NURBN1012 Legal & Ethical Decision Making in Person - centred care
Assignment Brief
Structure
A. INTRODUCTION
Write a paragraph which:
• Briefly introduces the scenario and its main issues in your own words.
• As an introduction to your main assignment topics and discussion points from Part B Critical Analysis section, briefly explain what is significant about the issues in relation to legal and ethical conduct in nursing practice.
B. CRITICAL ANALYSIS
B1: Identify and discuss two ethical principles that are breached and demonstrated by either the student and/or the RN in this scenario.
B2: Identify and discuss two legal breaches that have been demonstrated by either the student and/or the RN in this scenario.
Note: For all four breaches, you must write one paragraph per breach which addresses the following information:
What the breach was
o Clearly identify the ethical principle and/or legal breach demonstrated (e.g. maleficence) and justify with evidence from the case study.
Which nursing codes and standards have been violated
o Identify the specific nursing codes or standards that have been violated and justify why.
o Make sure you support your discussion with evidence from current published national legislation.
Implications for key stakeholders
o Discuss the implications of these violations for the Registered Nurse (RN), student nurse, and/or the patient.
o Make sure you support your discussion with scholarly literature.
Correct actions
o Identify what the correct actions should have been by the violating stakeholder(s) in relation to the identified violation.
o Make sure you support your discussion with scholarly literature.
B1. Ethical principles
B2. Legal breaches
C. CONCLUSION
Write a paragraph which:
• Summarises the main discussion points clearly and concisely
• Does not introduce new content or ideas
Solution
Introduction
In a case study where Sara who is a first year undergraduate student in the nursing school and the student mentor Tom face various trying circumstances during her clinical training in a nursing home that does not have some sophisticated conditions barely manage to go on. Sara, Tom's absence unsupervised, is charged with medicine administration without an order and then violates protocol later by taking a controlled substance. Both medical staff is witnesses to and may participate in the seclusion of an old confused and rowdy patient. This turns to be a clear summary of serious law breach and ethics violations of nurses, among them, improper drugs dispensing, unallowable drugs intake, and patient's medical rights abuse through physical control and assault (Hall et al., 2024). These issues pose a big challenge considering that they blatantly disregard lawful structures and ethical norms that are put in place to safeguard the welfare of patients and preserve the values of the nursing profession. Apart from the principal HealthCare Business case, the actions of Sara and Tom put not only patient safety but also the professional status and legal compliance of their healthcare facility at stake.
Critical Analysis
Ethical principles
The nursing student accomplishing Drake is depicted in the presented vignette, wherein multiple ethical principles in nursing and healthcare have been contravened. The core data shed involves not adversely affecting the principles of non-maleficence and autonomy. Such confidentiality breaches have negative effects on care provision but also cause the violation of the code of conduct and the deficiency appearance in the mentorship of the clinical setting.
1. Breach of Non-maleficence
Non-maleficence is the first and foremost ethical admittance which requires physicians and other healthcare professionals to take no adverse actions against their patients. This principle is clearly breached in multiple instances in the scenario:
Improper Medication Management: Balancing her newly unsupervised responsibilities as a student nurse with a lack of experience, Sara was ordered by Tom to give the medication of a patient without prior checks from him. This behavior carries a high risk of injury as it skips all binding safety measures and misgivings mounted against drug error, which is a common and devastating source of patient jeopardy (Butts, 2021). The responsibilities of nursing supervisor include not only guiding but also assessing whether all actions of those who are less experienced encounters the set safety criteria. Foregoing this assignment could result in miscalculation of the patient’s drugs, if the patient is given, either too little or too much medicine for university assignment help.
Physical and Emotional Harm: Tom’s communication with an agitated and addled patient is, just as clearly, a blatant neglect of the principle of do no harm. Tom will tightly cultivate a bed that can stop the patient from moving much, and then slapping his hand will mentally squeeze him. However, this is a wrong way, as they are dealing with the patient, and it should not go with the compassionate care expected in nursing practice, which may cause greater embarrassment and aggression that could lead to more distress or injuries. In addition to Tom's inappropriate dealing with a lost and raw elderly patient, his behavior is unethical from the perspective of non-maleficence. Bringing the sheets tightly deprives the patient of physical and mental empowerment, although it is more severe than slapping. This act is not only upsetting but it further traumatizes the patient which may negatively affect their condition.
