Professional Ethics in the Nursing - Case Study Example

There are four bodies that are concerned with the professional ethics in the nursing profession in Australia. Queensland Nursing Council is one of the bodies that are charged with the responsibility of setting and maintaining the ethical standard of both enrolled and registered nurses. (Queensland Nursing council, 2008). In addition, Australian Nursing & Midwifery council (ANMC) lays down the code of professional conduct for nurses in Australia. ANMC states that; The nursing profession expects that the nurses will conduct themselves personally and professionally in a way that will maintain public trust and confidence in the profession. Nurses have responsibility to the individual, society, and the profession to provide safe and competent nursing care which is responsive to individual, group and community needs, and the profession. (ANMC, p. 1). Both the Queensland nursing council and the ANMC concur that the professional standards in the nursing profession must be maintained. Professionalism can only be achieved by strictly adhering to the laid down code of ethics and conduct for the nursing profession. For a nurse to be considered, conducting him/herself professionally he/she has to treat information obtained in a professional capacity as confidential. A nurse is under obligation to follow the agreed standards of the profession, furthermore he/she has to practice the laws relevant in his/her profession. A nurse shouldn’t be involved in any exploitation or misinformation in regard to healthcare services. It is the responsibility of the nurse to maintain the trust inherent between him/her and the patient. The nursing profession requires the nurse to respect the dignity, culture, values and beliefs of a patient; this has to be done by also supporting the health of an individual and making informed decisions concerning an individual. Moreover, the nurse should not be negligent and should practice in a safe and competent manner. A nurse should not in whatsoever circumstances discuss a patient’s medical condition with another patient. The enrolled nurse answers to the registered since he/she has a high authority. However, this does not mean that the enrolled nurse shouldn’t take action against the registered nurse for violating the code of ethics and conduct set for the nursing profession. The code of conduct is based on five principles. The first principle that should be put in mind in this case is respect for people. It is also upon the patient to determine who is to be provided with information concerning his/her personal medical condition. The registered nurse made a statement that was way out of line, claiming that there was a certain patient whose condition had no treatment. In relation to this a nurse has no right to disclose medical information of one patient to another. This is tantamount to disrespect to the other patients in the hospital. In addition this exemplifies the nurse’s lack of integrity. In this case, since patient B had undergone palliative surgery two days earlier and had not received any results from the doctor made an assumption that the registered nurse was referring to her condition. Registered nurse could have avoided this situation by sticking to the code of conduct that is supposed to guide the nurse’s behavior at the work place. The Health Services Act 1991 stipulates that the information about a person receiving public health service must be treated with the strictest confidence.(Queensland Health Code of Conduct). According to the code of ethics and conduct a patient trusts that the nurse will not cause any psychological damage to him or her. Through breach of confidentiality the registered nurse caused patient A psychological stress since she started thinking about the worst even before the doctor had officially presented the results to the patient. According to the Queensland Health Code of Conduct, discussion involving patient details with other patients or employees for that matter should be avoided unless it is part of your duty to do so. It follows that the nurse had both moral and legal duty to make sure that the privacy of the individual prevails by restricting information that is solicited in a professional manner to appropriate individuals. The information given out by the nurse was neither directed to the appropriate personnel nor was it meant to serve any professional purpose. This information was only supposed to be given by the doctor in charge of handling the patient in question. It could have been ethical if the nurse was to communicate this information to the affected patient through consent from the doctor who had the authority to do so. Queensland Nursing Council has documented that the disclosure of of patient information on the patient should only occur within an established therapeutic relationship and that the revealing of patient should be of the therapeutic value to the patient herself. The registered should have therefore, carefully considered her motives before disclosing persona information about a patient’s medical condition The Enrolled Nurse has responsibility to contribute to decision making by using critical and