Application of Law and Ethical Modules - Assignment Example

Application of Law and Ethical Modules Student’s Name & No. Institution Section I: Nursing Care Analysis Ms. Young was acutely ill, and there was a need to apply critical nursing care approaches based on best practices in nursing. She was high at risk of potentially life-threatening problems like cancer, heart disease, and acute coronary syndrome. Therefore, as licensed professionals, Ms. Young’s nurses and doctors ought to have acted with due care, skills and informed judgment to ensure she received intense and vigilant nursing care. The Australian Charter of Healthcare Rights (2008) provides that all health system users including patients have the right to quality and safe care. It recognizes that both patients and care providers have important roles to play in achieving safety and quality care. According to the findings of Coroner (2015), Ms. Young’s nursing care was coupled with series of failures in terms of care provision and involvement of nurses in clinical decision making. These failures range from staff’s to systems’. They included inadequacy of hand over, failure to recognize the significance of her acute condition, inadequate observations and poor recording of observations and notes and inability to exercise professional skills and competence in lifesaving situations. The hospital lacked a trained staff to perform an echocardiogram therapy during the weekend. This implies a limited and an unsatisfactory involvement of nurses in Ms. Young’s care. According to the requirements of nursing best practice, nurses are expected to perform their duty with passion, care, and professionalism (Australian Nursing and Midwifery Federation, 2015).This should include active involvement in patient care to ensure safety and quality life. It is important to develop and sustain effective staffing and workload practices in a health setting. This creates a strong career relationship between professionals and clients since clients would always bestow their trust in the hands of the professionals (Berglund, 2012). And as the relationship grows, the expectations and obligations attached to become increasingly defined. This is one aspect that lacked in Dubbo Hospital’s health care system leading to unsafe transfers and inadequatehandover, thus, compromising patient safety and care quality. There was no echocardiogram professional in Dubbo Hospital on the weekend. This forced the attendants to transfer Ms. Young to Orange Base Hospital for echocardiogram therapy (Coroner, 2015). According to nurse Mulvana, her handover of Ms. Young to a night shift nurse was more general than clinical in nature. Clinical handover in the hospital is usually done at nurses’ station or in the handover room where a patient is officially allocated a new nurse to ensure safety. However, Nurse Mulvana’s process of handing over did not follow this protocol leaving Ms. Young alone in the High Dependency Unit (HDU). The Coroner (2015) finds that Nurse Richardson who takes charge of the HDU noted the absence of one of the nurses but did nothing about the hand over at that critical time. This alludes to total fabrication and a failed nursing care system. With regards to Australian Nursing and Midwifery Federation (2015), it is a best practice if nurses support a patient’s decision or transfer care to a qualified critical care provider. Thus, the kind of exhibited in this case fell out of reasonable standards of care in Australia. Ms. Young’s clinical condition drew and became more critical and debilitating towards the 29th April 2012. However, nurses failed to recognize this situation to make an immediate transfer of Ms. Young to the Medical Emergency Team (MET) for palliative care. Instead, Ms. Young was transferred to the High Dependency Unit in which no proper care intervention measures were initiated. Her blood pressure lowered, breathing rate increased, and body temperature dropped below the optimal leading to cardiac arrest. MET medical interventions using intravenous fluid and CPR were unsuccessful since they were administered late leading to the demise of Ms. Young. As a primary intervention to an end-of-life situation, it would have been important for the nurses to consider integration of intensive care unit once they had observed unfamiliar changes in Ms. Young’s situation. By acting on the contrary, care providers showed a lack of duty of care and professional negligence. They failed in their professional obligation to offer reasonable care based on skills and professional competence. Caring for Ms.Young demanded complex assessment, high-intensity therapies and medical interventions administered with continuous nursing vigilance. For effective outcomes, therefore, the nurses ought to have relied on a specialized body of skills, knowledge, and experience to provide care and create a healing, humane and caring environment (Considine & Currey, 2015). In this role, also Ms. Young’s nurses would have respected and supported her right to life by making autonomous and informed decisions based on clear clinical observations. All these never existed within nursing care described in the case. Apparently, the care provision at Dubbo Hospital was based on inadequate and poor recording. Ms. Young was admitted to the hospital intensive care unit on 28th April 2012. At this time she was categorized as a category two patient who receives hourly observations on vital signs. This categorization was based on the Between the Flags policy system initiated the government’s NSW Department of Health to record vital observation (Hughes et al., 2014). An observation indicating a yellow “flag” implies the need for a medical review, but that which indicates a red “flag” shows the need to call for an emergency medical team. Coroner’s finding proves that all doctors accepted being well versed with the Between the Flagspolicy, however, their actions were on the contrary. Prior to admission to G-wards, only two sets observations were recorded at the Emergency Department: ECG which indicated that patient had ST elevation in almost all leads alluding to pericarditis and chest X-ray which was normal. Based on Dr.Lang’s conclusions echocardiogram examination of Ms. Young, the patient did not experience pericardial effusion. This finding was not based true findings but rather based theoretical projections. As a qualified medical practioner, it is important to ensure that all findings are evidence-based and follows the principles of best practice. This nursing care, therefore, was just simulative of a qualified nursing care. Further, it is important to note that Coroner espoused several circumstances of negligence in Ms. Young’s nursing care at the Emergency Department. For instance, the doctor ordered for the patient to be placed on monitored bed, however, she ended up in unmonitored bed and no explanations were given to substantiate such actions. Additionally, in G-Wards, it was ordered that the patient was to be connected to telemetry. However, there is no evidence that telemetry monitoring was actually implemented since no telemetry readings were recorded. Attempts to explain the reason behind this by Mulvana was ruled unintelligible and impossible to understand since it had not logical flow of context. Based on the context Ms. Young’s clinical condition, it was important to conduct urine test at the admission. However, there is no evidence of urine output reading. This implies that no vital signs were documented when Ms. Young was being admitted to G-Ward. Nursing best practice demands that before administering any medical intervention to a critically ill patient, care providers need to asses, diagnose and examine the patient to establish the possible problem (Considine & Currey, 2015). This, in the end, forms the basis for medical treatment which can assure patient safety and quality care. Poor documentation of IV therapy, fluid chart balance, and urine test denotes a lack of a systematic approach to disease assessment. This health system, therefore, breaches the principles of best practice in nursing care and nursing as a profession through negligence and lack of due care in care provision leading to the demise of Ms.Young. It epitomizes a kind a care made up of quarks rather than skilled care providers and doctors. Section II: Application of Tort of Negligence It is important for health professionals to be careful of their actions or omission regarding patients whom they handle. This is because people are always sensitive about how medical practitioners deal with their health conditions. When a doctor acts in a way to compromise a person’s health especially due to negligence, the tort of negligence becomes applicable. This law allows the affected person to claim damages against health professionals when their actions or omissions have breached the contract, thus, causing harm (Mcdonald & Then, 2014). For instance, Ms. Young established a contractual relationship with the doctors and nurses who attended to her. Therefore, she expected the maximum level of commitment and care from them, since at the end of it all, she had to pay the medical service fee. Law of negligence can be applied to nurses and doctors in Ms. Young case based on three elements: the duty of care, breach of duty and damage (Macdonald and Then, 2014). These elements element enables plaintiff balance probabilities for the advancement of a successful claim for negligence. Although the law of negligence is common to all states in Australia, different states have modified it to fit their specifications and interests. Atkins (2014) defines duty of care as the legal obligation on a professional to exercise reasonable care and skill when providing a professional treatment. Therefore, all health care professionals including midwives, nurses and doctors owe patients a duty to exercise provision of care and treatments with reasonable care and skills. This also applies when they provide information relating to a patient health records since patient’s safety has to prevail. In Ms. Young’s case, it is apparent that the doctors failed to exercise duty of care to arrest her clinical condition. Regardless of the patient being critically ill, the doctors and nurses delayed to administer appropriate clinical interventions in time, and she dies due to the reckless actions of the nurses and doctors in the hospital. One of the nurses (Mulvana) stated that she did not make a clinical handover of Ms. Young to the night shift nurse, but she rather made a general handover. This is a clear instance of negligence, and according to the tort of negligence, Ms. Young beneficiaries need to claim for damages against health professionals in the Hospital. Australian nurses and doctors work under uniform and reasonable standards of practice and breaching these standards amount to negligence. A reasonable standard of practice is that which would be expected of any other nurse who is experienced and trained in the same role (Atkins, 2014). It is, therefore, expected that all health professionals will always act or work in a way to achieve quality care and ensure patient safety. It is clear that Ms. Young safety and quality care