Discuss about the Legal and Ethical Parameters to Nursing Practice.
As an Enrolled Nurse you find that the provision of total patient care is not possible in your Nursing Home. The team is becoming frustrated and morale is very low. There has been a deterioration of care since staff cut backs occurred with the new management 9 months ago.
– The incontinent residents are only permitted to have a change of ‘continence aid’ twice a day and once during the night.
– The meals are now of limited size and many residents request more at meal time or within a few hours of the meal.
– Skin tears and pressure sores are now beginning to occur more frequently than previously. Time does not permit a thorough checking of the client except during the quick showering in the morning
– Physical and chemical restraints are implemented to limit the necessity to meet the needs of, or handle wandering and time consuming residents.
– Residents and relatives are voicing concerns that would support these complaints
– You decide to address these perceived problems with the management of the Nursing Home. What ethical and legal strategies would you discuss with management?
I would inform the management that it is unethical to limit the care given to patient since according to the code of ethics of nurses; patients should receive the best quality of care. I would boldly point out to them that limiting the number of times that continence aid to only twice a day and once during the night as well as limiting the size of the meals that patients take is crossing the line as far as ethics is concerned (American Nurses Association, 2010).
I would inform them that better services attract customers. The purpose of most businesses is to increase their earning potential and in institutions where services are offered then, the best way to attract customers is to provide better services to clients. I would point out to them that the families of the patients are complaining and it is mostly likely that next time they will seek help from other institutions since this one is offering substandard services to patients. Furthermore, the way the inappropriate manner that the management is treating the patients will discourage any potential personal who would want to be admitted in the institution (Australian Nursing and Midwifery Council & Nurses Board of South Australia, 2008).
I would inform them that there are legal consequences that can result from failing to provide proper care to patients as stipulated in the professional code of conduct (American Nurses Association, 2010).
Based on the above, discuss using the various Codes of Professional Conduct for Nurses, ANMC 2008. Complete the summary of the discussion on Code of Professional conduct for nurses in the the Handouts for the unit and upload in the “Attach Files” section of the question.
Following lack of ‘adequate’ response by management, you also take the matter to the Australian Nursing and Midwifery Federation (ANMF), who support and assist you. Management, upon hearing of your actions with the ANMF, decides to terminate your employment. Their claim is that the termination is as a result of continuing ‘downsizing’ and the resulting redundancy of staff. Some of your colleagues support your actions, some do not support you.
What ethical and legal reasons would both groups have for supporting or rejecting your stance, and the resulting consequences? Use the following ethical principles as a means of presenting your case:
The nursing home management can make decisions that they deem right for the organization to achieve success for example downsizing (Wheeler, 2012).
The Australian nursing and midwifery federation are ethically supposed to help the person reporting negative incidents in a health care institution since he or she wants the best for the patients (Australian Nursing and Midwifery Council & Nurses Board of South Australia, 2008).
The Australian nursing and midwifery federation have grounds to support a medical professional who reports matters to them since health institutions who force their medical staff to provide ineffective treatment need to be accountable (Australian Nursing and Midwifery Council & Nurses Board of South Australia, 2008).
The patients in the institution are being treated in an inhuman way and they need to be given justice since the management has refused to rectify the situation and that’s where the Australian nursing and midwifery federation comes in (Australian Nursing and Midwifery Council & Nurses Board of South Australia, 2008).
The nurses are required to keep personal health information except in a situation where the health of the patient is at risk hence disclosing this information to the Australian nursing and midwifery federation will ensure that something is done fast (Australian Nursing and Midwifery Council & Nurses Board of South Australia, 2008).
One should always tell the truth to ensure that justice prevails especially in a situation where patients are being mistreated. With that in mind it would be very difficult for the nursing federation to ignore such claims (Australian Nursing and Midwifery Council & Nurses Board of South Australia, 2008).
A diabetic patient is admitted to hospital with complications and consequences of his badly managed diabetes. He has had his foot amputated as a result of the poor peripheral circulation to his feet. He is causing injuries to himself as a result of his poor eyesight. He is non-compliant in regards to his diet and eats lollies, chocolate, potato chips, ice cream, and drinks 1 litre of soft drink per day. A regular recording of his blood glucose levels have been ordered although he is refusing to comply with this and complains each time an attempt is made to take and record his BGLs.
Discuss this patient in relation to the Nurses’ Code of Ethics, and the legal responsibilities of the providers of patient care. Each of the Value Statements of the Code of Ethics for Nurses is to be discussed.
Should this man continue to occupy an “acute” hospital bed when his non-compliance is not assisting in a change in his health status?
The man should continue to occupy the hospital bed since nurses value the access of quality healthcare for all people.
Can this man be stopped from leaving the ward where he goes downstairs to the kiosk and buys the items outside his diet control?
Yes he can be stopped since nurses should assist him in making proper decisions regarding his health (Australian Nursing and Midwifery Council & Nurses Board of South Australia, 2008).
How do you propose to record this information in the client’s record whilst remaining objective and sensitive?
I will ensure that I record only facts that are beneficial to the patient (Lachman, 2006).
Nurses value quality nursing care for all people
People are entitled to quality healthcare hence every decision should be grounded on quality (Australian Nursing and Midwifery Council, Royal College of Nursing, Australia & Australian Nursing Federation, 2008).
Nurses value respect and kindness for self and others.
Nurses should value the moral worth and dignity of an individual (Australian Nursing and Midwifery Council, Royal College of Nursing, Australia & Australian Nursing Federation, 2008).
Nurses value the diversity of people.
Nurses acknowledge that people are different and they should be responded to as such (Australian Nursing and Midwifery Council, Royal College of Nursing, Australia & Australian Nursing Federation, 2008).
