Critically Examine and Identify the Issues within The Case Study from a Legal and Ethical Perspective
Scenario Description
Gordon is a first-year undergraduate nursing student who is currently on his first clinical placement in a busy nursing home and has been allocated 4 residents with RN buddy, Homer. The following is a list of the patients who have been allocated to Homer and Gordon for the morning shift.
.png)
Gordon’s buddy, Homer, who is exhausted after being awake the previous night attending to his 2-week-old baby, explains to Gordon how he is feeling and asks him if he would get the first patient's medication from the treatment room and bring it to him at the patient’s bedside where he will be waiting.
Alone in the treatment room, Gordon prepares the following for Mr. Broadus
.png)
On arrival back to the patient’s room, Gordon hands Homer the medication. Without checking them to make sure they were correct; Homer asks Gordon to take them to Mr. Broadus and administer the insulin. Once given, Homer said he will sign the medication sheets.
Gordon says to Homer that he has not given a subcutaneous insulin injection before, Homer replies in a tired voice, “that’s ok, it’s easy, just point and stick the needle in the leg”.
Gordon feels bad for Homer’s lack of sleep and wants to make a good impression on his first clinical placement, so he administers the oral medications and accidentally injects the insulin dangerously, causing the patient to yelp in pain.
Assignment Instructions:
In addition to the peer-reviewed articles you use as evidence for your ideas, please refer to the following documents in your essay:
The NMBA code of conduct for Registered Nurses, The National Standards, the scope of practice of a student nurse, and the medication rights for administration.
Structure of Assignment:
You may wish to use the template provided on the essay structure help sheet and the paragraph structure help sheet provided in Moodle under the assessment tab. Please see the course descriptor for the assignment formatting expectations as per Federation University policy
Introduction:
• Briefly introduce the scenario and its main issues as a summary in your own words.
• Do not repeat or copy the description of the scenario provided word-for-word
• As an introduction to your main assignment topics and discussion points, briefly explain what is significant about the issues in relation to legal and ethical conduct in nursing practice.
Main Content
Discuss 2 (two) ethical and 2 (two) legal breaches (4 breaches in total) that Gordon and Homer have demonstrated in this scenario You must:
• Clearly identify the name and type of breach (ethical or legal)
• Explain why it may breach legal or ethical requirements by referring to specific nursing codes, standards, and/or other requirements
• Discuss the implications of these breaches for the RN, Student nurse, and the patient, and what corrective actions Gordon and Homer should have taken.
Support your ideas by referring to specific codes from within the NMBA Code of Conduct, Standards of Practice for Registered Nurses, and peer-reviewed journal articles.
Conclusion
• Summarise your main topics and discussion points clearly and concisely
• Do not introduce new content or ideas
Solution
Introduction
Nursing is one of the critical professions that support well- the being of patients as an independent profession. After a treatment plan is developed for the patient, it becomes essential to conduct continuous monitoring to improve well-being aspects and enhance positive impacts on the family. Uni assignment help, Since the effects of care and tracking directly affect patients, families, and society, complying with professional ethics and legal requirements becomes very important. This essay will discuss the nursing practice, aligning with ethical and legal requirements violated in the case study analysis. The case study demonstrates a condition where a nurse named Homer is tired owing to night duty and handovers, the care-related responsibilities to an RN buddy named Gordon, who needs to be sufficiently trained. This incompetency of the nurse impacts patients well- being. Thus, the main focus of this essay will be outlining two ethical and two legal violations related to this case study scenario which will be supported by NMBA codes of practice, National Standards, and journal evidence. The reader can expect explicit discussion about the case supported with real-time evidence.
Main Content
NMBA and codes of practice
Ethical and legal compliances are crucial in the medical profession, as any negligence could severely damage the health and well-being of the patient (NMBA. 2023a). This section will outline ethical and legal issues in the case scenario of Homer and Gordon, who has been allocated four patients to care for in their morning shifts.
In this case, Homer is more accountable for adhering to the practice as he is trained and registered than Gordon.
NMBA has outlined seven standards, which have been discussed below
1: Critical thinking in nursing practice
2: Engaging with others to develop therapeutic and profession-based relations.
3: Maintaining the practice capability (NMBA. 2023a)
4: Conducting assessments comprehensively
5: Developing plans for practice within the nursing profession
6: Providing safe and responsive quality practice in the nursing profession
7: Evaluating outcomes for informed nursing practice.
All the standards have been developed from values and beliefs like accountability, evidenced-based practice, a person-centered approach, supervision for enrolled nurses, a delegation of responsibility, and acting within the scope of practice (NMBA. 2023a).
The four issues highlighted in the case scenario are given below.
• Homer works when he is professionally sound or fully fit
• Homer not guiding Gordon during medicine collection and injection of insulin
• Gordon's Negligence while injecting insulin
• Homer's Negligence when giving medicine to the patient without checking and aligning with a treatment plan
Legal Issues
There is legal compliance for nurses to follow NMBA codes and national standards. Also, the codes specify nurses' responsibilities, behavioural patterns, and codes of conduct, specifically registered nursing practitioners (Hanadi, 2017). In addition, the practices within the nursing profession are likely to change and be updated, due to which it becomes essential for all types of nurses like Homer (RN) and Gordon (Enrolled nurse) (NMBA. 2023a).