reflective thinking skills; part of this responsibility is to identify any abnormality in the assessment and treatment of a patient. Albeit being junior to the registered nurse the Enrolled nurse is supposed to take action against her colleague for gross misconduct. For that reason, if she fails to report the registered nurse, her behavior may as well be considered to be unethical. According to the Queensland Nursing Council access to/ disclosure of information is one of the four areas that require that medical practice be informed by guidelines. Consequently confidentiality should be informed by guidelines set for both enrolled and practicing nurses. The first action that should be taken by the enrolled nurse is for her to explain to her colleague on the code of professional conduct concerning disclosure of information. The enrolled nurse also has a duty to go ahead and report the registered nurse to the management because of the potential harm caused to patient A due to unethical behavior. This incidence by the registered nurse is one that is not guided by specific policy or guideline. Thus in this case the Enrolled Nurse is supposed to follow certain principles that work in the best interest of the hospital and the public. For instance, in addressing the case of patient A the enrolled nurse is supposed to act in an impartial and fair manner. The most important principle applicable to this situation should have been to be honest and responsive to work place issues. Guided by this principle number two it is clear enough that the Enrolled should just have reported the Registered nurse to the management or the relevant authority. One of the competency elements of an enrolled nurse is to communicate information accurately in accordance with organizational policies regarding disclosure of information. In this regard it is very much correct for Enrolled nurse to report the Registered Nurse so long as her actions are within the policies of the organization. The Queensland code of conduct states that any official misconduct should be reported once a person is aware of such misconduct. This can be reported to the line manager or to Assurance and Risk Advisory Services. In responding to the patient the registered nurse should give reassurance to the patient A that she doesn’t have to worry about the nurse’s comments given by the Registered Nurse since the doctor has not yet given out the results concerning. Further more the opinion of the Registered Nurse doesn’t necessarily mean that she is referring to her situation, it could be, she is talking about another patient apart from patient A. Other than providing moral support to the patient the Enrolled Nurse has a duty to give patient A advice concerning what is the best course action if she feels aggrieved. This advice given to the patient by the Enrolled nurse should not be malicious or aimed at tarnishing the reputation of the registered nurse but should provide facts. By giving the patient advice the Enrolled Nurse must tell the patient the advantages and disadvantages of the course of action they are about to take. For instance, the Enrolled Nurse can ask the patient to report the Registered Nurse to the doctor provided that she is going to support the patient’ claims. The gross misconduct committed by the registered nurse goes beyond ethical and moral boundaries. As a result of breaching the patient’s confidentiality the matter calls for legal action. Nursing has to follow the law and that is why there is the statute law that touches on the nursing profession. In this statute there are several Acts that have been implemented to guard against misconduct in the Nursing profession and to also protect the nurses’ themselves. Some of these acts include Anti-Discrimination Act 1991, Equal Opportunity & Public Employment Act 1992, Nurses Act 1992, Freedom of Information Act 1992, Health Services Act 1991 and the Whistleblowers Protection Act 1994. According to Queensland Government 2006, the whistleblowers Protection Act 1994 makes it a criminal offence to take a reprisal against a whistleblower. The Enrolled Nurse therefore has no reason to fear reporting the gross misconduct of the registered nurse since she is protected by the law from victimization. It has been made clear that an employee who makes disclosure about a breach of the code of conduct shall be protected from retaliation or reprisals. On the other hand the principles of natural justice demand that the accused nurse be given a chance to present her case. Moreover the Nursing Act 1992 gives the Queensland Nursing Council the authority to develop and determine the regulations for nursing that is, setting laws, standards, rules and code of practice for the nurses. In relation to this case whereby the registered nurse breached the confidentiality of his doctor; the Queensland Health code of conduct (2006) established strict duty of confidentiality on the part of all the hospital staff. This stern measure is a requirement of the Health Services Act 1991; section 62 that deal with the patient and hospital staff. The Registered Nurse went against the law that requires that disclosure concerning a patient’s medical treatment can only