Ethical legal and professional issues following the case study of Marie and Tom

Ethical legal and professional issues following the case study of Marie and Tom

In healthcare, duty of care is the core value that defines nursing. In this case, it incorporates observation to legal, professional, and ethical duties that, combined,result in quality care that has optimal patient satisfaction. As studies by Ashalata (2017) suggest, nurses must prioritize people, which means that they are bound to ensure patient safety, problem recognition, and timely response to their concerns. In fact, further studies suggest that during undergraduate and postgraduate studies, nursing practitioners are frequently informed that in nursing care, they remain accountable for their actions such as omissions and poor procedural care (Iwan, 2017). Further, it is noted that nurses need to foresee consequences associated with their actions as any discrepancy or breach of their duty is subject to legal consequences. Notably, to avoid compromising the practice of their licensure or being candidates of malpractice suit, nurses need to realize their legal responsibilities such as patient advocacy, practice act, and patient neglect, among others (Diwan, 2017).  Equally, it is of great importance that for nurses to realize the moral codes governing their actions. This includes observing bioethics principles such as justice, autonomy, non-maleficence, and maleficence, among others. In so doing, they able to realize a working framework characterized by compassionate care andstandard care practice (Diwan, 2017). Further, fully defined duty of care is also characterized by professional attributes such as empathetic disposition, attention to detail, autonomy, and exceptional communication skills. Such obligations enhance patient safety, accountability, and efficient working relationships (Mohammed, 2017). Even though there are internal and external factors that jeopardize the entire premise of duty care, nurses must always remember that patients will come first, and therefore it is their duty to make it successful. In detail, the concept of duty of care and its impacts is well represented by the case study of Marie and Tom, who appears to reveal a medical lawsuit scenario and a deviation from ethical and professional standards in nursing.

Ethical issues and associated impacts

As noted above, duty of care is a dynamic approach requiring a balance and heed to legal, ethical, and professional standards guiding the scope of nursing practice. This means that even though there exist performance challenges, nurses must establish a balance of probabilities to avoid harming the patient or inducing law aspects such as care negligence (Diwan, 2017). Following the case study of Marie and Tom, it is realized that, to a larger extent, duty of care had been breached. This emanates from the finding that a chart that was blank prior patient admission to the hospital was again filled during the review of care by the service directors, and by noting this, Marie is found to confront Tom to remain silent about it. Firstly, filling a blank column that had not being filled during its time is a breach of nursing code of conduct under the provision that regulated nurses must act in integrity as well justify both consumer and public trust in confidence in their performance (Beth, 2015).  Further, according to the nursing council of NewZealand, retaining consumer’s trust in nurses requires nurses to be honest as well act consistently with respect to values, accountability, and justified decisions (Mohammed, 2017). In this case, it means that to earn consumer trust, nurses must be committed to transparent actions. Accordingly, this also ensures that nurses do not abuse their position of trust and competency. In extension, this principle requires that for consumer trust and safety, nurses must keep accurate and clear records, focus on the appropriate care and need for health consumers, as well as deliver services based on evidence practice (Diwan, 2017). In relation, Marie seems not to have observed this ethical principle. This emanates from the notion that she didn’t have accurate documentation, she implied dishonesty and abuse of justice principle, which require nurses to preserve the spirit of law, patient rights, and nursing obligations (Beth, 2015). Apparently, in line with the provision of the American nurses association (ANA) under professional ethics, it is provided that nurses must act to promote benefit or prevent harm (Beth, 2015). In this case, they should share their perception ethically to undo unsafe practices by colleagues that may compromise the health of patients. Contrary, In Emily’s case study, Tom seems to have understood that Marie had intentionally filled the blank chart as a cover-up for investigation.  While it may seem an ethical dilemma,it would be perfect for Tom to ethically share his perception with Marie about her did and what that means both to the patient safety and to their profession as registered nurses..