In the first legal aspect, Homer violated Standards 4 and 6 when the RN did not supervise Gordon in collecting medicine and injecting insulin. This broke the belief in a person-centered approach. As an RN, Homer holds the accountability for adopting a person-centered approach to the care of the patients and directing enrolled nurses to perform legally. Standard four indicates that RN must work in partnerships to determine factors that affect their well-being (NMBA. 2023a). Thus, Gordon needed to be more effectively guided, from collecting medicines to injecting insulin. When Gordon asked about the technique of injecting insulin, Homer verbally taught the enrolled nurse without showing him the way in practice. In addition, Homer and Gordon did not collaborate when Gordon collected the medicine and returned. Homer did not cross-check if the medicines brought by Gordon aligned with the combination and dosage of the drug prescribed by a practitioner. In addition, Standard 6 indicates that registered nurses should provide adequate direction to enrolled nurses. Homer did not give Gordon effective oversight and supervision while injecting insulin (NMBA, 2023a). Since Gordon asked for leadership and guidance, this indicates that either enrolled nurses were doing it for the first time or needed to improve. Lack of practical advice led to the wrong injecting of insulin, due to which Mr. Broadus yelped in pain (Rutledge et al., 2017). Thus, Negligence towards practice could also lead to legal issues.
The second legal violation is Negligence in practice, which violates Standards 6 and 7. Thus, in this legal issue, Homer and Gordon violate the safe and quality method indicated in Standard 6. Homer did not assess the risks of Gordon injecting insulin into an elderly patient. In addition. Homer did not evaluate and monitor the patient's progress before giving him the medication. Also, as he received the drugs from the treatment room from Gordon, he did not cross-check the medicines with the prescription. This would impact the recovery speed and well-being of elderly patient Mr. Broadus.
Cowin et al. (2019) conducted a study on Australian nurses, incorporating the seven values of NMBA through a survey and open-ended questionnaire. The results indicated midwives and nurses needed more information on codes, revision, and the role of study within their study. Thus, as a registered nurse, Homer must be better informed about applying codes within the practice. In addition to this, Homer, in these two issues, violates principle 1 (that is, legal compliance), principle 2 (person-centered approach), and principle five that is, teaching, supervising, and assessing.
RN could have been penalized with suspension in both issues, while student nurses would have credibility-related problems (Morley et al., 2020). The worst impact would be on patients, specifically Mr. Broadus, who trust Homer and Gordon on their experience and knowledge while their well-being would have been sacrificed. Hence, Homer should have guided Gordon, while both the nurses must be accountable and responsible for managing well- the being of each other by taking help from support services.
Ethical Issues
Professional ethics is primarily called regular and consistent communication accompanied by knowledge, emotional regulation, and clinical capability within the nursing practice (Epstein et al., 2019). To encourage nurses to follow professional ethics, it is crucial to be aware of ethical issues, dilemmas, and alignment of ethics with national standards and compliance (Nittari et al., 2020). In this case scenario, there were two broad ethical issues Negligence in professional practice by both Homer and Gordon. It cannot be said that unethical behaviours were intentionally done, but it could be summarised that there was a lack of awareness and accountability.
Homer's first ethical violation was performing when the nurse was not professionally sound. This moral issue violates standards 1, 3, and 6. Homer was awake the night and actively engaged in handling a two-week-old baby. Thus, Standard Three indicates that the nurses must perform promptly, considering the well-being of themselves and along with others (NMBA, 2023a). Here Homer was frustrated and very tired, which he ignored and handover the task to Gordon. Homer did not consider his well-being and his health's impact on the four patients. Standard six indicates that registered nurses must provide safe and quality practice. Because Homer was tired, he could not perform his morning shift well and handed the responsibilities to Gordon (Jia et al., 2021). Homer did not direct Gordon on various tasks, so Mr. Broadus did not receive quality practice as the injection was wrongly injected, causing him pain. In addition, Standard 1 states that the registered nurse must use an ethical framework while making decisions. Homer continued the morning shift despite feeling unwell (NMBA, 2023a). Homer also did not report his health condition to the midwifery or any other senior member of the nursing department.
The second ethical issue was Gordon's blindly following Homer when tasks were handed to him. Gordon needed to have accountability and professional ethics as he wanted to create an impression on the RN buddy. Thus, the ethical issue violates many standards of enrolled nursing practice, that is, 2, 3, and 9.
Standard two indicates that nursing practice must give rights and dignity to people. He did not report Homer's unethical behaviour of not guiding and being negligent. Also, per these standards, a person-centered approach should be followed, which needs to be improved in the process. The standard indicates accountability and acceptance of responsibility (NMBA, 2023b). Gordon showed good behavior when he was handed over the tasks. He was responsible for providing safe and quality service; despite communicating with seniors, he followed Homer, who needed to give accurate guidance. This also aligns with Negligence to Standard 9, which provides safe and quality service.