were not guaranteed Dubbo Hospital. Apart from lacking necessary knowledge for some procedures (like echocardiogram), the doctors and nurses acted as if they wanted the patient to die. Thus, they failed in their duty as professional causing damage to Ms. Young. Leaving Ms.Young in emergency department without proper medical treatment denotes a breach of duty because it was the duty of these nurses and doctors to ensure Ms. Young was safely treated and taken care of. According to Stauton (2013), the action of these “professionals” overlooked a foreseeable risk of harm and was unreasonable in light of foreseeable risk. Therefore, the tort of negligence would apply appropriately on the ground that they breached their professional duty, thus, harming the patient and causing damage to her. The legal application would affect both Dubbo Hospital and its employees. For one, Dubbo would be held vicariously liable for the actions of its employees towards the demise of Ms. Young . Two, all Dubbo nurses and doctors who were involved Ms. Young’s case would face legal charges for damages they caused her as a result of negligent actions and omissions. Section III: Ethical Analysis Medical professionals at all levels and areas of practice deal with ethical or moral issues (Johnstone & Crock, 2007). As such, all nurses and nursing students are strongly advised to embrace codes of ethics and ethical statements when reflecting on the extent to which their clinical, educational and managerial practice upholds ethical values. Besides legal aspects, the case espouses a number of ethical considerations regarding the nursing care advanced to Ms. Young. According to the Australian College of nursing (2008), nurses need to value the quality of nursing care for all people. This is one the codes of ethics recommended to all nurses in practice within Australia. Essentially, nurses and other medical practitioners are expected to accept as a standard of nursing care they provide, act on reasonable grounds, and help uplift acceptable standards of nursing care. This means medical practitioners ought to be as ethical as possible in terms of behaviors and modes of treatment. Ethical nurses recognize that they are accountable for the clinical decisions they make concerning an individual’s care, agree to their legal and moral responsibilities to ensure they have adequate skills, knowledge, and experience necessary provide to safe and quality nursing care. Also, nurses who value quality care ensure their professional engagements comply with the agreed professional standards. Ms. Young’s care providers breached the ethical code of quality nursing care. In one instance, it was found that the nurses lacked professional skills and knowledge to conduct an echocardiogram therapy. In other instances, the nurses failed to recognize that Ms. Young’s clinical condition was life-threatening and required vigilant and intensive nursing care. Instead, they ended up making clinical decisions lacking reasonable grounds. For instance, instead of transferring Ms. Young to intensive care unit, they placed her in HDU department which furthered the deterioration of her condition. Another ethical consideration is patient safety. Mcdonald & Then (2014) defines patient as protecting patients from harm, damage or from exposure to conditions that can compromise a patient life. It is ethical for nurses to value safe practice and safe working environments, avoid cases where their ability to offer quality care may be impaired and practice within the limits of their areas of specialization, knowledge, and skills (Fedoruk, 2012.) By so doing, they recognize that people are vulnerable to injuries and illnesses resulting from the preventable human errors. Health system and care providers in Dubbo Hospital failed to ensure that Ms. Young was safe. This is evident in both system structures and actions of care providers. These actions ranged from negligence, lack of duty of care, poor observations, poor recording of vital sign, inadequate handover and making uninformed decisions. For instance, when MS Youngwas admitted to the emergency department, she was supposed to be connected to telemetry. However, the nurses disregarded this order and left her unconnected. This debilitated her condition causing her untimely death. References Australian College of Nursing., 2008. Codes of Ethics for nurses in Australia. Nursing and midwifery Board of Australia. Australian Nursing and Midwifery Federation. 2015. List of Available RNAO Best Practice Guidelines. Web retrieved from https://www.anmfsa.org.au/wp-content/uploads/2013/10/RNAO-Best-Practice-Guidelines-Current-February-2015.pdf Considine, J., &Currey, J. (2015). Ensuring a proactive, evidence-based, patient safety approach to patient assessment. Journal Of Clinical Nursing, 24(1/2), 300-307. doi:10.1111/jocn.12641 Fedoruk,. M. 2012. Legal responsibilities and ethics. Hughes, C., Pain, C., Braithwaite, J., & Hillman, K. (2014). ‘Between the flags’: implementing a rapid response system at scale. BMJ quality & safety, 23(9), 714-717. Johnstone., M &Crock.,E. 2007. Dealing with ethical issues in nursing practice. Macdonald & Then. 2014. Ethics, Law and Health Care State Coroner’s Court of New South Wales. 2015. Young, Lynnette findings. Retrieved from http://www.coroners.justice.nsw.gov.au/Documents/Young,%20Lynette%20findings.pdf The Australian Charter of Healthcare Rights .2008. Australian Commissionon on safety and quality of health care. Web retrieved from http://www.safetyandquality.gov.au/national-priorities/charter-of-healthcare-rights/. 10/8/2016 Read More