Discuss about the Legal and Professional Issues In Nursing.
In nursing, just like in any other profession, nurses are expected to adhere to certain professional standards, which include but are not limited to competency, professional code conduct, and ethics. Additionally, states have laws that professional ought to abide by, as far as conducting their duties is concerned (Buka, 2014, p.14). Thus, failure for nurses to adhere to those rules, standards, and regulations may and often attracts charges to maintain a certain degree of competency and professionalism expected of nurses. Thus, this paper focuses on a case study of two nurses on an infant. In so doing, the paper will look at the specific standard of practice; ethical, competence and professional applicable to the case study that the two nurses appear to have broken (Douglas et al., 2014, p. 118). In addition to that, the paper will weigh in on the legal provision relevant to the conduct of the two nurses.
On the other hand, there have been cases of nurses engaging in malpractices. One of the most common forms of malpractices is a misdiagnosis, where a patient is diagnosed with a different disease but the one suffering from. Lastly, communicating, documenting and reporting patient’s conditions are essential for all nurses if at all the patient has to receive proper care (Yoder-Wise, 2014, p. 23). The paper will give a comprehensive analysis on all of these about the case study.
The case study is a six-month-old infant who is suffering from bowel obstruction and taken to the emergency department, but the nurses that assess the child fails to recognize the condition but instead mistakenly confuse it with gastroenteritis. It is the medical staff that realizes the condition but their attempt to save the child fails as he passes on before the next treatment. Thus, due to the conduct of the two nurses, complain is launched against the two nurses and are found guilty of behaving in an unprofessional way.
In legal practice and health care, there are certain aspects that one considers before a person is convicted or pronounced to be liable to the charges brought against him or her. For nurses, for instance, a person must establish that there was a patient-nurse relationship. It is important to ascribe a duty of care for the nurse or nurses involved (Carroll, Parikh, & Buddenbaum, 2012, p.140). This can be done by looking at the medical records that stipulates that such a relationship existed. Secondly, there must be an elaborate way of determining the scope of duty that the nurse was supposed to offer. In addition to that, it is important that a complaint establish that there was an omission or absence of good and acceptable care that any competent and experienced nurse would have offered (Fairman et al., 2011, p. 194). Lastly, there must be an establishment of a causal of the relationship between what the nurse and nurses did that resulted in injury or what they omitted to do that could not have led to an injury.
In the case study, there are various aspects that one can draw that are not professional in any sense that can be used as evidence to establish the malpractices that the two nurses engage in. Firstly, the two nurses do not document their assessment. In nursing, documentation of patient assessment is important and mandatory (Westrick, 2013, p.62). The act of not documenting their assessment is unprofessional and not acceptable (Potts, & Mandleco, 2012, p.12). Secondly, the two nurses fail to communicate or report earlier enough to the medical staff even though it is an emergency case. This is another issue that the nurse violates in regards to professionalism (Mason, Laurie, & Smith, 2013, p. 102). It is not recommended for nurses to report late for cases they are unable to handle, or that calls for an emergency intervention. Lastly, the two nurses make a misdiagnosis for the infant patient. Specifically, instead of diagnosing the patient for bowel obstruction, they make a wrong diagnosis of gastroenteritis, which encourages delay of recovery and perhaps more harm to the patient body than good. In effect, the patient is not well taken care of by the two nurses.
On the other hand, the manner in which the nurses conduct themselves can well be demonstrated by looking at the specific ethical and code of competency or conduct that they break as this is what makes them liable for punishment.
In Australia, the Board of Nurses has laid out specific ethical codes that nurses ought to follow in his or her provision of services. However, the two nurses in their assessment to the patient fail to honor one of ethical code. In particular, statement 6 of the code of ethics for nurses states that nurses value a culture of safety in nursing and healthcare (Ferrara et al., 2013, p. 4). This suggests that nurses must engage in an undertaking that encourages sharing of knowledge and understanding as a crucial pertinent aspect of safety in contemporary health care. Thus, the nurse ought to value safe working environment by working within the limits of his or her knowledge or skills.
However, from the case study, the two nurses do not honor this but instead practice and offer services that are not safe to the patient. Precisely, it appears that the two nurses are not aware of what is ailing the patient. However, they go ahead to diagnose the patient who turns out to be a misdiagnosis. This keeps the patient health at risk and may have been one of the reasons why it becomes difficult to save the patient.
