Ethics and Professional Issues

This assignment discusses the ethical and legal issues that arise in the nursing profession, specifically in relation to the administration of flu vaccines. It explores the violation of patient safety, the principles of nursing ethics, and the importance of open disclosure. The case scenario highlights the need for healthcare professionals to adhere to ethical principles and prioritize patient health and safety.

Running head: ESSAY
Ethics and Professional Issues
Name of the Student
Name of the University
Author Note

1ESSAY
Introduction- The nature of the nursing profession takes into account the fact that all
professionals must perform their duties, in alignment with nursing ethics, while exploring
their regular interactions with the patients in care. Time and again it has been found that
nursing staff are entitled with the responsibility of placing due emphasis on nurture and care
of their patients, in place of merely providing a cure for diseases (Butts and Rich 2019).
Additionally, nursing ethics also comprise of the characteristics everyday nursing practice
that helps the professionals to resolve moral dilemmas. Owing to the fact that decisions
related to life and death of the patients form a core component of nursing, maintaining ethical
standards is imperative for the integrity of their profession (Kangasniemi, Pakkanen and
Korhonen 2015). In addition, while delivering care services, the nurses are also expected to
provide support to each other, with the aim of fulfilling their ethical obligations to the public
and the occupation. This assignment will identify the ethical and legal dilemmas that arose, in
relation to administration of flu vaccines.
Issues identified- The major issue identified in the case study involves a violation of
patient safety. The patient Mrs Quinn demonstrated refusal, with respect to administration of
influenza vaccine, which in turn can be accredited to her probable history of an allergic
reaction to flu vaccine. However, despite knowing the wishes of the patient, in relation to her
treatment procedure, Dorinda, the newly qualified registered nurse committed a grave
mistake in wrongly administering the vaccine to Mrs Quinn, in place of Mrs Benson. Patient
safety is an umbrella term that commonly refers to the discipline that highlights safety of
consumers and/or clients in healthcare services, with the assistance of disease prevention,
reporting, reduction, and investigation of medical errors that often result in manifestation of
adverse effects (Carayon et al. 2014). The magnitude and frequency of preventable adverse
events that are endured by patients has gained attention in recent years (DiCuccio 2015). In
addition, reports from the World Health Organisation provides evidence for the fact that as

2ESSAY
much as 1 in 4 patients are commonly subjected to harm, while they receive ambulatory and
primary healthcare services. Furthermore, 134 million adverse events are recorded across
hospitals every year, and these medication errors contribute to roughly $42 billion of annual
costs (WHO 2018). Thus, it can be stated that violation of patient safety by Dorinda was a
major issue in the case scenario. According to Grace (2017) the ethical principle of patient
autonomy highlights the rights of patients in informed decision making, without the influence
of any healthcare provider. Thus, not taking into consideration the wish of the patient
regarding refusal to flu vaccine was a violation of the autonomy principle.
The principle 2 of the code of ethics focuses on maintaining accountability and
professional responsibility. In addition, it also elaborates on the fact that nursing staff are
expected to demonstrate high professional behaviour standards and are also accountable for
their actions and decisions (together with inactions and omissions) (NMBI 2014). Owing to
the fact that Dorinda failed to administer care in a manner that was in accordance to the
expectations and preferences of the patient, it can be stated that there was a major failure on
her part, in showing adherence to the codes of practice. In addition, the department of health
of Ireland has recognised patient safety as the keystone to delivery of quality healthcare
services. Furthermore, the National Patient Safety Office also places a focus on the
enforcement and formulation of patient safety program initiatives (Department of Health
2018). Hence, taking into consideration the fact that adverse events due to medical errors are
associated with significant human and economic costs, and directly threaten the health and
wellbeing of the patients, there is a need to immediately address this concern.
Flu vaccine, also known as influenza vaccines have been found effective in providing
protection against infections that occur due to the action of influenza viruses. Hence, the
hospital authorities were correct in advising the registered nurses to administer the vaccines
to the two patients, to prevent flu outbreak (Blyth et al. 2014). However, there is mounting

