strict supervision of their mentors. For instance, the UK laws on health practitioners spell out that nurse practitioners are the only people allowed to handle such emergencies, and in the absence of their mentors, should refer the cases to referral. This argument owes to the possible mistakes, ethical, legal and professional that the practitioners are liable to cause. Various regulatory frameworks, laws and legislation on the mandates in Australia, USA, Britain, and India call for a mandatory presence of a mentor in cases where the ODPs have to deal directly with emergency cases. The HCPC should hold mentors responsible for any mistake committed by ODPs in their absence, as it is the sole responsibility of the mentor to ensure that the ODPs under their control do the right things at any given moment (Dawson & Verweij, 2007). The fact that the mentor left in the process of carrying out an emergency admission shows the neglect for duty; hence, should be held responsible for any mistake committed by the trainee, while attending to the emergency case above. According to the case in question, the mentor left the student practitioner to act on the patient alone, and make own decisions by completing the admission process. This negligence resulted into overlooking of serious offences under the nursing and practitioners laws. Treating the case as an emergency, the student practitioner did not wait to confirm the actions with the mentor. Allowing the patient to sign a consent form was the initial mistake committed, which required correction at the admission stage. This did not happen; hence, is a serious breach of the existing laws and regulatory frameworks mandating only the accompanying persons, described in the ODP document for ODPs (Gott, Hinchliff & Galena, 2004). All medical practitioners act in constant consultation with their colleagues in order to ensure that the patients are cared for adequately. The general rule of the health sector implies that in cases where the health practitioners charged with the obligation of caring for the patients at any stage, they are only required to act on the basis of their surety. The ethical concerns in the medical field require medical practitioners to act only on cases for which they are certain. Moreover, Madden (2011) adds that the two additional aspects include having a good knowledge of the patients and accurate assessment of the patient’s and clinical situations. An adequate and effective assessment of the prevailing condition stated above should be enough to inform the medical practitioners of the required course of action. The legal requirements set for all ODPs in the UK states the responsibilities of the practitioners highlighting the limits and the course of operations expected of all practitioners (Gardiner, 2003). In line with these requirements, the medical practitioners are needed to offer health services to patients, and uphold their professionalism in alleviating the patients’ pains. Inflicting pain on the patients is an indication of the level of unpreparedness on the side of the medical practitioners (Forrester & Griffiths, 2011). ODPs are also required to strictly adhere to the set standards for the maintenance of their professional abilities and avoid erroneous performances. In this regard, the levels of qualification of the nurses should be closely scrutinized by the recruiting bodies before registration. Professional qualifications determine the purported success in executing the roles of any nursing practitioner (Boon & Turner, 2004). The philosophy of ethics has attracted the attention of many people, including researchers and experts in various fields of knowledge. In medicine, just as in sociology and other related disciplines, the term has been widely used to define appropriate behaviour of nurses and other medical practitioners while executing their mandates (Van De Camp, Vernooij-Dassen, Grol & Bottema, 2004). Owing to its wide application in different fields of knowledge, the term ethics has been defined differently by different people depending on their areas of specialization and contexts in question (Savage, Chilingerian & Powell, 2005). A lot of medical literatures are in agreement with the definition provided of ethics being the philosophical discipline that studies how nurses and other medical practitioners are expected to behave, or how to determine between right and wrong while interacting with others, especially with patients (Beauchamp & Childress, 2009). Medical practitioners are expected to uphold their ethical standards to ensure that their actions are in line with the ethical standards specified in the guiding laws and regulations set by various medical bodies. Different theories have been designed by different people to help illustrate situations under which medical practitioners are mandated to observe ethics while providing care to patients (Mansfield et al., 2011). In this section, I have discussed some of these theories in relation to this case study. Among these important theories include the utilitarian and deontological theories. I have related the propositions of the theories above with the case context described in this paper. The utilitarian theories, also referred to as the consequentialists theories, advocate for the satisfaction of a majority of the population involved in an affair. Utilitarianism hold to the fact that before one carries out an act on the basis of their responsibilities or courtesy, they should weigh all possible outcomes on different people. Beauchamp & Childress, (2009) have investigated the relevance of the utilitarian theory to unveil the underlying consequences associated with it. In this sense, the actions that lead to the best outcome for most people is to be selected among the other actions. There were several possibilities to be deliberated on in the absence of a mentor and which were not put into consideration. A lot of laws have addressed various options to be considered in such situations (Munro, Bore & Powis, 2005). Consultation is of prime importance in situations where one is not sure of the possible action to be considered. The rule for health practitioners dictates that where one is not sure of the possible course of action, the expert is required to consult with other experts and other senior members in the same field of specialisation (Biegler, 2011.p.112-119). According to the utilitarian theory, lack of consultation with the other experts was the core cause of harm experienced by the patient. Psychological pains inflicted on the patients due to practitioners’ negligence and unprofessionalism can have much impact on the patients’ lives compared to the physical pains resulting from their illnesses (Savage, Chilingerian & Powell, 2005). The utilitarian theory has been widely applied in medical research and patients care strategies. Beauchamp & Childress, (2009) has presented an absolute assertion on the need to uphold the utilitarian theory. He records that any action geared towards a person’s life must be well evaluated and no negative impacts be tolerated. He specifically mentions the increment of pain on patients as the initial point of argument in the nullification of an action as ineffective and inappropriate, an idea that is commensurate with the assertions of the utilitarian theory. Non- compliance with the utilitarian theory in conducting the whole process was a great breach of the laws and makes both parties involved liable for prosecution and other forms of punishment (Gastmans, 2002). Deontological theories are among the ethical theories that hold to the fact that the