Legal and Professional Issues in Nursing

Legal and Professional Issues in Nursing 1
LEGAL AND PROFESSIONAL ISSUES IN NURSING
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Legal and Professional Issues in Nursing 2
Legal and Professional Issues in Nursing
Introduction
One of the fundamental aspects of nursing is the duty of care which most of the nurses
view it as a vital part of their professional duties. The legal underpinnings of duty care have
however been overlooked hence nurses tend to get stranded on what to do in cases of emergency,
especially when off duty (Dowie 2017). Some of the ethical obligations involve confidentiality,
accuracy, safety, and workplace relationships (Williams n.d.). Additionally, ensuring patients’
safety is another fundamental role of nurses (Registered Nursing n.d.). Failure to adhere to the
set ethical and professional guidelines while on duty has its repercussions as was the case below.
Overview
Ms Silvia Csepregi’s registration with the NMBA (Nursing and Midwifery Board of
Australia) was suspended for professional misconduct by the South Australian Health
Practitioners Tribunal in 2016 (Nursing and Midwifery Board of Australia 2016). The tribunal’s
decision followed proven allegations that Ms Csepregi had behaved in a manner that amounted
to professional misconduct in three ways. Firstly, the registered nurse engaged in unwarranted
physical contact by placing her hand on, over, or in contact with the left lateral jaw of a patient.
As a consequence, a bruise of about 5cm in diameter developed on the face of the patient (Health
Practitioner Tribunal of South Australia 2016). The patient was 98 years old and had been
admitted at the Royal Adelaide Hospital for treatment. The hospital is located in Adelaide, South
Australia. According to the Health Practitioner Tribunal of South Australia (2016), the patient,
whose name was not disclosed, had been admitted to the hospital with several health complaints

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including a mild cognitive impairment. More precisely, the client was in a vulnerable position
while lacking basic skills of communication.
In addition to causing injury to the patient, another form of professional misconduct
resulted when Ms Csepregi falsified a report in the Safety Learning System database claiming
that the patient’s injury had resulted from accidental contact with her bed railing (Nursing and
Midwifery Board of Australia 2016). What is more, the registered nurse beseeched a colleague to
substantiate the falsified report that she had come up with (Nursing and Midwifery Board of
Australia 2016). After Ms Csepregi owned up the mentioned allegations, the South Australian
Health Practitioners Tribunal established that the nurse’s behavior had resulted to professional
misconduct and that her conduct amounted to a significant departure from appropriate standards
(Health Practitioner Tribunal of South Australia 2016). As a consequence, Ms Csepregi was
reprimanded, her registration was suspended for approximately one year, and certain conditions
were imposed on her registration (Health Practitioner Tribunal of South Australia). These
conditions required the nurse to practice under supervision of a registered nurse and enroll for
further education in the management of cognitive impairment and challenging behaviors, and
nurses’ ethical behavior (Nursing and Midwifery Board of Australia 2016).
Actions Contributing to Causing Bruise on Patient’s Face
As evidenced in the above case, Ms Csepregi’s actions directly contributed to the injury
or bruise on the face of the patient. More precisely, on 3 April 2014, she engaged in unwarranted
physical contact with the patient. She placed her hand on or over the mouth of the patient causing
a bruise around that area. According to Ms Csepregi, her actions were not meant to hurt the
patient. On the contrary, the conduct that led to bruising was aimed at preventing the patient

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from screaming and yelling at her ear as she carried out her duty of hygiene care to the patient. It
was later revealed that the patient was agitated and aggressive, whirled hands and body, and
spitted at nurses as they tried to discharge their care duties towards them. Despite these
revelations, Ms Csepregi committed a professional misconduct when she had unwarranted
physical contact with the patient which led to bruising. Additionally, the nurse failed to give
considerations to the old age and health condition of the client, and thus their vulnerability while
handling them. As already mentioned the patient was 98 years old and had various health issues,
and was in a frail condition.
Other Factors that Contributed to Adverse Outcome
Falsifying Record
In an attempt to cover up her misconduct, Ms Csepregi also engaged in other actions that
were deemed as professional misconduct. During the time of the mentioned incident the hygiene
needs of the patient were being attended by Ms Csepregi in collaboration with another nurse. The
other nurse had briefly stepped out of the room and when she returned she noticed that Ms
Csepregi’s hand was on the chin and mouth of the patient. After Ms Csepregi noticed the nurse
re-entering the room she removed her hand and they both continued with their professional
duties towards the patient. After some time, a bruise which was noticed by the two nurses
appeared on the same location where the nurse had placed her hand. Ms Csepregi acknowledged
to the colleague that her earlier action may have contributed to the bruising. However, Ms
Csepregi did not own up to her actions when documenting the events of day. Instead, she
prepared a Safety Learning System (SLS) report where she associated the incident that caused
bruising as one which involved inadvertent contact between the bed rail and the patient’s face.