3ESSAY
evidence for the fact that some individuals display hypersensitivity to flu shots and common
symptoms include pain, swelling and redness at the location of injection (Woo 2014). In
addition, it has also been found that administration of the vaccine to such hypersensitive
individuals also increases the likelihood of manifestation of severe side effects such as, racing
heartbeat, high fever, difficulty in breathing and dizziness, thus aggravating the health
condition (HSE 2011). The principle 3 focuses on quality of practice and illustrates that
nurses must try to delivery highest quality care to their patients, while using evidence-based
knowledge and applying best standards of practice in their work (NMBI 2014). Nonetheless,
the fact that Dorinda suggested that “an allergic reaction is very unlikely” was a major issue
and demonstrated that she was not able to effectively administer evidence-based medicine.
The Health Information and Quality Authority (HIQA) is a pioneer organisation that
had been established, in relation to the Health Act 2007, with the aim of driving incessant
improvement the delivery of health and social care in Ireland (HIQA 2018). Hence, it can be
suggested that despite the focus placed on patient health and wellbeing, Dorinda
demonstrated a failure in abiding by the regulations. Delivery of care services encompass the
aspect of incident reporting and documentation across all nursing homes, hospitals and/or
assisted living facilities. According to Macrae (2016) incident reports generally contain
information about accidents involving the patients, and their sole purpose is to record the
exact details of the happening, while it is still fresh in the minds of the individuals involved,
and those who were a witness to the incident. In other words, identification and keeping a
track on the existence of certain serious surgical and medical errors that constitute
malpractice, is imperative (Kelly, Blake and Plunkett 2016).
According to the Madden Commission Report on Patient Safety and Quality
Assurance, the Patient Safety Bill passed in Ireland in 2018 makes it essential to report
adverse events to authorities (HIQA 2018). Furthermore, the bill states that it will be

4ESSAY
considered as an offence on the part of a healthcare provider, who fails to notify reportable
incidents to particular external authorities. This was another major issue identified from the
case scenario owing to the fact that on realising the medication error that had occurred,
Dorinda immediately became anxious and pleaded with Fred, her fellow nurse, not to report
the incident to any other person. Furthermore, Dorinda also demonstrated an intention to
wrongly record that the vaccine had been accurately administered to Mrs Benson, in place of
Mrs Quinn, thus demonstrating an inappropriate nursing action. Thus, it can be stated that
besides demonstrating a failure in accurately reporting adverse incident, the ethical principle
of nonmaleficence was also violated. This principle is based on inflicting least harm or not
harming the patients, with the aim of obtaining optimal health outcomes.
Further analysis of the case scenario also helped in identifying the fact that Dorinda
tried to utilise the present health condition of Mrs Benson that includes dementia and
disruption in her level of understanding, and intended to show that the flu vaccine had been
administered accurately. This is directly association with violation of the concept of open
disclosure. Open disclosure forms a crucial part of health and social care delivery and
comprises of holding an open discussion regarding incidents that have the probability of
causing harm to patients, carers, or family members (Watson et al. 2015). The importance of
open disclosure can be accredited to the fact that it aim to enhance patient safety and
wellbeing thought adoption of an organisational learning approach (Piper, Iedema and Bower
2014). The Provisions on Open Disclosure published in 2015 helped the HIQA to set specific
standards for both private and public healthcare providers, related to disclosing adverse
events that threaten patient safety, to the service users (HIQA 2015).
In addition, the Patient Safety Bill promotes mandatory open disclosure and
emphasises on the fact that any patient safety incidents that have resulted in death of the
patient, or unexpected and/or unintended harm must be discussed with the clients, as

5ESSAY
formulated in Part 4 of the Civil Liabilities (Amendment) Act 2017 (HSE 2017). The act has
also been designed with the aim of providing legal protection for apology and information
sent to a patient at the time of open disclosure, made in alignment with existing legislation. In
other words, making a disclosure is necessary for creating a positive and voluntary climate
for delivery of care services. Hence, Dorinda was at fault in not making an open disclosure
about the medication error. Principle 5 of the codes of practice make it mandatory for all
nurses to develop mutual trust and respect with their colleagues, and also suggests that
consistent and effective documentation forms a core component of their practice (NMBI
2014). However, requesting Fred to withhold actual information from the hospital authorities
and patients indicated violation of professional relationship.
Conclusion- Thus, it can be concluded that working in the domain of health and social
care is both challenging and rewarding. However, all healthcare professionals have the sole
responsibility of showing adherence to the basic principles of healthcare ethics, with the aim
of providing benefit to the patients, and enhancing their health and wellbeing. Therefore, an
analysis of the case scenario suggested that there were several ethical and legal issues that
arose, when Dorinda administered flu vaccine to Mrs Quinn, in place of Mrs Benson, which
in turn directly threatened patient health and safety.

6ESSAY
References
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7ESSAY
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8ESSAY
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