Legal and Ethical Frameworks for Nursing - Essay Example

Order no. 342177 Topic: Registered nurses must make clinically sound decisions within the legal and ethical frameworks to ensure professional care for patients. The aim of this essay is for you to demonstrate our knowledge of law and ethics. 1. Introduction: This paper seeks to evaluate how the registered nurses (RN) must make clinically sound decisions within the legal and ethical frameworks to ensure professional care for patients given the limitations of their resources. Presently RNs are beset of the scarcity in time, resources and energy as the patients become demanding as a result of increasing need of health care and the proper application of the same during their treatment while the law appears to protect more the patient with possible charge of malpractice against physicians and other health professional likes the registered nurses. Patient’s education is one of the requirements for many practicing RNs and may turn out to be inadequate or incomplete due to reasons as indicated. The first part of the paper will discuss the possible legal implications of providing limited patient education in the light of limited resources and the relation with such roles of RN with possible complaints for negligence against the nurse. The next part will be the necessary strategies to cope with the situation and the last part will be utilizing an ethical decision-making framework to show how an RN to have patient autonomy, non-malfeasance, beneficence and justice and other goods things pursuant to nursing practice. 2. Analysis and Discussion 2.1 Discuss the possible legal implications for a Registered Nurse (RN) of providing limited patient education. *Include in your discussion the relationship between the RN’s role of educator and possible complaints by a patient of negligence against the nurse (600 words) The possible legal implications of a Registered Nurse having provided only limited patient education is the possible charge of the medical malpractice. Aucoin (2004) said that patient education is the responsibility of the RN in most states. She defined patient education as “the comprehensive approach to providing teaching to the patient. However, much like the nursing care plan, it is the RN who is expected to perform the complete assessment and create a plan of care that includes the patient education plan (Aucoin, 2004). But why the issue of limited patient education when the RN can do well? No, the phenomenon is a reality of the times which may be attributed to the lack of sufficient number of RN’s and their increasing functions as technology changes. The present situation of the registered nurses is best illustrated by the case facts provided for as follows: “You and your colleagues are cutting on the attention you give to patients, particularly in areas like patient instruction. ‘There are so many other demands,’ a fellow RN says, ‘who‘s got time for long explanations?’ You ‘re as short on time as the next nurse, but feel guilty when you rush through patient education or cut their questions short...The majority of nurses today practice insetting with short-staffing and limited and equipment and resources. Most have responsibilities for several if not many patients. Even when scarcity is not an issue, we have to decisions about how we spend our time and energies as nurses.” (Haddad, A 2003, p. 23) The case facts so indicate clearly that nurses too are bound by the scarcity of the equipment and resources and the wisdom of how really to properly spend their time and energies given the limitations stated. Is it an assurance that if the nurse will make the patient education well will lessen the charge of negligence as result of possible complaints of patients? It is submitted that the patients that are better informed or education of what they should do and they should avoid would be less demanding of any possible charge of negligence by nurses. But the dilemma of nurses will still be there because ensuring quality of a single of few patients through educating them well will cause them to sacrifice the others again because of limited energies and sources. The challenge therefore is how to strike a balance between the price of doing and good patient education. As in everything, things are not perfect yet everybody must be aiming perfection to avoid possible charge of negligence. Forrester (2001) defined a claim in negligence as “the civil action initiated under the law of torts in which health professionals, and health care institutions, may become involved if a patient or client sustains an industry while in their care” and that it may allege conduct, which may include not only an act, but also, an omission to act, which is casually linked to the injury. The author explained that to succeed in a claim for in negligence therefore, the patient (plaintiff) must be able to establish, on the balance of probability, all the following elements: (a) patient was owed a duty of care by the health professional (defendant); (b) that there was a breach of that duty in that the health professional’s conduct fell below the required standard of care; (c) this