2. Breach of Autonomy
Autonomy defends the freedom of the patient. This means the choice is made from his notions is done in an educated manner. This principle is compromised in the scenario:
Restriction of Movement: It is made clear in the case that Tom lacks any clinical justification to support his decision. He also forgets all about the patient's personal worth which portrays that Tom is not friendly with the idea of autonomy. The rights of patients, even those people with delirium or aggression towards others, should be respected and reflected in the humane treatment they receive (Royal College of Nursing, 2018). Non-physical constraints should always be the first choice and physical limits should only be applied when absolutely necessary, after other less restrictive methods have been applied and have proven to be ineffective.
Lack of Informed Consent: Despite considerable literature suggesting the elderly patient was not willing for methods used by Tom to control behavior behaviors. Informed consent is one of the most important components of preserving patient autonomy. This means that any medical condition that needs intervention must be explained by the healthcare service provider to the patient, highlighting the cause of the problem and the possible outcomes of the procedure (Chang et al., 2024). Tom’s inability to fulfill the obligation of obtaining informed consent and his violation of the patient’s autonomy destroy the ethical values of trust and respect that have to be the basis of the interactions between patients and a care provider.
Professional Responsibility and Mentorship
Rather than the ethics, the situation also brings serious challenges to professional responsibility and how Tom as senior nurse is expected to stand for the juniors’ next generation of nursing. Tom's let-down in ethics and also tending to rub shoulders with them doesn't give a good example to Sara to pursue hence the educational aspect of the clinical placement is put at risk. Furthermore, her consumption of medication without a prescription exhibits a lack of knowledge of a physician boundaries and also what is right or wrong, which was meant to be part of her training (Elliot et al., 2021). Tom's response to Sara's decision on the matter—to overlook the indecency and keep it secret from everyone—as a way of inappropriately solving the problem, which in turn sets the tone of how mistakes and misconduct issues should be be handled in a healthcare setting.
Two Legal Breaches
Sara, as a nursing student, along with her friend Tom, RN, is caught in a story that reveals some legally unjustly behaviors like using drugs and treating patients. Such law breaches are in fact violating nursing and healthcare regulations, thus it is possible that the healthcare facility and the individuals involved may be held legally concerned in the respective cases.
1. Legal Breach Related to Medication Handling
One significant legal breach in this scenario is related to the handling and administration of medications:
Unsupervised Medication Administration by an Undergraduate Student: The freshman nursing student, Sara, takes the medication of the patient under the instruction by no one else but Tom, without proper supervision. By opposing these set parameters of healthcare regulations, where medication administration is considered a critical job viewed as more appropriate to be done by persons that have more experience or are legally licensed personnel like nurses and interns, it is a contradiction (Nursing and Midwifery Council, 2018). Tom takes Sara for some medications without direct supervision he does not comply with healthcare rules designed to make sure of patient safety as well as proper management of drugs. This can even reach tort responsibilities due to not meeting the safety standards.
Misappropriation and Consumption of a Controlled Substance: Sara’s intention of taking Oxycodone from women's medication drawer and swallowing it was a serious violation of law and regulation which regulate the controlled substances (Moran et al., 2023). The very detail of this drug being accessible to a unsupervised nursing student point towards the fact that normal procedures under which controlled substance is stored has not been complied with and security of drug storage is a regulatory requirement. Another violation committed by Sara is that the possession of Oxycodone by the other person that it does not belong to is felony as it is intended for the abuse and misuse implying that the accused will be charged in a criminal mill.
Legal Breach Related to Patient Treatment
The treatment of the elderly patient by Tom showcases breaches in legal standards concerning patient care and rights:
Use of Excessive Restraint: Around the case of Tom’s using belts tightened at the feet to tie the patient to the bed, and at the same time making the rails way higher, to restrain the patient, can be considered clearly an illegal use of restraint. The use of physical restraints is heavily governed in healthcare settings, allowing only medical-related necessitated justifications, which often involve inquiries from a physician (British Journal of Nursing, 2023). Such act that Tom has done might not only violate those laws, which are set to limit the unfair use of restraints and therefore any possible harm from them, but can also be referred to as abusive.
Physical Assault: Tom adds further insult to the patient’s injury when the latter complains that the restraints are too painful and reflexively reaches out (Drury et al., 2023). This is met with Tom wrestling the patient’s hand away. This behavior is, in fact, physical assault, therefore it violates the medical laws that protect patients from such violence and ensures that the patient will be safe and treated with respect.
