Death of Julienne Maria McKay-Hall - Case Study Example

CASE ANALYSIS OF DEATH OF JULIENNE MARIA McKay-HALL Name: Affiliate Institution: CASE ANALYSIS OF DEATH OF JULIENNE MARIA McKay-HALL (a) Analysis of nursing care Nurses are usually an integral part of a healing patient. They offer the necessary care to the patient while he or she is recuperating. Patient’s recovery time is a crucial time where the nurse should be present. There are many skills that the nurses should practice to ensure that the patient is in good condition while in a hospital bed. In this case, they should be in a position to practice psychomotor skills, communication, knowledge that they have obtained during training, reporting, monitoring, responsibility and accountability (Ganz et al., 2010) Nurse Laja appeared ignorant of what happened during the day that she was taking care of Julienne. While being questioned by the court, she was unable to present adequate information that she took good care of the patient. She claimed that she might have consulted someone after taking the readings; in a real sense, it would be difficult to understand if the Nurse Coordinator had been alerted. As per the Australian Health Practitioner Regulation Agency (AHPRA), a nurse should be vigilant with the condition of a patient whilst reporting suspicious changes to the Nurse Coordinator for appropriate action to be undertaken. In this case, Nurse Laja might not have reported any suspicious changes, hence putting the patient vulnerable to the risk of becoming susceptible to infection. However in the earlier days of postoperative care, Nurse Laja entered the correct observations and readings based on Frequent Observations Chart, but Dr. Ahmad did not take a necessary step in averting the situation. The nurse did not take another appropriate action especially about “green fluid” of which Dr. Ahmad claimed that it was not his oversight role (Aldebasi & Ahmed, 2011) The next nurse who attended to the patient after Laja was Nurse Jodi Windram, who was a registered nurse. Her shift was for afternoon/evening that started from 11th November 2007. She did not call even after checking the readings of the deceased; there was a required criterion put in place for nurses to notify a doctor of patient’s vital signs. The nurse is supposed to observe any changes that occur in a patient while taking the necessary steps to draw the attention of the doctor in charge or any other physician. However, Windram made sure she increased the frequency of observations on the deceased. Even though this was an appropriate step, it would have been better if she initiated an MET (Medical Emergency Team) call while she supplemented with the frequency of observations (Magruder & Yeager, 2007). A health professional should be able to practice due knowledge in his or her field. To be a qualified health professional, one should have undergone necessary training in the field. This means that Windram, just like other nurses, were trained well and registered as a qualified nurse. She should not give any excuse for her failure to disseminate the needed care to patients. Nurses should also act as patient’s advocate. This means she should check the medication that patients respond to and then communicate them for necessary courses of action to be effected (Greysen et al., 2011). During the night shift of 11 to 12th November, Nurse Gloria Kuyper was in control. The respiration rate and pulse of the deceased increased alarmingly during that period. However, the failure of this nurse to increase frequency, as indicated in the report, showed a high level of negligence on the side of the nurse. She breached nurses’ code of ethics that one should be vigilant of any deteriorating health changes of a patient and take a necessary course of action (Post & Blustein, 2015). She should have either reported to the doctor in charge or increase the frequency of observation in monitoring the situation at hand. Also, she assumed that Dr. Ahmed was aware of the status of the patient. This should not be the case; instead, she should have notified him about the persistence of the symptoms even though the medication was still ongoing. This showed irresponsibility in the case of Kuyper in handling the situation of the deceased (Post & Blustein, 2015) According to the rules of postoperative care, the nurses should frequently check the body temperature of the patient while they note any changes. This is due to the ability of a patient to be hypothermic after surgery. This is not the only responsibility; the nurse needs to take the appropriate action of reporting such changes. During the mid-morning of 12th November, deceased had suffered a tremendous fall in temperature. This was alarming and needed to be taken care of because it indicated her case was worsening. Her oxygen level had also dropped while pulse increased alarmingly. Despite all these signs of deteriorating health, the Medical Emergency Team did not get notified. This indicated that the nurse in charge failed to apply her knowledge of the situation of a patient on postoperative care. The only thing that was done positively in this period was the administration of three litres of oxygen. However, this was short-lived since there was a break of observations regardless of the worsening state of the deceased (Chlan et al., 2009). Nurses should never take anything for granted because any actions may cost a life. The fact that senior Nurse Karen Pene made an entry in Integrated Progress Notes without checking on observation chart and Frequent Observation Chart showed irresponsibility on her side. She should not assume that because a nurse has not communicated any problems then nothing happened. It is the role of a nurse to be accountable for each and every action she takes. Nurse Baloyi was also negligent in attending to the patient during that period even though it was not her duty. Another nurse had asked her to take up her position as she went to prepare for surgery. For any registered nurse, any field of patient care should be well known, and due diligence should be displayed in dealing with any situation. Baloyi, despite being aware of deceased’s situation did not take the time to monitor her appropriately (Coyne et al., 2014) According to considerations of vital sign frequency, the registered nurse or the one enrolled to care for the patient, should be well responsible for measurement of critical measurements. In this case, all the nurses are registered but they failed to take into deep considerations the vital signs. Some of them measured those signs, although not frequently, and did not report anomalies to appropriate authority. Nurse Windram was the one in charge of vital signs and therefore she is the most negligent? (Lee & Higgins, 2010). The Tort of Negligence For the success of a negligence claim in the court case, some elements need to be looked into for nurses involved. As seen earlier, nurses who handled postoperative care displayed sluggishness in their job in one way or another. This would not be enough to come up with