conduct caused the damages suffered by the patient; and (d) the loss or damage suffered was reasonably foreseeable (Forrester, 2001). In the eyes of the law, negligence as ground for liability is a liability based on circumstance and the dictate of the best options under many compelling choices that a human person normally takes. In other words as long as registered nurses are in good faith, even despite the apparent helpless to solve the ideal proper patient education, the principle of good faith will be an issue that must be proven for any registered nurse who may want to escape liability for patients making their complaints to courts. In other words, assuming that the nurse do have limited resources and energies, when a patient complaints, it will be a matter of defense to invoke the limitation of resources. But in the meantime nurses are human and they can be subject to the dictates of conscience making them to do the moral action under challenging circumstances. The practice of nursing entails a lot of emotions and seeing patients not to recover because of known failure to do acts which could have been done could bring feelings of guilt on the part of the practitioner but this observation may not be the same for all practitioners. Hence, there is the relevance of well defined ethics and legal boundaries for the nurse practitioner to see himself or herself in certain challenging situations. Sometime this could be a question of values, which nurses have differently from others. 2.2 Outline strategies that the RN can take to ensure that adequate education is made available to ensure the risk of malpractice is minimized (300 words). The strategies to ensure that RN can take to ensure that adequate education is made available to ensure the risk of malpractice is minimized could be numerous and the following are just few ideas: a. Practice good faith under all circumstances when dealing with the patient. Haddad A (2003), admits that the practising registered has limitations on many things in giving the best patient education. She suggested that the RN could ask the patient to excuse you as you had to do something for another patient, but would return, return to continue the conversation. This idea connotes willingness to give education before the excuse. One way to keep the patient waiting for example is to provide the patients “with literature and videos that pertain to them.” The nurse the can then “return at an arranged time to discuss the information.” The authors are suggesting a practical approach to patient education since she is doing what a responsible educator does. Teaching the patient need not be in the presence of the registered nurse. Depending upon the capacity of the patient physically or emotionally, the RN can really give the patient some literature to read so that during the absence of the registered nurse the patient would actually helping himself to heal by learning how do things that should be done while under medication. b. Set priorities correctly. Another way is by setting priorities correctly. Haddad (2003) admitted that time is short, and priorities compete but a wise RN will do much if she knows how to set priorities. She explained, “All patients may need education about their condition and treatment, but do all need it to the same degree?” A wise registered nurse wanting to impart good patient education must also like a teacher inside the classroom who understands how to help slow learner but letting alone the more intelligent students to learn for themselves in their own pace. 2.3 Feelings of guilt will indicate that the RN’s ethical values have been compromised. Utilize an ethical decision-making model or framework to demonstrate how an RN might proceed to ensure patient autonomy, non-malfeasance, beneficence and justice (700 words). The decision-making model or framework that an RN can use to demonstrate how he or she might proceed to ensure patient autonomy, non-malfeasance, beneficence and justice may take the form of practising balanced ethics and seeking out time-saving teaching strategies. As to practicing balance ethics, Haddad (2003) stated that several principles are involved in the practice of RN and that one ethical principle obliges us to seek an equitable distribution of benefits in a given population, which she called “the principle of distributive justice—which in this case means that we believe that all members of society who are ill should have access to good medical care.” (Paraphrasing made) Haddad (2003) explained that upholding of the principle of distributive justice was rooted in our belief of equal and fair treatment. However she countered those other factors balances these ideals. She then argues that nurses “would like to give equal time to patients— including time to learn about each patient and help all of them, understand their condition and treatment” But according to her, we also know that “some of our patients require more of our time than others, usually because of the severity or complexity of their illness.” She further supported her statement that similarly, “we know that patients aren’t all equal when it comes to