Nurses value access to quality nursing and health care for all people
Quality nursing and healthcare should be available and accessible by all people (Australian Nursing and Midwifery Council, Royal College of Nursing, Australia & Australian Nursing Federation, 2008).
Nurses value informed decision-making.
Nurses make decisions in accordance with ethical and legal requirements for the benefit of the patient (Australian Nursing and Midwifery Council, Royal College of Nursing, Australia & Australian Nursing Federation, 2008).
Nurses value a culture of safety in nursing and health care.
Nurses value safe working environment and they try to work within the limits of their knowledge and skills (Australian Nursing and Midwifery Council, Royal College of Nursing, Australia & Australian Nursing Federation, 2008).
Nurses value ethical management of information.
Patient information that is recorded by a nurse should be accurate, non-judgmental as well as relevant to the treatment of the individual (Australian Nursing and Midwifery Council, Royal College of Nursing, Australia & Australian Nursing Federation, 2008).
Nurses value a socially, economically and ecologically sustainable environment promoting health and wellbeing
Plans aimed at preventing, minimizing as well as overcoming the negative effects of economic, social or ecological factors on the health of an individual and communities are always valued by nurses (Australian Nursing and Midwifery Council, Royal College of Nursing, Australia & Australian Nursing Federation, 2008).
Discuss the Standards for practice: Enrolled Nurses in relation to the above scenario (Topic 2A). Based on the discussion, choose 2 standards you believe to relevant to this discussion and elaborate how these standards are addressed or affected in the above scenario.
Standard:1
Enrolled nurses should provide high quality health care service to their patients. The patient is making it very hard for the nurse to provide the best service since he is non-compliant (Australia, 2001).
Standard:2
Enrolled nurses should make decisions that are beneficial to the health of the patient. Since the patient is non-compliant, he is contributing to the escalation of the disease hence a decision has to be made to ensure that he is not a danger to himself (Fry, Johnstone & International Council of Nurses, 2008).
Read through the article on “Bullying” and discuss/ present on the following questions
The article is available from the following URL. You may ask your trainer for a copy. https://www.nursingtimes.net/Journals/2013/03/20/k/…
Have you ever been a victim of bullying or do you know of anyone who has been a victim? Provide a short description of the situation.
I know a someone who has been bullied. The individual was a nursing student reporting for clinical placement. His precepeter Would humiliate him infront of other co-workers By stating that he is just an extra load that the hospital Administration forces medical professionals to take care of.
Do you believe that you have ever been a perpetrator of bullying?
No. I always ensure that I maintain high standards as far as handling of people is concerned.
What behavioural signs would a colleague display if he or she is being bullied?
The person tends to be stressed all the time while at work, decrease of self-esteem as well avoidance of social situations (Nunn, 2010).
What would you do in the case of bullying?
Incase of bullying i would report the matter then write an incident report so that investigations can commence and the perpetrator faces the consequences for his or her actions (Nunn, 2010).
Read the article “I See and Am Silent / I See and Speak Out: The Ethical Dilemma of Whistle blowing” from “Ethics in Nursing” in the Canadian Nurses Association website and address the following:
What is “whistle blowing”?
Whistle blowing is the act of exposing any kind of information or activity that can be viewed as illegal, unethical as well as incorrect within a public or private organization (Tschudin, 2003).
What have been the consequences of “whistle blowing”?
Whistle blowing has positive and negative consequences. On the positive side the act ensures that action is taken and the existing problem is finally eliminated. Secondly the Whistle blower is stress reduces since his or her conscience is at peace (Tschudin, 2003).
As far as the negative consequences are concerned, the Whistle blower may face retaliation from the people that he or she implicates. He or she may be fired from because of reporting the matter. Further more he or she way be ostracized by his or her collegues since they would consider the act as being disloyal to the members of the profession (Wheeler, 2012).
Why do nurses, and others, “blow the whistle” on situations?
Nurses and other people blow the Whistle on situations when all other intrventions they have tried have failed to solve the existing problem (Tschudin, 2003).
What considerations would you make before you “blew the whistle” on a situation?
Before blowing the Whistle i must ascertain that there is serious harm on client, employee as well as other members of the public. Secondly, I must report the problem to my superious first before Whistle blowing (Tschudin, 2003).
References
American Nurses Association. (2010). Nursing: Scope and standards of practice. Silver Spring, Md: American Nurses Association.
Australian Nursing and Midwifery Council., & Nurses Board of South Australia. (2008).Codes of professional conduct & ethics for nurses & midwives in Australia 2008. South Australia: Nurses Board of South Australia.
Australian Nursing and Midwifery Council., Royal College of Nursing, Australia., & Australian Nursing Federation. (2008). Code of ethics for nurses in Australia. Canberra: Australian Nursing Council.
Australia. (2001). Code of ethics and guide to ethical conduct for residential aged care. Canberra: Public Affairs, Parliamentary and Access Branch, Commonwealth Dept of Health and Aged Care.
Fry, S. T., Johnstone, M.-J., & International Council of Nurses. (2008). Ethics in nursing practice: A guide to ethical decision making. Chichester, U.K: Wiley-Blackwell.
Lachman, V. D. (2006). Applied ethics in nursing. New York: Springer Pub. Co.
Nunn, K. P. (January 01, 2010). Bullying. Journal of Paediatrics and Child Health, 46, 4, 140-1.
Stanwick, P. A., & Stanwick, S. D. (2014). Understanding business ethics.
Tschudin, V. (2003). Ethics in nursing: The caring relationship. Edinburgh: Butterworth-Heinemann.
Wheeler, H. (2012). Law, ethics, and professional issues for nursing: A reflective and portfolio-building approach. Abingdon, Oxon: Routledge.
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