occur in a limited number of ways that have been laid down in the Act. The nurse can provide security of patient information provided that the she does not give out information without the doctor’s consent and by following the guidelines provided by the Act. In the nursing profession an Enrolled Nurse can be faced with issues of Negligence. Negligence in most cases is not attributed to the breach of conduct or moral/ethical values. However negligence as determined by the court of law is that conduct that falls below the accepted standards. For instance if the Enrolled Nurse is dressing the wound of patient A and it happens that she infects it causing complications due to lack of proper hygiene; then this action can be considered as negligence on the part of nurse. Negligence includes both the action taken by a nurse or omissions in the provision of information to a patient which in the opinion of the court is below the normal standard that is practically require under the given circumstances. In the Nursing profession negligence is considered to falls within the violation of the basic four fundamentals. First, a nurse might be considered negligent if duty of care was owed to the patient and the nurse did not provide it. Secondly in cases where there is the dereliction of duty by the nurse. Thirdly, a nurse is guilty of medical malpractice if he/she causes damage to the patient as a result of breach of duty. Finally, if damage to a patient can be directly attributed to the breach of duty by the nurse then he/she is considered to be negligent. Negligence is therefore a medical malpractice that cannot be defined by specific conduct or behavior but by the method of carrying out activities. When it comes to duty of care the Enrolled Nurse should out in mind hi/her or scope of practice. They should not allow being delegated duties that are not within their scope of practice. Practicing outside ones scope of practice either through consent or willingly amounts to breach of the duty of care. The conflict here is most likely between enrolled and registered nurse. A registered Nurse is senior and there are some duties that she is not supposed to delegate to the Enrolled Nurse. Likewise an Enrolled Nurse should not take up the responsibility of her senior not unless she has been given consent to do so. In situations whereby a nurse is responsible for negligence that has led to the patient’s damage she does not bare responsibility alone but shares it with the employer; this is referred to as vicarious liability. The hospital has to pay the plaintiff a sum of money granted by the court as a consequence of employees’ negligence. The law gives the management the authority to recover the money from the employee. A disciplinary action can later be taken against the nurse. According to the Queensland Nursing Council investigation into an offence by the nurse may be launched by Inspectors authorized by the Council under the Nursing Act 1992, division 2. The council then comes up with recommendations on the course of action to be taken concerning the Nurse. The law has set up bodies like the Queensland Nursing Council to help ensure that the nurses treat people safely and competently with dignity and respect. To ensure that the public is protected from the nurses’ misconduct and negligence such bodies should make sure that the public receives highest possible standard care. To begin with his can be done by approving courses that lead to registration, enrolment or endorsement for nursing practice. It is the mandate of such bodies to asses and investigates complaints about the competence, health, behavior and conduct of the nurses. In addition to this they can also asses the nurses’ competency tests and renewal of their licenses. A competence test may be conducted if the council finds the ability of the nurse to provide safe nursing care is in doubt, hence recommends that the nurse should undergo assessment. The code of conduct of conduct set for the Nursing profession is supposed to be followed at all times. The code does not give meticulous professional advice on areas of practice but somewhat identifies the minimum requirements for conduct in the Nursing profession. A breach of the code of ethics and conduct may lead to malpractice on the part of the Nurse. Consequently the Nurses must behave professionally. It is this professionalism that will maintain public trust and confidence in the profession. Moreover the nurses should be in a position to provide safe and competent nursing care that is open to the needs of the patient and the profession. References Australian Nursing and Midwifery Council, 2003. Code of Professional Conduct for Nurses. Dickson ACT 2602. Queensland Nursing Council 2008. Setting the Standards for Nursing and Midwifery.Brisbane. Queensland Nursing Council 2005. Professionalism Documentation Standards. Brisbane. Queensland Government 2006. Summary of the Code of Conduct. Queensland Nursing Council 2005. Framework for Nurses and Midwives. Brisbane. Australian Nursing Council, 2002. Principles for the Assessment of National Competency Standards for Registered and Enrolled Nurses. Dickson ACT 2602. Royal College of Nursing. Read More