their level of formal education, experience, or the amount of time it takes them to learn a particular skill, such as self-administering an injectable drug. For these reasons, we can’t treat all individuals the same when it comes to patient education.” (Haddad, 2003) (Paraphrasing made). Haddad (2003) therefore advocated that balancing of “our ideals of justice and equality with another principle, utility.” She explained that “the principle of utility holds that resources—in this case, a nurse’s expertise, time, and energy— should be used where they’ll do the most good.” By so doing, she in effect sees situations on case to case basis or that there are very rich areas of discretion where the RN could use his or her wise discretion in addressing the patients’ needs. Part of the models is to “seek out time-saving teaching strategies.” Haddad (2003) explained that ethics gives us with ideals while “the real world presents problems that we need to surmount to live up to our ideals.” She again admitted that “the No. I baffler that inhibits patient education is time.” She then demonstrated the needs of nurses and patients for enough time to think over and discuss “various aspects of care—which can range from teaching concrete skills for asthma inhaler use to more abstract topics such as the effects of chemotherapy on a patient’s self-image.” Haddad (2003) therefore at this point advocated proper time management. She explained that not giving or assigning enough time can be damaging to the process itself. She noted that a patient who is sensing that instruction is being rushed or is perfunctory may lessen his or her motivation to learn. Haddad (2003) clearly pointed out that if the patient “is not given time to digest the basic points of your instruction, it’s less likely that she’ll comprehend what you say next.” Haddad (2003) further pointed out that patient education is not the sole responsibility of the RN and the patient when she explained that it’s not simply the nurse who that should make choices in allocating of time for the education of the patient education. Haddad (2003) emphasized that nurses employers, whether they be clinics, physicians offices, or hospitals, likewise share in the obligation to provide support, educational programs, and professional resources. It is in these resources “that nurses can obtain the skills and knowledge to provide patient education effectively and efficiently.” She added that if nurses sense that patient education is being shortchanged, then the obligation should come out to advocate for such resources. She cited as example, doing some online research to identify educational tools or strategies or experiences that “have worked elsewhere and that could help you to make the best use of the time available for patient education.” In another instance it could be in the case of just by starting to ask patients about their particular needs. Haddad (2003) had admitted this to be the s the approach which was taken by “one group of nurse researchers who used focus groups to determine patient information needs regarding patient-controlled analgesia.” Using the feedback from the focus group, she announced that “these nurses made substantial changes to an educational leaflet they had planned— which rendered it a clearer, more attractive, and more informative educational tool.” (Haddad, 2003) (Paraphrasing made). 3. Conclusion (100 words) Registered nurses are professionals and as such they render a service to the community and this is the reason that state has provided a legal and ethical framework under which they must perform their functions. There is therefore justifiable basis to say that they must make clinically sound decisions within the legal and ethical frameworks to ensure professional care for patients. Related however to the issue that nursing is a profession they must also practice within the realm of economic realities because if limited resources hence, it should be pointed out that legal and ethical obligations must also take also into consideration the economic factors that could limit the efficient functioning of the profession of nursing. 4. References: Aucoin, J. (2004) Licensed Practical Nurse Areas of Liability, {www document} URL http://www.fadavis.com/related_resources/27_1554_445.pdf, Accessed March 23, 2007 Forrester, Kim (2001), Essentials of law for health professionals, Elsevier (Australia) Pty Limited, NSW, Australia Haddad, a (2003), RN, Volume 66. No. July, 2003 Jameton, (2005) Jameton, A. 2005. “Environmental Health Ethics.” In Environmental Health: From Global to Local. Ed: Frumkin, H. San Francisco: Jossey-Bass. Leopold, A. 1949. A Sand County Almanac. New York: Oxford University Press. Pierce and Jameton (2003), Pierce, J., and A. Jameton. 2003. The Ethics of Environmentally Responsible Health Care. New York: Oxford University Press. The Center for Health Design and Health Care Without Harm (2006) Designing the 21st Century Hospital Environmental Leadership for Healthier Patients and Facilities (n.d.), {www document} http://www.rwjf.org/files/publications/other/Report%20-%20Designingthe21stCenturyHospital-September2006.pdf Read More