a successful lawsuit without the four elements. First, for negligence to have occurred, the defendant must have owed the plaintiff a duty of care; a duty of care means that there should be the proximity of the two parties. This would also mean increasing the frequency of observations when deemed so. Taking the case of Nurse Gloria Kuyper, the condition that the deceased was in required a nurse to be close to monitor her situation. Postoperative care was supposed to be offered to the maximum to ensure the patient healed well. The nurse must have reported the deteriorating health of the patient either through MET (Medical Emergency Team) or to DR. Ahmed. She should have avoided taking assumptions about whether Dr. Ahmed was aware of deceased’s situation. Instead, she was supposed to attend to the patient appropriately (Azétsop & Ochieng, 2015) Secondly, it is important to understand if there was a breach of duty by the defendant. The court would inquire if standard care were offered to the patient. This level of care would match with the situation of the patient. It is a care that any reasonable person would undertake. If the nurse had taken unreasonable care, that would be a breach of duty. However, in the case of Nurse Gloria Kuyper, failure to increase the frequency of observations even though the pulse rate and respiration of the deceased had risen considerably showed that she breached her duty. She owed the dead a duty of care during that critical time. This element can be established to be true that Kuyper breached her duty by failing to attend frequently to the deceased (Abramczyk, 2009) Thirdly, it is also paramount to assess whether the breach of duty caused harm. In the case of Nurse Kuyper, failure to undertake a reasonable standard of care to the deceased made her health situation deteriorate significantly. This was believed to have contributed to her ultimate death. In this case of causation, it should only be the breach of duty which triggered the said harm but not any other thing. If she were monitored carefully, she would have recuperated well. Hence her health would have improved, unlike what was the case for this kind of negligence (Post & Blustein, 2015). Finally, it should be found out by the court that the damage or loss suffered was reasonable and can be foreseen. It is up to the plaintiff to prove beyond reasonable doubt that the defendant planned the damage. According to the knowledge bestowed to a nurse, she would quickly know what would happen when a patient is in a critical condition, especially if the patient has just come from the theater. It is difficult for one to say that the nurses that were supposed to take care of the deceased were unaware of what would befall her if she were not carefully monitored. If such procedure between 10th November and 12th November were tamed well, especially avoiding any leaks, then the other issues that resulted from the ultimate demise would have been forgotten items (Lee & Higgins, 2010). Ethical analysis Referring to the noble codes of Nurses in Australia, a nurse should uphold human dignity and respect of the patient (Post & Blustein, 2015). Fundamental rights of people shall also be taken into deep consideration when offering nursing services to patients in any category. Nurses should also be in the forefront in making informed decisions based on their duties. For instance, Nurse Karen Pene should have made the right decision on either making an entry in Integrated Progress Notes or first checking on what a junior nurse had entered in Observation Chart and Frequent Observations Chart. This action displayed a poor decision making on the side of this nurse; it, therefore, violates the Code of ethics for nurses. In most of the cases where the nurses involved did not make a Medical Emergency Team (MET) call, it showed how they made decisions that were questionable as far as the situation of the patient was concerned. They would have made that call or inform a Nurse Coordinator for the patient to be attended to properly (Chlan et al., 2009). Nurses should value kindness and utmost respect for others just as they do for themselves. It is unfortunate that when Josephine McKay, the deceased’s sister visited the hospital, the nurses reacted arrogantly after she informed them of deteriorating health state of the deceased. It is shown that they threw up their hands arguing that there was nothing that they could do. This displayed disrespect to both the patient and her sister. They had many choices to undertake. They could call Dr. Ahmed or make an MET call for more specialized care to be carried out (Magruder & Yeager, 2007). Finally, according to the code of ethics of Australian nurses, a nurse should always uphold a culture of safety in both health care and nursing (Post & Blustein, 2015). A nurse should ensure a safe environment for recuperating patient. Nurse Baloyi should have understood the health state of the deceased and discouraged her from using a toilet. She was still weak hence could not be fit to go to the bathroom. What happened next showed that she was suffering from oxygen deficit. She developed dizziness and eventually fainted. Something miserable might have taken place when the patient fainted hence worsening her state. For instance, there might have been leaks and shock caused by positional hypertension. However, nurses should consistently practice ethics in attending to patients as it is part of their professionalism and humanity (Greysen et al., 2011). In conclusion, the nurses are displayed as being negligent, and it is not professional. The nurses should be driven but the above-stated codes of ethics. The misbehaving nurses should be disciplined as outlined by the laws. This will improve the service delivery and the recuperation process of the patients. References Azétsop, J., & Ochieng, M. (2015). The right to health, health systems development and public health policy challenges in Chad. Philosophy, Ethics, and Humanities in Medicine, 10(1), 1. Abramczyk, A. (2009). Psycho-emotional state, social and health situation of patients with diabetes–a national study. Biopsychosocial Aspects of Health and Disease Vol. 1, 1, 77. Aldebasi, Y. H., & Ahmed, M. I. (2011). Patients’ Satisfaction with Medical Services in the Qassim Area. J. Clin. Diagn. Res, 5(4), 813-817. Chlan, L., Guttormson, J., Tracy, M. F., & Bremer, K. L. (2009). Strategies for overcoming site and recruitment challenges in research studies based in intensive care units. American Journal of Critical Care, 18(5), 410-417. Coyne, K. S., Wein, A., Nicholson, S., Kvasz, M., Chen, C. I., & Milsom, I. (2014). Economic burden of urgency urinary incontinence in the United States: a systematic review. J Manag Care Pharm, 20(2), 130-40. Magruder, K. M., & Yeager, D. E. (2007). Mental health problems in primary care: Progress in North America. The European journal of psychiatry, 21(1), 55-61. Ganz, M. L., Smalarz, A. M., Krupski, T. L., Anger, J. T., Hu, J. C., Wittrup-Jensen, K. U., & Pashos, C. L. 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