Legal issues and associated impacts

In terms of legal perspective, ithad been seen earlier that the law holds nurses accountable for omissions and actions that are reasonably foreseeable but neglected. Additionally, failure to determine the appropriate standard of care is a violation that has the potential to subjects nurses to a law. As studies inform, this is based on the premise that harm inflicted to patient due to inappropriate standard of care can be subject to a precedent of negligence considering nurses as first witnesses (Diwan, 2017). For example, Emily being found with lithium toxicity while she hadn’t received two-day checkup means that there was a breach of duty care, and therefore,Tom and Marie would be convicted with care negligence. More openly, this can be attributed to omissions, which further according to medical laws linkage between patient outcome and nurse attendance imply breach of duty care and nursing negligence (Nikki, 2015). Ideally, this means that a relationship between health outcome of Emily and the routine of care during the onset of her illness can imply care negligence, and therefore, Tom and Marie be subject to legal malpractices. Notably, lithium toxicity emanates from overdose and is accompanied by symptoms such as vomiting, diarrhea, and drowsiness. Following the case study, it is revealed that Emily had complained of feeling unwell just a day before her illness could elevate. This means that she had not been attended by a nurse while also the medication issued was not monitored as per its contraindication. Reflecting this on legal responsibilities, it implies dual malpractice. Firstly, according to the provisions of legal responsibilities, monitory of allergic reactions associated with medications is one of the legal responsibility of a nurse and risk of patient health associated with medical allergic reactions implies a malpractice suit both for the involved nurse and to medical facility at large (Beth, 2015). Essentially, in relation to the case of Emily, it seems that medication monitoring was not done while routine care of vital signs was neglected. Therefore, this implies that the involved nurse can be held accountable for negligence despite stable recovery of the patient. Further, there seems to be an act of negligence associated with informed consent. According to medical laws, it is a legal obligation for nurses to provide informed consent to the patient prior administration of any medication of procedure (Nikki, 2015). This includes notifying the contraindications subject to a drug and its possible consequences. Apparently, complications associated with failure to include informed consent during treatment can lead to legal consequences. In relation, it appears that there was no informed consent during the administration of the drug that led to lithium toxicity. Hence, although there seems to be no complication,to some extent, the nurses involved can be held with negligence of informed consent, which is considered as an important aspect of the patient-physician relationship in medical care.

Professional issues and associated impacts

Earlier, it had been identified that in nursing, nurses are expected to have some sets of professionalism such as strong commitment, autonomy, power for standard service, teamwork and integrity, and compassionate care, among others. However, in some cases, nurses fail to oblige to the code of professionalism, thereby impacting the health of the patients in negative ways. From studies by Nikki (2018), it is identified that in most cases, issues such as poor documentation, inappropriate address to patient concern, and poor communication indicate high levels of unprofessionalism. Juxtaposing this, it is realized that the case of Tom and Marie implies several aspects of unprofessionalism. For example, failure to document the chart timely imply a bias in nursing documentation. Equally, failure to communicate it also implies lack of effective communication skills. Then, failure to address patient vital signs consecutively imply lack of compassionate care among the nurses. Hence, based on this perspective, it is arguable that evidently, Tom and Marie are short of professional codes required in nursing care. Notably, this not only imply incompetency but also is a risk factor to Emily health and the process of recovery.

To sum up, the case study of Tom and Marie implies violation of duty of care as an attribute of nursing. Following the above analysis, it has been identified that the conduct actions by the nurses violate principles of bioethics, legal responsibilities, and professional expectations of registered nurses. In particular, the fact that Marie filled a blank column that had not been addressed during the required date implies being dishonest, lack of integrity, and violation of the justice principle. Moreover, it corrupts the principle ofnon-maleficencein that the routine care that would have protected the patient from toxicity is jeopardized. Equally, negligence, poor medical monitory, and lack of informed consent has implied violation of legal responsibilities bestowed on nurses. Further, nonprofessional acts such as poor documentation, poor communication, and negligence of care indicate low standards of professionalism. The impact of such a code of conduct to the patient is lack of trust towards the nurses, risk of complications,and dissatisfaction following poor nurse-patient relationships.

References

Ashalata Devi, W 2017. “Nurse’s Awareness On Legal And Ethical Responsibilities In Nursing.” International Journal Of Nursing Research And Practice (IJNRP), vol 4, no. 1, United Publication For Health And Tech Research, doi:10.15509/ijnrp.2017.4.1.346. Accessed 4 Mar 2020.

Al-breiki, Mohammed (2017). “What Influence Nurses Practice More: Law Or Ethics.” Juniperpublishers.Com, https://juniperpublishers.com/jojnhc/pdf/JOJNHC.MS.ID.555664.pdf.

Dowie, Iwan (2017). “Legal, Ethical And Professional Aspects Of Duty Of Care For Nurses”. Nursing Standard, vol 32, no. 16-19, 2017, pp. 47-52. RCN Publishing Ltd., doi:10.7748/ns.2017.e10959.

Epstein, Beth 2015. “The Nursing Code Of Ethics: Its Value, Its History”. Ojin.Nursingworld.Org, , https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-20-2015/No2-May-2015/The-Nursing-Code-of-Ethics-Its-Value-Its-History.html.

Wills, Nikki L. et al. (2018) “Appearance Of Nurses And Perceived Professionalism”. International Journal Of Studies In Nursing, vol 3, no. 3,, p. 30. July Press Pte. Ltd., doi:10.20849/ijsn.v3i3.466. Accessed 4 Mar 2020.