In this case, there were many ethical issues that both Homer and Gordon did not consider. By attending the morning shift, Homer violated principle 6 of National Standards, which is health and well-being. Gordon broke pPrinciple2 (person-centered approach), principle 4 (professional behaviour), and principle 6 (Health and well-being).
Nasiriani et al. (2018) opined that there could be various reasons and factors that have an impact on ethical behaviour in the medical profession. A study conducted on 125 midwives in Tehran indicated that compliance with professional ethics directly correlated with income earned by midwives. This included a need for more awareness of the application of codes within the practice. In addition, Guerrero-Dib, Portales & Heredia-Escorza (2020) argued that the primary purpose of any healthcare organization is providing quality care. Hence, the standards or national policies must be connected with ethics, quality, and legal compliance.
In this case, Homer and Gordon’s act could have impacted their professional credit, licensing, and practice within the organization. Mr. Broadus might be severally injured due to Gordon's Negligence and following Homer. Homer and Gordon should have reported their issues to the support services or the Midwifery Council. Homer must have been honest in writing about his condition from night duty, while Gordon must have said about the RN's lack of guidance and support, due to which his code of conduct was hampered.
Conclusion
Nursing is a severe profession that deals with the lives and well-being of people. Thus, Australia understands nurses' integral role in healthcare and has aligned national codes and practices so that the conduct is professional and ethical. The legal compliances of nursing practice are known as nursing standards defining codes of practice, ethics and conduct. In the Australian continent, the nursing standard is developed by NMBA, which stands for Nursing and Midwifery Board. In addition, Homer is a registered nurse, while Gordon has been placed as a nursing student to understand and learn about the standards and practices and adhere to a person-centered approach. This case study analysis indicates that registered nurses, enrolled and other subcategorizes of nursing practitioners are legally abided to perform on high and best standards. Many national laws lack focus on professional ethics aspects, due to which nurses like Homer and Gordon indulge in unethical behavioural patterns. This case highlights that it is essential for organizations in healthcare to raise awareness and train professionals to mitigate the impacts of not complying with legal and ethical standards.
Reference List
Cowin, L. S., Riley, T. K., Heiler, J., & Gregory, L. R. (2019). The relevance of nurses and midwives' code of conduct in Australia. International nursing review, 66(3), 320-328. DOI: 10.1111/inr.12534
Epstein, E. G., Whitehead, P. B., Prompahakul, C., Thacker, L. R., & Hamric, A. B. (2019). Enhancing understanding of moral distress: the measure of moral distress for health care professionals. AJOB empirical bioethics, 10(2), 113-124. https://doi.org/10.1080/23294515.2019.1586008
Guerrero-Dib, J. G., Portales, L., & Heredia-Escorza, Y. (2020). Impact of academic integrity on workplace ethical behaviour. International Journal for Educational Integrity, 16(1), 1-18. https://doi.org/10.1007/s40979-020-0051-3
Hanadi, S. (2017). Nurse’s Legal Compliance on Health Promotion Management System In Nursing PracTICES (A Study in Ajibarang Regional Public Hospital/RSUD in Banyumas Regency). Jurnal Dinamika Hukum, 17(3), 250-257. DOI:10.20884/1.jdh.2017.17.3.1664
Jia, Y., Chen, O., Xiao, Z., Xiao, J., Bian, J., & Jia, H. (2021). Nurses’ ethical challenges caring for people with COVID-19: a qualitative study. Nursing ethics, 28(1), 33-45. https://doi.org/10.1177/0969733020944453
Morley, G., Grady, C., McCarthy, J., & Ulrich, C. M. (2020). Covid?19: Ethical challenges for nurses. Hastings Center Report, 50(3), 35-39. https://doi.org/10.1002/hast.1110
Nasiriani, L., Rahimparvar, S. F. V., Farajkhoda, T., & Bahrani, N. (2018). The related factors of compliance to professional codes of ethics from midwives' perspective working in healthcare centres of Tehran-Iran. Pan African Medical Journal, 30(1). doi: 10.11604/pam.2018.30.40.14436
Nittari, G., Khuman, R., Baldoni, S., Pallotta, G., Battineni, G., Sirignano, A., ... & Ricci, G. (2020). Telemedicine practice: review of the current ethical and legal challenges. Telemedicine and e-Health, 26(12), 1427-1437. DOI: 10.1089/tmj.2019.0158
NMBA. (2023a). Registered nurse standards for practice. https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx
NMBA. (2023b). Enrolled nurse standards for practice. https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/enrolled-nurse-standards-for-practice.aspx
Rutledge, C. M., Kott, K., Schweickert, P. A., Poston, R., Fowler, C., & Haney, T. S. (2017). Telehealth and eHealth in nurse practitioner training: current perspectives. Advances in medical education and practice, 399-409. https://doi.org/10.2147/AMEP.S116071
Would you like to schedule a callback?
Send us a message and we will get back to you
Highlights
Earn While You Learn With Us
Confidentiality Agreement
Money Back Guarantee
Live Expert Sessions
550+ Ph.D Experts
21 Step Quality Check
100% Quality
24*7 Live Help
On Time Delivery
Plagiarism-Free
81 Isla Avenue Glenroy, Mel, VIC, 3046 AU