ethical consideration of an action depends on the motivational basis informing the particular action. The term ‘deontological’ was developed to distinguish duty- bound ethics from more utilitarian ethical consequences. The term has however been considerably expanded to include an emphasis laid on other consequences other than the utilitarian ones alone. The term was coined by Immanuel Kant, a philosopher by profession, who lived between 1724 and 1804 (Little, Dorward, Warner, Stephens, Senior & Moore, 2004). The sole intention for the development of the term, and consequently, the theory was to elaborate the rationale for ethical behaviours that were based on pure reasons as opposed to those that were developed on the basis of traditions and other authoritative pronouncements. Deontological theories have, for instance, been extensively utilized in informing rational decision making in various circumstances. Two foundational principles have been used to inform decision making under deontological theories. These principles or rules included: categorical imperatives and unconditional ethical laws. Law, according to this theory was defined as the reason for an action that is universal and must be followed by everyone (Goldie, Schwartz, McConnachie & Morrison, 2003). According to the theory, the rules, laws and other regulatory frameworks must be adhered to by the global communities that subscribe to the same laws. Despite every country developing their own laws and regulations to control the operations of their medical practitioners, these laws are commensurate to the international legal frameworks put in place by the international community and thus hold universally. Breaches of deontological laws are consequential and lead to severe punishment all over the globe. Nursing ethics are laws that bound internationally. Carrying out the cannulation process while not sure was a clear breach of both the utilitarian as well as deontological laws and was subject to prosecution in a court of law (Little et al., 2004). The HCPC codes are a group of regulatory frameworks that have been designed by the Health and Care Professions Council to guide student practitioners on the right behavioural mannerisms. The codes realign the students’ behaviour with that of the international health care community. Furthermore, it is vivacious to identify that the HCPC codes are a combination of all international care rules that guide the actions of all practicing nurses across the globe. These rules are applicable both at the local and international levels hence their observance is guided by the international laws (Hooper, Meakin & Jones, 2005). Among the key regulations stipulated in the HCPC codes is the ability to meet the required principles of the nursing profession including academic standards set by the council of nurses. All student practitioners, according to the HCPC codes regulations are required to execute their mandates only under the regulatory frameworks of the nursing council and ethical stipulations. The body expects all student practitioners to maintain a high standard of conduct and ethics during the period when they are attached at any institution or conducting an action on behalf of an approved medical practitioner. The codes advocate for equal treatment of all persons seeking medical care at all levels by desisting from doing anything that can put one in danger. The HCPC codes addresses the course of action in situations of uncertainty, especially, when one is not sure of or worried about the situation at hand and suspects that such situations can lead one to risk. Under such conditions, the codes accord that the persons in charge seek guidance from the senior members of the placement team or their education providers for further guidance on the right course of action. Making an unsure decision that can pose risks to the health of the persons seeking medical assistance from the care centres around the globe is, therefore, reciprocate to going against the set laws by the HCPC codes. All student practitioners are expected to comply with the situations mentioned above and give their best to the unsuspecting patients all over the globe. Under these laws, it is certain that both the student and the mentor all committed similar offences by not adhering to the rules of consultation in cases where they were unsure of the appropriate course of action. Moreover, the codes also direct every practitioner, including the student practitioners to only act within the limits of their knowledge. This ensues that where the practitioners are not certain of the way forward, such cases are be referred to the persons that are able to handle them appropriately. All the above mentioned codes of conduct were entirely breached by both the student and his mentor hence totally in collision with the regulatory measures put forth by the HCPC codes (Slowther, Johnston, Goodall & Hope, 2004). The ethical laws and theories advocate for actions that favour the majority while trying to alleviate the ill conditions of the patients seeking medication at all levels. It is, therefore, very necessary for the student practitioners as well as the practicing nurses registered by the nursing council to comply fully with the set regulations and maintain a high standard of ethics and conduct while handling patients. Non compliance with the set ethical rules is not tolerated by the nursing council and all regulatory frameworks guiding the conducts of all practitioners around the globe. Qualified practitioners, on the other hand, are expected to provide assistance to all student practitioners attached under their directives. The students are only allowed to carry out instructions under the keen watch of their mentors. Therefore, the mentors should ensure that their student practitioners are kept updated with the latest occurrences and avoid commission of simple mistakes that can lead to grievous mistakes later in the course of their practice (Taboada & Bruera, 2001). Conclusion In conclusion, it is good mentioning at this stage that the operating department profession is a very critical and risky area of speciality that requires very keen attention by all practitioners. All rules, laws and regulations governing the conduct of all medical practitioners are therefore to be stringently observed to ensure the success of the whole operations (Surbone, 2008). Overlooking any of the simple ethical rules and codes of conduct often result into grievous mistakes as has been described in the past sections of this paper and, therefore, should be avoided at all costs. The ultimate desire of every care provider is to ensure that the health conditions of their patients are alleviated to better than they came. Inflicting injuries on unsuspecting patients as seen in the case described above, as a result of ignorance and negligence due to lack of adequate consultation with other members of the council for a better course must not be under the rules and regulations set for the sector. The student in the case study was supposed to adhere with all set rules in the nursing sector and consult with any senior practitioner around before making any decision on a course of action for the patient. Both the student and the qualified medical practitioners have a precarious part to perform in confirming that the lives of patients are kept in check while upholding the obligatory ethical standards. The roles played by each partner are well spelt out in the various laws, rules and regulations developed by various health care councils around the globe. 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