Application of Law and Ethics in Nursing Practice - Case Study Example

Application of Law and Ethics Name Institution Date Application of Law and Ethics Part A Ms Lord was assigned to work in the afternoon shift on March 6, 2010 and this was her second day working as a registered nurse. This is an indication that she was not experienced and yet she was assigned to work on her own with the elderly who required high are needs. This is in itself was a mistake considering that she had not been taken through an induction process for the purposes of enabling her to fully understand her role. This mistake is on the part of the system and the management of the facility as noted later by Dr Ullman. This is considering that Ms Lord had no choice and could not refuse to perform the duty assigned to her. According to the ethical reasoning, it is the duty of the registered nurse to ensure that action is taken to protect and benefit the disadvantaged, underprivileged and vulnerable (Park, 2012). Dr Jones on the other hand had earlier visited Mr. Whiley and he had noted that his condition was in a poor state and he also appeared to be in a terminal state and hence the recommending for morphine sulphate. He also noted that he might not be able to see Mr. Whiley alive during his next visit as he always visited the facility on weekly basis. This is an indication that Mr. Whiley was in a critical condition, his chances of survival were very low, and it was only a matter of days before his death. Mr. Perry who was in the morning shift also advised Ms Lord of the condition facing Mr. Whiley including the time that she was required to administer the next dosage. Ms Lord began her shift by attending to Mrs. Harper who had 60% of rashes in her body. Her condition was serious and it required full attention, which Kept Ms Lord occupied for a long period. While making her rounds, she attempted to give Mr. Whiley some medication but she was unable, as he could not open his mouth, which she noted as semi conscious and defiance. This is an indication that she was performing her duties effectively despite being occupied by the case of Mrs. Harper. It took a long time for her to get authorization and medication that was required for Mrs. Harper, as she had to undertake frequent consultations. She ended up forgetting the case of Mr. Whiley who was supposed to receive her medication at 4.00 pm and this had to wait until 5.00pm. The delays were due to her busy schedule and the complicated process that was required in order to give medication to Ms Harper. During the administration of the morphine, she made a mistake when drawing it from the store. She made an error in terms of not reading the packaging correctly. In her own statement, she admitted that she had never administered morphine before and was not familiar with the standard dosage of morphine. Such an error is not only personal but also it cam also be attributed to the system (McDonald, et al, 2012). Her confusion that led to the administration of the wrong dosage can be attributed to her busy schedule and low level of experience. She had also asked the carer to double check the dosage but she did not notice any mistake. It is always important to take the necessary precautions before administering the dosage (Chiarella, 2010). Mr. Whiley was attended by the care assistants thirty minutes later and was not attended again for the next four and a half hours when Ms Lord discovered that he was dead. It is also at this point that Ms Lord discovered her mistake in terms of the dosage but she did not inform her care assistant. This was a mistake on her part as such sensitive information should have been disclosed. It is also important to note that the failure of attending to Mr. Whiley in for more than four hours considering their situation may amount to neglecting the patient. However, Ms Lord was busy throughout and she lacked the necessary experience. The autopsy, which was carried out by Dr Lawrence, indicated that the probable cause of death was ischemic heart disease or stroke although morphine intoxication could not be ruled out. It was impossible to determine the actual cause of death since the time of death was not known. Although Ms Lord made errors during the medication process, the system was also to blame. The complexity of the system can contribute to the errors that are made by the individuals (Fedoruk, et al, 2012). This is because the system failed to provide proper information and guidance regarding how certain procedures could be carried out or how certain situations can be dealt with. It is due to this reason that it was recommended that the changes in terms of the standards be carried out. Part B Had the coroner proved that Mr. Whiley had died as a result of morphine dose, criminal charges could have applied. According to the laws of Australia, the criminal proceedings can be brought against the nurses incase of criminal negligence which is applicable to this situation (Collins, 2007). The case of death resulting to morphine dose can be considered as criminal negligence or manslaughter. This is also considering that Ms Lord made an error during the process of administering the dose, which amounts to negligence. In the case of the criminal negligence, the management of the hospital and specifically Ms Renshaw for appointing Ms lord as the sole nurses on duty despite her low levels of experience. During criminal proceedings, the prosecution has to prove without reasonable doubt that the defendants needs to be found guilty. It is also important to note that Mr. Whiley was not attended to for more than four hours, which can also be considered an act of negligence and hence strengthening the criminal case against Ms Lord if the cause of death was to be a result of Morphine dosage. The main purpose of the criminal law is to ensure that the criminal behavior is punished which in this case could have been criminal negligence. The criminal prosecution could have resulted to a fine or custodial sentence. The court may also decide to impose a custodial sentence and a fine considering that the criminal