Nurses and Midwives Ethical and legal Accountabilities and Responsibilities Case Study 2022

UNIT:
NAME:
DATE:

Nurses and Midwives Ethical and
legal Accountabilities and
Responsibilities
Case 1: Informed Consent
Consent is an ethical and legal requirement when providing nursing care. A nurse is required by
law to obtain consent before undertaking any nursing procedures or administering medication. A
patient has to give informed consent after being given reasonable information about the
treatment and the risks associated with the treatment (Chrimes & Marshall, 2018). In this case
scenario, a student nurse on placement is faced with a stressing situation where a patient refuses
to consent while the RN/RM mentor has requested the student to come into the theatre. The
patient does not want a student being present while she is under anaesthetic. This situation leads
to a dilemma where on one side the RN/RM wants the student nurse to come along and on the
other side, the patient does not want the student nurse to be present. To understand and decide on
the situation, one needs to consider the legal requirements for the student nurse, and RN/RM and
the implications of failing to honour the patient’s consent by the health facility and the education
provider.
Student nurses are legally required by law to obtain consent prior to a clinical procedure (Young,
2010). The law requires a student nurse, to obtain informed consent from the patient as of the
same level as a qualified practitioner does. The autonomy principle of ethics requires a nurse to
respect a patient’s choices even when they disagree as contained in Value Statement 5 of the
Code of Ethics for Nurses of Australia. According to Consent to Medical Treatment and
Palliative Care Act 1995, Section 2, a patient above 16 years of age informed consent is supreme
when making decisions regarding the patient. The RN/RM cannot go against the patient’s
consent that who does not want to have a student nurse observe her while a procedure is being
undertaken. The Nursing and Midwifery Code of Conduct for Nurses in Australia principle 2
Section 2.3 require nurses in support to informed consent rights to obtain informed consent
before investigating, examining, or providing treatment. The Code of Conduct for Nurses in
Australia Principle 3 section 3.5 also requires RM to respect the privacy and confidentiality of a

patient seeking informed consent and providing a surround that enable confidential and private
consultations and discussion . Therefore both the student midwife and RN/RM need to adhere to
the patient’s consent and the student midwife should not observe or assist the patient’s
procedure.
Failure to honour a patient consent has several implications to health facility and the education
provider. First, not establishing consent has legal consequences. The patient is in a position to
sue the health facility and claim that her rights to informed consent were undermined. The health
facilities will therefore be charged that will lead to penalties. The educator who undermines the
patience consent when teaching a student can be reported to the Nursing and Midwifery Board of
Australia (NMBA) that reports the RN/RM to the Australian Health Practitioners Regulatory
Agency (AHPRA). The AHPRA then investigates and charges the education provider with
professional miscount that requires RN/RM to respect and upload informed consent.
Reflection
In my placement I had a similar case scenario to case study 1 where I had a dilemma of either
following registered nurse instructions or the patient’s decisions. The registered nurse had given
me instruction to administer medication to a patient who refused to allow me undertake the
procedure. The medicine was to be administered at a specific time and I was stressed that I was
to miss the time indicated by my RN educator and it would have an impact to the patient’s health
recovery process. In this case scenario, I have learnt RN/RM instructions and opportunities for
learning does not override patient’s informed consent. As a student nurse on placement, there is a
need to listen and upload the decisions or wish of the patient (Nursing Midwifery Board, 2018).
Before this case study discussion, I thought that the RN educator decisions/instructions are above
patient’s wishes or decision. I also thought that I should only follow the RN educator decisions
and did not know there is law protecting the patient’s decisions. While undertaking this study, I
felt amused by how law protects the patient’s autonomy. The law protects the patient’s
confidentiality and privacy and it requires all health practitioners to uphold patient’s informed
consent prior to any procedures or treatment (Dunn et al., 2019). A health practitioner needs to
uphold ethical principle of autonomy and respect each patient’s choices. Therefore the patient’s
decision is final and RN educator and student nurse should abide to it. In my future practice, I