Nursing Practice and Legal Ethics

This assignment delves into the critical intersection of nursing practice and legal ethics. It requires students to analyze the ethical principles guiding nursing care, understand the legal framework surrounding patient safety and informed consent, and apply these concepts to real-world scenarios. The provided references cover a range of topics including professional ethics, negligence in healthcare, information management in aged care, and the role of nurse practitioners within the Australian context.

Running head: NURSING CARE
Nursing Care
Name of the Student
Name of the University
Author Note

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Table of Contents
Assignment 1...................................................................................................................................2
Assignment 2...................................................................................................................................6
Assignment 3...................................................................................................................................8
Reference.......................................................................................................................................10

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Assignment 1
Nurses play an essential role in providing quality health care to all and being respected
healthcare providers they are expected to be adequately qualified and maintain professionalism
with a caring concern for the patients (Daly, Speedy, & Jackson, 2017). Under section 141 of the
Nursing Act 1992, any person who is authorized to use the titles, enrolled nurse and registered
nurse are entitled to practice nursing. A registered nurse and an enrolled nurse work together and
an enrolled nurse assists the registered nurse in decision-making process relating to the medical
status of the patient (Gaskin, 2017).
The primary responsibilities of an enrolled nurse is to recognizing normal and
abnormality in assessment; performing the delegated responsibilities; monitoring the impact of
care by assessing the health status of any individual (McDonald & Then, 2014). The enrolled
nurse is required to communicate with the registered nurse relating to the health status of the
patients on a regular basis. There are times, when it becomes imperative and a necessity for a
registered nurse to give more attention and be more involved with any particular patient,
especially, under circumstances, when the patient is responding unpredictably or there is a
constant change in the health status of the patient (Masters, Role development in professional
nursing practice, 2015). The registered nurse must also be more attentive under circumstances,
when the patient is subject to continual assessment and there is a constant need to make changes
in the care plan of the patient.
In regards to the nursing care outlined in the Inquest into the death of Mr. Albert Eric
Bruce Biffin, it questions the accountability of the nurses and the adequacy of the medical care
that was provided to Mr. Biffin. The coroner found that Bruce was suffering from umbilical

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hernia that had developed recently, which called for immediate medical treatment by his general
practitioner Dr. Lambie, following nursing care.
An enrolled nurse called for a registered nurse on 24 February as Bruce had vomiting.
The registered noted that he was suffering from pain in his lower abdomen and she detected
hernia. She advised the enrolled nurse to give Movicol to Bruce for his constipation and advised
to monitor Bruce. Thereafter, as the registered nurse was communicating with Bruce she noticed
the size of the hernia that looked inflamed and pink. Since she was meeting Mr. Briffin for the
first time and he did not complain of any pain in his stomach, the registered nurse did not
examine the hernia and thought that he was feeling unwell due to constipation, thus, advised him
movicol.
Here it can be observed that the registered nurse did not pay much attention to the
changing health condition in Mr. Briffin in that while she assessed him, he complained of feeling
unwell and a stomachache. However, in the next minute he denied of having any pain or did not
seem to be stressed. Furthermore, he even told the registered nurse about the hernia and that it
was not painful and seemed to be more worried about his constipation. As per the nursing code
of practice, a registered nurse is required to be more attentive towards patients who have rapid
changes in their health status and requires constant assessment (Kangasniemi, Pakkanen, &
Korhonen, 2015). However, even after noticing and being aware of the hernia and the
stomachache, the nurse neither touched nor examined the same.
Further, another registered nurse reviewed Bruce on 24 February afternoon and gave him
another dose of Movicol for constipation. The nurse noted about his vomiting and pain in lower
and central lower abdomen and a prominent bulging of umbilical hernia.

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The registered nurse mentioned that he is required to be assessed by Dr. Lambie next day
mentioning about an offensive wound in his lower leg. After Dr. lambie’s visit, no registered
nurse recorded the observations until the registered nurse who visited Bruce on Sunday evening,
although three registered nurses were scheduled to observe and take care of Bruce. Further, since
Mr. Biffin was in the residential aged facilities (RACFs) where the nurses are responsible for
daily maintenance, recording and reporting of the operation of the facility and care of each
resident, the registered nurses failed to perform their responsibility of taking account of the
condition of Mr. Biffin (Gaskin, Georgiou, Barton & Westbrook, 2017).
After Dr. Lambie left on Monday, an enrolled nurse reviewed Mr. Biffin, he complained
of feeling nausea, and that he was not feeling well. Instead of administering medicines, she
merely described that he was feeling unwell before Dr. Lambie’s visit as well. Thereafter at
16:30, a registered nurse gave him two doses of Movicol. Thereafter, neither any nurse nor any
doctor visited or reviewed Mr. Biffin until the next day, Tuesday 26, lacking responsibility to
provide health care.
The clinical nurse observed he had not vomited and was given movicol for his
constipation. Although the responsibility of the clinical nurse was to supervise the enrolled and
the assistant nurses in Jacaranda and supervise all the residents, in particular those who had been
unwell and are undergoing frequent changes in the health status, which implies she should have
taken extra care towards Mr. Biffin. Although she asserted that she had asked the enrolled nurse
to take observations of Bruce but she did not record this document as she expected that in case
any abnormality is observed in the observation, the enrolled nurse would inform the registered
nurse about the same. She was not even certain whether she instructed the enrolled nurse to
inform Dr. Lambie in case of any abnormal condition is observed. This demonstrates how the