Implications of Legal Breaches
The legal breaches observed in this scenario have serious implications:
Liability for the Healthcare Facility: The med-tech program may be held responsible for negligence that occurred when no supervision was provided during a patient care activity and a staff member was left alone with potentially dangerous medication (Hall et al., 2024).
Professional Sanctions: Tom might face penalties from both professional and legal authorities, and eventually has defense success the chance to remove his license because of his participation in in both unethical and illegal actions.
Criminal Consequences: Certainly Sara and Tom could both get arrested for Sara's misuse as well as consumption of drugs Tom's case of assault.
In this situation there are clear legal violations regarding the handling of the medications as well as inappropriate behavior toward a patient (Care Quality Commission, 2023). Beyond these actions that risk lives, they violate the moral and ethical fundaments of healthcare settings, more so, highlight the imperativeness of adherence to legal regulations for patient safety and protection of the code of the practice of nursing.
Conclusion
Summarizing the case where Sara and Tom are the main characters, it is highlighted that there were disrespectful deviations from both legal and unethical codes in nursing practice. The factual records display different medications misapplied and controlled substances combined unstopped to be used. Such conditions exposed the insurmountable patient safety and self-respect violation. This kind of breach is not only responsible for patient care but the hospital and even the individual can file legal charges and be imposed with professional sanctions. This prominence of the ethos of ethical purity focuses on properly conducting the nursing profession. The assumption of ethical responsibilities is also meant to support and ensure the adoption of ethical practices, by means of continuing edification on ethics, strict adherence to regulations, and the need for effective supervision to safeguard patients and support the nursing profession. Through examining such lapses, it is visible that it is necessary to inculcate in a consciousness of maintaining ethical and legal norms not only through instructing but also controlling, as this will ensure that all patients` rights and safety are inevitably observed.
References:
British Journal of Nursing. (2023). Maintaining patient safety in medication administration. Retrieved from https://www.britishjournalofnursing.com/
Chang, E., & Hatcher, D. (2024). Transitions in nursing: Preparing for professional practice. Elsevier Health Sciences. https://books.google.com/books?hl=en&lr=&id=NZrxEAAAQBAJ&oi=fnd&pg=PT17&dq=nursing+practice&ots=0YpZA1AkDs&sig=QVQTjL3rQTYDSwGejAioPDrGIfY
Drury, A., Sulosaari, V., Sharp, L., Ullgren, H., de Munter, J., & Oldenmenger, W. (2023). The future of cancer nursing in Europe: Addressing professional issues in education, research, policy and practice. European Journal of Oncology Nursing, 63, 102271. https://www.sciencedirect.com/science/article/pii/S1462388923000054
Elliot, R. A., Camacho, E., & Jankovic, D. (2021). Economic analysis of the prevalence and clinical and economic burden of medication error in England. BMJ Quality & Safety, 30(2), 96-105. https://doi.org/10.1136/bmjqs-2019-010206
Hall, M.A., Bobinski, M.A., Orentlicher, D., Cohen, I.G., Bagley, N. and Sawicki, N.N., 2024. Health care law and ethics. Aspen Publishing. https://books.google.com/books?hl=en&lr=&id=lkb2EAAAQBAJ&oi=fnd&pg=PR27&dq=Liability+for+the+Healthcare+Facility:+&ots=XIeGmTXmU5&sig=2Fska0VeFF1M7iVWek5dy9C9bRY
Butts, J. B., & Rich, K. L. (2021). Philosophies and theories for advanced nursing practice. Jones & Bartlett Learning. https://books.google.com/books?hl=en&lr=&id=ZDVCEAAAQBAJ&oi=fnd&pg=PP1&dq=+Nursing+practices&ots=5LQmcQrUwc&sig=gX5RpjIJ1pJswtmHVUGkcEhnAgM
Moran, K. J., Burson, R., & Conrad, D. (2023). The doctor of nursing practice project: A framework for success. Jones & Bartlett Learning. https://books.google.com/books?hl=en&lr=&id=0f-pEAAAQBAJ&oi=fnd&pg=PP1&dq=nursing+practice&ots=bfDFrrThAL&sig=AJ6yhq9VSbbfBBB7bEy-gg9tydE
Nursing and Midwifery Council. (2018). The code: Professional standards of practice and behaviour for nurses, midwives and nursing associates. Retrieved from https://tinyurl.com/7upnytyy
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