Apply Legal and Ethical Parameters to Nursing Practice - Assignment Example

Apply Legal & Ethical Parameters to Nursing Practice APPLY LEGAL & ETHICAL PARAMETERS TO NURSING PRACTICE Titus Rock Manickam Order No. 298924 26 May 2009 Table of Contents Introduction………………………………………………………….3 Legal implication if the patient is not patient A…………………..3 Legal implication if the patient is indeed patient A………………5 Disciplinary measures……………………………………………...7 Discuss the ethical dilemmas……………………………………...8 How would the enrolled nurse……………………………………..8 How would the enrolled nurses interactions……………………..9 Conclusion…………………………………………………………...9 Source………………………………………………………………..11 APPLY LEGAL & ETHICAL PARAMETERS TO NURSING PRACTICE Introduction This is not a very serious case although there is the potential for breakdown in the event the patient in question turns out to be patient A. However, the die is cast and the damage is done. Although patient B does not specifically name patient A, the information she lets out in conversation with the registered nurse coincides with the events patient A has undergone. Patient A is highly disturbed by what she has heard patient B utter unobtrusively in her conversation with the registered nurse. The registered nurse has not used discretion in her response and has added insult to injury with her careless remarks that the doctor has no treatment alternatives for the patient, a remark heard and taken personally by patient A. This episode can get nurse B into trouble with the law. There are two legal implications to this episode. One, there is the legal implication that nurse B has not acted discretely and caused anxiety to patient A, but only for a short while as the patient in question is not patient A. The second legal implication is more serious in that the patient implied is indeed patient A. Legal implication if the patient is not patient A Even if patient B had expressed her relief to the registered nurse, the latter must not have responded and said that, “one patient had surgery two days ago and her doctor said today that he has no treatment alternatives for her and is not looking forward to telling her tonight”. This particular sentence coming from the registered nurse is the epicenter of the whole issue and can make the going tough for the registered nurse. Given that the patient in question is not patient A, the information is damning enough to cause concern and anxiety to patient A. Patient A can make a complaint against the registered nurse. The registered nurse has violated the rules and regulations governing the practice of nurses. The nature of the violation has the potential to snowball into a major crisis. Some mitigation effect is possible it the registered nurse tenders an apology. But here again, it depends on the outcome if the patient in question is indeed patient A. Legal requirements for nursing practice exist to assure the health, safety, and welfare of the general public and to protect the integrity of the nursing profession. The specific remark made by the registered does not assure the health, safety and welfare of patient A. The enrolled nurse who is attending to patient A too overhears the conversation between patient B and the registered nurse. The enrolled nurse becomes duty bound to either back patient A or make a separate complaint against the registered nurse. Once a complaint is received, it is assigned to a State Board investigator who will review the complaint and gather additional information, should the need arise. The investigation is done to make charges against the nurse. The nurse must be aware of this fact and must not make any statement until she has received counseling from an experienced solicitor. In case patient A and the enrolled nurse complain to the State Board on the registered nurse’s behavior, the State Board can charge the registered nurse appropriately. The Board can also conduct an investigation and take disciplinary measures. If the registered nurse feels that the Board has been extremely harsh on its disciplinary action, she can petition to have the decision reviewed by the appropriate court in her state (Smith, Mable H). Legal implication if the patient is indeed patient A Disciplinary measures for the nature of the offense may not differ even if the patient about whom patient B and the registered nurse were discussing was indeed patient A. The offense has cascading effect in that the concerned doctor too expressed the opinion that he was not looking forward to talking to patient A that night. According to reports, the pathology results for patient A have yet to come. Until the pathology results are received, doctors are not in a position to convey their opinion. Perhaps it is the doctor who had performed the palliative surgery on patient A two days ago. Nonetheless, it is not possible to conclusively opinionate on a patient’s condition until the pathology results are received. If the registered nurse had referred to patient A and the patient complaints, the nurse can be charged. If it is a first offence, the nurse can be let off with a strict warning. The nurse is not responsible for patient A’s condition. The charges against the nurse are indiscretion. Nurses are solemnly bound to keep confidential information to themselves and not divulge it before others. Technically, the registered nurse can be charged for violating the rules and regulations defining and governing the practice of nurses. Morally, the registered nurse faces deeper incrimination in case the patient referred is actually patient A. Doctors and nurses do not write off patients’ chances of recovery. Every attempt is made to help the patient recover. Hospitals and medical institutions are premises for recoveries and rehabilitations. No stone must be left unturned in seeking