In addition to the ethical code, the Australian Board for nurses has a professional code of conduct as other requirements for practicing nurses. In this category, the two nurses violate statement 11 which states that it is the responsibility of all the nurses to maintain the required competency by participating in professional development education programs (Furrow et al., 2014, p.15). In the case study, it appears that the nurses have not been participating in this program to boost their competency. Such mistake like not documenting or reporting an emergency case is not something that is expected of not only one, but two nurses. Thus, the nurses do not conform to this code of conduct which attracts disciplinary actions for it puts the patient at risk.
Lastly, as far as professional standards for nurses are concerned, there are competency standards for all nurses. In the case study, the two nurses also violate some of them in their professional handling of the patient. Firstly, competency standard 1.3 embraces the notion that nurses ought to recognize and respond appropriately to unsafe or unprofessional practice (Iglehart, 2013, p. 12). In their ruling, the committee in charge of investigating the conduct of the two nurses concludes that the two failed to manage or communicate with the pediatrician for any changes and responses to the patient condition or even maintain clinical records of the patient’s observation. It is not in line with this standard, and thus, the two are liable to punishment.
Secondly, another competency standards that the two nurses fail to honor is 2.2 which stipulates that nurses are obliged to integrate organizational policies and guidelines with professional standards (Jalian, Jalian, & Avram, 2013, p.12). Although the two nurses are in the department of emergency, they are unable to differentiate and properly diagnosis bowel blockage but instead confuses it with gastroenteritis. This is not what the hospital expects of the two nurses as per their guidelines. The hospital tasks them with the responsibility they believe are capable of handling.
Additionally, they ought to integrate nursing health care knowledge, attitude, and skills to provide safe and effective nursing care. It is clear that the two did not seek intervention at the right time and if only they had done so, the medical staff was in a better position to help the patient. Lastly, competency standard 5.3 states that a nurse must analyze, interpret assessment and data accurately (Kukreja, Dodwad, & Kukreja, 2013, p.19). It is evident that the two nurses responded to the emergency case and the changes in the patient in contrast to what a competent nurse would, in analyzing and assessing the conditions of the patient, leading to wrong judgment.
In Australia, the National law provides for disciplinary actions for nurses who violate section 139B. In its readings, it stipulates that nurses ought to be punished for portraying “unsatisfactory professional conduct” (Kapp, 2012, p.17). According to the section, the conduct is unsatisfactory if it is below the reasonable standard. This is one that demonstrates that the knowledge, care exercised, or skill is below the bar that the professional body expects of a healthcare practitioner of an equivalent level of training. In the case study, the two nurses do some things that are indeed below the standard of practice. Firstly, they fail to make the patient’s clinical records of the observations (Wachter, 2012, p.78). Secondly, they do not communicate in time to medical staff although it is an emergency case. Lastly, they misdiagnose the patient. This is below the standards expected of the two nurses.
Research indicates that there is a lot of concern about ineffective communication between nurses and doctors. Some reasons have been attributed to this poor communication. To start with the first one, junior nurses and those with minimal experience may feel uncomfortable to call for assistance because of fear of doing the wrong thing or be seen as incompetent (Raingruber, 2016, p. 71). Additionally, another study reveals that nurses may not be in the best position to articulate the concerns as well as it should be or as urgent as it should (Dearmon, and NEA, 2013, p. 14). Lastly, they may not be confident enough to cross hierarchical or occupational boundaries, and this affects the patient from receiving the best medical care. The case study is in a rural area, and similar cases have been reported where nurses who are not competent enough work in the various important department. This happens due to the shortage of medics, and it is a problem affecting many parts of rural areas in Australia. However, the nurses have violated various legal provisions and professional code of conducts or standards of practice, and they must account for as per the rules and judgment of the body in charge (Schwartz, 2013, p.17). Additionally, there is a separate case that the nurse is charged with that also demonstrates incompetency and unwelcoming behavior which further demonstrate that the incident is not an accident but a repetitive behavior that is likely to persist if something is done.
Conclusion
Thus, the case study provides various ways in which legal and professional conduct of nurses in taking care of a patient can be bleached. Specifically, the two nurses conduct themselves in a manner that is in violation of the national laws and of what is expected by their professional standards. In addition to that, there are various ways to establish the charges of whoever appears to have engaged in malpractice. In the case study, four of the most basics elements that one has to consider have been highlighted, which include establishing whether the nurse has a duty, omission of behavior that made an impact or injury to the patient and scope of duty among others. It is worth noting that one can learn from the case study that failing to make clinical records of patient’s observation is in violation of professional standards and this makes the charges against nurses valid. In addition to that, cases of misdiagnosis can come from nurses not reporting to medical staff as soon as possible who are in a better position in terms of skills, knowledge, and experience to handle patients. Although rural hospital faces challenges in treating patients, the misconduct of the nurses needs to be taken care of to avoid recurrence.
References
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