Ethical and Legal Issues in Nursing case study
When encountering such distress, a health practitioner needs to understand the ethical and legal responsibilities that he or she has to adhere to in order to assure on the quality of care and improve on health outcomes (Varcoe et al. Healthcare providers at various levels encounter a diverse range of ethical and legal issues (Holmboe & Batalden, 2015). In particular, nurses are no exception when it comes to moral dilemmas in medicine. When a nurse encounters an ethical dilemma where he/she cannot do or choose the most appropriate thing, he/she remove he or she please is likely to experience moral distress (Trautmann et al. Although some prefer to act by seeking advice, others choose to remain silent. Although all treatments constitute some elements of harm, the harm should not be disproportionate to the benefits of treatment.
Therefore, Jo was exposed to more harm by not being adequately assessed than when she would have been treated properly. The paper will analyze the legal and ethical issues in nursing as it relates to Jo's incident while considering the possible actions that could be taken and their implications. Nurses perform based on the institution’s guidelines and are expected to use their judgment accordingly. Such judgment should apply ethics, which constitutes fair and equitable treatment to all patients regardless of their condition (Kim, 2015). Thus, any procedure subjected to Jo should have contributed to alleviating the suffering and not the opposite. However, it is essential to acknowledge that medications have side effects too and pose implications for the patient’s wellbeing. However, the risk to Jo’s wellbeing may be worse by not subjecting her to medication than the side effects of the medication if it was given to her.
Moreover, side effects are bound to occur from a treatment as illustrated in the principle of double-effect (Atkins et al. Although harm was expected through side-effect, the intention was to alleviate pain, which is promoting good. Hence, the failure of the nurse to act accordingly may have also caused Jo's emotional harm, which was associated with lowered dignity. Equally, the unmanaged pain equates to indirect harm (Moss, Nelson, Connor, Wensley, McKinlay, & Boulton, 2015). Nevertheless, unrelieved pain has the potential to increase the patient’s anxiety and stress as it pertains to not being cared for adequately, and such can be psychologically fatal (Moss et al. Thus, the nurse's failure to manage Jo's pain must have resulted in increased psychological, emotional, or indirect harm. Nursing ethics demands the provision of adequate treatment to maximise the patient’s good.
argue that nurses’ actions are not harmful and instead believes that harm can only be committed when the patient believes it exists. In other words, Jo is equally to blame for her experience. For example, she was aware that she was kept waiting, which was as a result of the department being busy attending to the accident victims There was a shortage of staff, and Jo felt that there was no need to air her concern of being given equal attention despite experiencing pain. McKie, Singer & Richardson (2016), raise fundamental questions of whether all patients are given equal value be it in the emergency or other departments. They assess whether health care should be provided based on need or fairness. As an important consideration, nurses should strive to respect their patients’ autonomy regardless of the outcome of decisions made.
On the contrary, just because Jo gave her consent to wait did not mean that the nurse was to agree with the same. Instead, he/she should have supported Jo to make an autonomous decision that would have led to improved health outcome. Moreover, Ek and Svedlund (2015) argues that registered nurses decision-making abilities in the emergency department are critical to the patient's outcome. Thus, the nurse's ability to guide Jo effectively was dependent on his/her capability to make an adequate decision when under pressure. In addition, it will also show principle of beneficence at work as the nurse will be promoting the good of the patient. As illustrated by Venkat et al. actions that promote the principle of beneficence necessitates the need for a nurse to provide pain medication after reaching the Emergency Department.
The principle of justice is also seen through this case. Although there were other patients that were critically injured in a road accident, justice mandates all patients to be treated equally (Gurney, Gillespie, McMahon, & Kolbuk, 2017). However, it posed a moral dilemma since Jo was incompetent. The nurse's actions thus raise an ethical concern since nurses have a legal obligation to ensure a reasonable standard of care. However, the nurse perceived his/her action as reasonable since he/she thought that the condition was beyond her intervention. Moreover, Brack (2014) illustrates the expectation of nurses to notify appropriate personnel in the event that they encounter a challenging situation as they are not expected to know everything. Jo was kept waiting before she could be assessed by the doctor in question, which equates to an act of negligence since the nurse did not adequately prevent the foreseeable harm.
Despite Jo’s conditions being reviewed by the nurse, she was kept waiting, and there was no sign that intervention was underway to alleviate her pain. From Atkins’ et al. argument, providers should take a reasonable standard of care that would enhance the prevention of acts and omissions. In other words, failure to prevent or remove foreseeable harm is considered as a civil wrong (Staunton & Chiarella, 2017). Although Jo was experiencing the moderate pain, she is had the right to receive treatment similar to the accident victim. However, making an informed decision requires three fundamental elements. These are the patients’ mental capacity, information such as the risk and benefits of the procedure and available alternatives, and the patient’s compliance, where she gives a verbal consent to be assessed. As part of reasonable care, Jo could have been given a chance to communicate her health needs.
Doing so would have helped the nurse be sure about the patients' health wishes. Thus, not doing so subjected the patient to a risk of future complications attribute to inadequate treatment, which manifested by Jo vomiting twice later after interacting with the nurse. Even more, patients’ conditions should be assessed adequately and defined with ethical reasoning processes before executing any interventions. Ensuring that the care and treatment of patients are not only ethical but also legal should be the paramount priority of nurses. While the decision-making process regarding the best approach to intervene might be involved, there is the need to make a judgment regarding the same by discussing the situation with other care providers. References Atkins, K. De Lacey, S. s13049-015-0166-3 Brack, G. Nurse prescribing and vicarious liability.
Nurse Prescribing, 12(3), 147-149. doi:10. npre. Eustace, P. Oldland, E. Glanville, D. Story, I. Developing professional attributes in critical care nurses using Team-Based Learning. Ek, B. Svedlund, M. Registered nurses' experiences of their decision‐making at an Emergency Medical Dispatch Centre. Journal of clinical nursing, 24(7-8), 1122-1131. doi:10. R. Narain, N. Freedman, T. Pain, aging and dementia: Towards a biopsychosocial model. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 87, 207-215. Gurney, D. Gillespie, G. L. McMahon, M. Kolbuk, M. Academic Medicine, 90(9), 1215-1223. doi:10. acm. Kim, H. The essence of nursing practice: Philosophy and perspective. Moss, C. Nelson, K. Connor, M. Wensley, C. McKinlay, E. Quinlan-Colwell, A. Rae, D. Broglio, K. Drew, D. American Society for Pain Management Nursing Position Statement: Prescribing and Administering Opioid Doses Based Solely on Pain Intensity. Chiarella, M. Law for nurses and midwives (8th edition.
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