to administer medical aid to a patient so that he or she recovers. Some of the grounds and leading causes for disciplinary action a nurse license are unprofessional conduct, unsafe practice, unethical practice, criminal convictions, and alcohol and substance abuse. The registered nurse has come close to violating some of these leading causes. The relationship between the patient and the nurse is sacrosanct because the patient depends on the nurse for recovery. The nurse with the doctor assumes the role of a life giver to the patient. If the confidence of the patient in the nurse is shattered, it is equivalent to abdication of responsibility of the nurse. Nurses cannot fall from grace and continue to practice. It can take substantial time for such nurses to regain their lost morale. It is part of the duty of a nurse to provide competent care. State Boards can initiate disciplinary actions against a nurse for errors made in practice. However, due process of the law makes it necessary for the nurse give her version of the case before charges are framed (Smith, Mable H). A nurse is expected to observe discipline in discharging her duty. He or she may or may not be conscious of the purpose of discipline. However, this discipline is achieved through silence and self-control. Discipline and character form the vital bulwark of a nurse in discharging her duty. Conversely, the duty of a nurse can be testing at times. There is severe shortage of nurses the world over. There is the possibility that a nurse could slip under pressure and say what she is not supposed to say. However, such instances cannot be used as excuse. The profession of nurse is noble and demanding. It demands the best standards in a person. Disciplinary measures The registered nurse had undoubtedly talked ill-advisedly. It is a grave error and she could be charged for the error. As registered nurse, she is fully aware of the implications of her actions. She is trained to exercise restraint while talking to patients. She is also trained to be aware of consequences that could result from irresponsible expressions and behavior. However, it is a fact that she was unaware that patient A was within hearing distance when she was speaking to patient B. She had the curtains drawn around patient B so that she could not see that patient A was within hearing distance. Her actions were not deliberate or intentional. Had the registered nurse been aware that patient A was within hearing distance, she may not have said what she did. The nurse will be given the benefit of doubt and there may not be any serious charges pressed against her. Under the circumstances, most probably she will be let off with a sound warning. The nature of offense is not strong enough for the State Board to discipline the nurse’s license. It is not indicated anywhere that the nurse had been under the influence of alcohol or any other banned substance (Smith, Mable H). Discuss the ethical dilemmas the enrolled nurse is encountering in this situation and how the enrolled nurse would manage this situation and the client involved. The enrolled nurse faces the ethical dilemma of having to reassure her patient that there is no merit in what they have overheard the registered nurse has mentioned in her conversation with patient B. The enrolled nurse is clear that the registered nurse has erred in disclosing confidential information in idle chatter. The enrolled nurse is clear that she has to at least speak to the registered nurse and exhort her not to repeat her mistake. How would the enrolled nurse ensure their legal responsibilities and duty of care are complied with in performing the client care activities? The enrolled nurse is fresh from training and knows her duties. She is also confronted with an issue that could snowball into a legal trial for the registered nurse. The enrolled nurse is determined to speak to the registered nurse and forewarn her against indulging in similar unguarded disclosures in the future. The enrolled nurse is also determined to speak to her immediate superior about the affair so that she is not put in any tight situation legally in the future. How would the enrolled nurses interactions and decisions be affected by these issues? How does the enrolled nurses legal requirements need to be met in relation to all of the above?   The enrolled nurse has the responsibility of reassuring her patient that she is in no danger as ill-advisedly mentioned by the registered nurse. The enrolled nurse must speak to the registered nurse and exhort the latter to be more circumspective in the future. The enrolled nurse must also address the issue to her immediate superior so that she is not put into any legally tight situation in the future. Conclusion The registered nurse had committed a serious lapse. However, there is the possibility that she was not referring to patient A. Doctors perform several operations in a day. The nurse may have referred to some other patient. It may have been purely coincidental that patient A happened to be around although she was out of sight. Nevertheless, the incident should prove to be an eye opener to the nurse. The nurse must understand her discretionary role. She must know that the nurse’s job carries great amount of responsibility and she may be privy to information which must be kept confidential. The work of a nurse involves not only medical care but also prudence, ethics and sound judgment. The patients may tell them whatever they like. But nurses must be guarded in their views and opinion. It is only in this environment of privacy that a nurse can conduct her duties more effectively and appreciatively. Sources: Smith, Mable H; Legal Basics for Professional Nursing: Nurse Practice Acts, http://www.nursingworld.org/mods/mod995/canlegalnrsfull.htm Read More