Law and Ethics in Health Care - Case Study

Running head: LAWS AND ETHICS IN HEALTH CARE
LAWS AND ETHICS IN HEALTH CARE
Name of the Student
Name of the university
Author’s note

1
LAWS AND ETHICS IN HEALTH CARE
Case study 1
1. The regulation 52 of the Nurses and Midwives Regulations 2012 (Cap. 209, S 119/2012)
signifies that consent is required from the board before practicing on own account. There are
three provisions for the regulation 52.
1. A registered nurse cannot practice nursing on his/ her own account without written
consent from the board.
2. A registered midwife will not practice nursing on his / her own or with partnership
with another without any written consent from the board.
3. Any person who will contravene the regulation will be penalized with a fine not
exceeding $5,000.
Such provisions are made for the public interest and to deliver a safe care to the public. This
is because SNB offers approval or accreditation only to those nurses and midwives who are
skilled and competent in their own scope practice. It is evident that an incompetent nurse or a
midwife can not only deteriorate a patient’s condition and can also bring about mortality. The
case can turn out to be more dangerous in case of the midwives as lack of skills and competence
may bring about fatal condition to both the child and the mother (Gachoud et al. 2012). Penalties
are imposed upon those contravening the regulations as penalties would help to retain the fear
among the lawbreakers.
2. According to the SNB Code for Nurses and Midwives (2018), the enrolled nurse has
breached the Principle 5, which states that a nurse should practice in a responsible and
accountable manner (SNB, 2018). According to this principle, enrolled nurses should

2
LAWS AND ETHICS IN HEALTH CARE
understand and abide by the legislative framework of the SNB. The SNB codes of ethics
provide guidelines for the nurses that a nurse should uphold in his/her professional career to
provide a safe care to the patients. The SNB codes of conduct help the enrolled nurses with
the knowledge of responsibility and accountability for the patient care (SNB, 2018).
Nurses and midwives hold positions of responsibility and are therefore accountable to the
care that they provide to the patients (Chadwick and Gallagher 2016). Responsibility can be
defined as the obligation to perform duties using the professional judgment and being
justifiable for his/ her decisions (Scrivener & Hooper, 2011). Accountability refers to the
capability to give proper justifications against any nursing action. It is all about maintenance
of the competency and safeguarding the patient and preserves the standards of the nursing
profession (Gachoud et al., 2012). In general, all the enrolled nurses are legally accountable
or answerable to any kind of decisions they are taking while providing care to the patients
(Lachman, 2012).
It is true that accountability cannot be achieved unless the enrolled nurses has got the
autonomy to practice the right to autonomy is actually provided by the written format
(Krautscheid, 2014). Nurses are accountable to the accreditation body, the patient and their
family. Lack of any legal consent form the board does not provide the nurse with any legal
accountability (Scrivener & Hooper, 2011). In order practice nursing, a nurse should ensure
that she/he has suitable professional indemnity insurance, as each patient has the right to hold
the insurance in case, any violation of the tort of negligence comes in to play (Lachman,
2012). The SNB also thrives to safe guard the nurses with their legal shields. In this case the
enrolled nurses practice nursing without any legal consent from the board. In such a case the
concerned nurse is not accountable if any adverse situation comes up. Hence it is clearly

3
LAWS AND ETHICS IN HEALTH CARE
evident that the nurse has breached the standards, as she has practiced nursing without any
consent from the regulatory body and she has also applied intravenous medications
independently at patient’s home. Normally it is the duty of an enrolled nurse to refrain from
practices where he/ she has not developed competence or has not received appropriate
training (Krautscheid, 2014). It should be remembered that as per the law no EN can apply
IV medications without notations and they can only do so in the supervision of the RNs and
if they have completed intravenous medication administration training (Krautscheid, 2014).
The nurse have also breached principle 6 that states that nurses should advocate patient
safety and should be aware of the current clinical practical guidelines (SNB, 2018).
An enrolled nurse should be aware of his/ her limitations in the scope of practice and
should understand the differences in the responsibility of an RN and an EN as long as the
situation demands. It has to be remembered that administration of IV medications needs
proper training as there are several factors that has to be taken care of such as the drug dose,
drug timing, and the intactness of the IV line (Cerit & Dinç 2013). IV drugs might not be
compatible with certain drugs and may interfere with their mode of action. The role of the
nurses is expanding with time, but these shifting boundaries are actually leading some nurses
anxious about their legal accountability and responsibilities (Krautscheid 2014). Apart from
specific situations that law does not allow the nurses to take up the responsibilities that are
not suitable for a particular designation (DeBourgh & Prion 2012).
Responsibility is equal to the duty of care in law and the duty of care applies from
simplest to the most complex type of care such as bathing a patient to a complex surgery
(Scrivener & Hooper, 2011).