negligence led to the death of the patient (Mair, 2010). It is thus important for the nurses to ensure that they comply with all the laws that are in place. The law of tort could also be applicable in this case as a wrongful act was committed. The administration of the wrong dosage of morphine to the patient by the nurse results to a tort. However, it is also important to note that the balance of probability must be shown by the plaintiff in order to prove that they had been wronged (Chiarella, et al, 2013). In this case, people representing the deceased have to prove that the death was a result of the morphine dosage. This means that the results of the autopsy have to be presented to court. It has to be proved that it is Ms Lord who was involved in the administration of the wrong dosage of morphine that caused the death. It will also be important to prove that the patient was under the care of Ms Lord when the death took place and it is Ms Lord who was responsible for the administration of the wrong dosage that caused the death of the patient. The law of tort also recognizes the basic human rights of the individual’s autonomy and bodily integrity, which in case have been violated. The nurse may be required to compensate the plaintiff upon successfully proving that a tort was committed. The compensation in most cases is in monetary terms. This means that Ms Lord could have been required to pay the amount determined by the court. It is also important to note that the main purpose of the civil case is not compensated and not to punish. Part C The principles of ethics are for the purposes of ensuring that the relationship between the patient and the nurses is good. According to the ethical principles, the nurses are supposed to ensure that the patients are protected from any direct or indirect harm. On the other hand, the rights of the patient have to be upheld at all times. In the case of Mr. Neilson, the nurse acted in an unethical manner. The nurse failed to inform Mr. Neilson about the policy of the hospital concerning the storage of the teeth. This caused Mr. Neilson to wake up at 1 am to search for it for the fear that it could be broken as he thought it had fallen on the floor. This caused him a lot of worries and distress, which has negative impacts on his heath. On the other hand, it is also important to note that he lacks morbidity and hence making it more difficult for him to search for his teeth. The nurses at the facility breached the ethical principle of respecting the dignity of the patients (Dickerson, 2013). This is considering that Mr. Neilson could not move and he had to spend most of the time looking for the teeth, which had been stored in the bedside drawe cabinet by the nurse without informing him. Although the policy of the hospital was for the purposes of preventing chocking, it is ethical for the nurses to give the patients full information before taking any action. The ethical principles of truthfulness require the nurses to provide the patients with information regarding their health and any risk factors (Johnstone, et al, 2012). This was however not done and hence contributing to the distress that was caused to Neilson. Treating the patient with respect is thus an ethical principle that was breached by the nurse at the facility. The nurse did not believe that Neilson was awake since 1am, which is an indication that the nurse is not ethical in terms of her reasoning. On the other hand, no one attended to Neilson for the whole timed that he was awake. This is an indication of negligence of the patient, which is also unethical. It is also against the rights of the patient under care. It is unethical to neglect a patient who is under care. His buzzer was also on the floor the whole time which is an indication that no one came to check on the patient the while time until his daughter visited him. This is further proof of negligence on the part of the nurses at the facility. The negligence also had negative impact on the health of the patient as he was under distress. There was also a high level of irresponsibility among the nurses, as they did not care much about the patient. It is unethical for the nurses to be irresponsible when providing care to the patients. This is because it may influence negatively on the quality of the care that the patients receive. According to the ethical principles, the nurses are supposed to keep the human system holism (Johnstone, 2009). The nurses also breached this principle, as they did not make frequent visit to the patient under their care. The safety of the patients is important when they are receiving care and the nurses neglected this. Neilson could have suffered injuries because of a fall when searching for his teeth since no nurse visited him at the time. This is an indication that the rights of the patients were not respected in accordance to the principles of ethics. References Park, E. (2012). An integrated ethical decision-making model for nurses. Nursing Ethics, 19(1), 139-159. Chiarella, M. (2013). Law for nurses and midwives. Chatswood, NSW: Churchill Livingstone. Fedoruk, M. et al. (2012). Becoming a nurse: Transistion to practice (1st ed.). South Melbourne: Oxford University Press. McDonald, F. et al. (2014). Ethics, law and health care : a guide for nurses and midwive. Australia: Palgrave Macmillan. Collins, S. E. (2007). Criminalization of negligence in nursing: a new trend? The Florida nurse, 55(1), 28. Mair, J. (2010). An introduction to legal aspects of nursing practice. In J. Daly, S. Speedy & D. Jackson (Eds.), Contexts of nursing (3rd ed.). Chatswood, NSW: Elsevier. Chiarella, M. et al. (2013). Nursing and the law. Sydney: Churchill Livingstone. Dickerson, P. (2013). What do I do now? Ethical dilemmas in nursing and health care. ISNA Bulletin, 39(2), 5-12. Johnstone, C. et al. (2012). Dealing with ethical issues in nursing practice In E. M. L. Chang & J. Daly (Eds.), Transitions in nursing: preparing for professional practice. Sydney: Elsevier. Johnstone, M. (2009). Bioethics: a nursing perspoective (5th ed.). Sydney: Elsevier Australia. Read More