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clinical nurse had acted in contravention of her professional conduct (Davis, Morgans, &
Burgess, 2017). She merely noted that Mr. Biffin did not vomit without having any knowledge
about his health condition or that he was feeling unwell, which contradictory to her early
statement that she saw Bruce is looking unwell while he was sitting on his chair.
A clinical nurse held a more senior position and had more responsibilities as compared to
the other staffs providing care o Mr. Biffin. Despite the fact that she was not directly involved n
the treatment of Mr. Biffin but her primary responsibility is to oversee a resident who had a
recent hernia operation and required special care. A mere verbal instruction to an enrolled nurse
that too, on her first shift, to observe the patient accordingly portrays lack of guidance to a less
experienced nurse and it is less information that is required for a clinical nurse to obtain about an
aged patient like Bruce (Scanlon, Cashin, Bryce, Kelly, & Buckely, 2016).
Furthermore, the enrolled nurse was aware of the deteriorating condition inform the but
instead of informing the registered nurse she handed over to the assistant nurse merely
mentioning that Mr. Biffin needed assistance to bathroom. When Bruce’s condition deteriorated,
the assistant nurse called the registered nurse who met Bruce for the first time. While she was
reading the records, instead of calling the ambulance she helped the assistant nurse to change
Bruce’s dress, clearly demonstrating lack of decision-making ability that is expected from a
registered and a qualified nurse (Street, Ottmann, Johnstone, Considine, & Livingston, 2015).
The above-mentioned instances are evident of the fact how the nurses have failed to
discharge their professional conduct and have raised question about their competency and
accountability. The registered nurses are expected to use their professional knowledge in a direct
non-clinical relationship with patients and play significant roles that ensure effective and safe

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delivery of health services in the health profession (Chadwick & Gallagher, 2016). Instead of
giving more attention to the hernia pain and nauseous feeling, they continued to give high doses
to Mr. Biffin when he regularly complained of feeling and was unable to eat. They were
accountable for the health services that were required to be provided to Mr. Biffin in the
residential care facilities which they have failed to exercise.
Assignment 2
The practice of nursing often entails close physical proximity between the patient and the
nurse. If a patient suffers damage due to lack of proper care and diligence exhibited by the
nurses, the patient is entitled to sue the nurse on the ground of negligence. The party complaining
about the negligence must establish the fact that he/she has suffered damages because of the
breach of duty of care (Masters, 2015). In order to establish the claim of negligence, it is
important that the aggrieved party establish the following essential elements:
 that the defendant owed a duty of care towards the plaintiff; that the defendant failed to exercise the required standard of care; that the plaintiff has suffered damages due to the breach of the duty of care;
 that the defendant could reasonably foresee the damages caused to the plaintiff;
In the given case, the registered or the clinical nurses have demonstrated a breach of a
duty of care that they owed to Mr. Biffin. The nurses owed a duty of care towards Bruce, as he
was a resident of the Residential Aged Care Facilities (RACFs) and being a registered nurse she
was responsible to give more attention to patients who display frequent changes in their health
status and their response is unpredictable (Dwyer, Craswell, Rossi, & Holzberger, 2017). The
registered nurses are accountable for conducting regular and continual assessments changing the

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care plan for such patients. Mr. Biffin being in an advanced age, was suffering from umbilical
hernia and regularly complained of feeling nauseous and unwell, but he was mostly given doses
of movicol for his constipation.
The clinical nurse is the senior nurse who is responsible for over viewing all the residents
of the resident age care facilities, especially, patients who requires regular observations and have
frequent changes in the health status (Blackman, et al., 2015). Instead of the overviewing the
compete records of Bruce and being aware of the high dose of movicol given to him, she merely
instructed the enrolled nurse, a less experienced nurse, to observe his health conditions. This
establishes the breach of the duty to exercise care towards Mr. Briffin. Furthermore, the
registered nurses continued to give him doses of movicol for his constipation. Despite the critical
health condition, the enrolled nurses with less experience were attending Bruce. The registered
nurses lacked a decision-making skill, as is evident when Bruce’s condition was deteriorating,
instead of calling for an ambulance, and Dr. Lambie, the registered nurse was assisting in
changing his dress (Chang & Daly, 2015).
The breach of the duty of care by the nurses caused deterioration of the health condition
of Mr. Briffin and the nurses despite, being aware of the deteriorated condition of Bruce; they
did not transfer him to hospital or informed Dr. Lambie for immediate medical assistance. This
implies they could reasonably foresee the damage that would be caused to Bruce (Foley &
Christensen, 2016).
The Coroner may refer to section 10AA under the Coroners Act 2003 (the Act) that
defines the deaths caused due to lack of health care and the professional and the Framework for

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Nurses and Midwifes in Queensland approved by the council in 2005. Therefore, a claim for
negligence can be made against the clinical nurses for breaching their duty of care.
Assignment 3
It is essential for health care providers to take the concerns and management of patients
into consideration and that idea decision-making process includes ethical principles, which
requires the health care providers to have the will to take actions for safeguarding the
disadvantages and the vulnerable. The nursing profession recognizes the standards of human
rights in health care that requires them to safeguards the fundamental human right of all people
to attain the highest standard of health. The nurses are required to demonstrate adequate
knowledge of ethical responsibilities as moral accountable healthcare practitioners (Heaton,
2014).
In this case, the Clinical nurse had the responsibility to supervise the assistant and the
enrolled nurses and held a senior position. She was accountable for overviewing all the residents
of the residential age care facility and was required to give more attention to the patients who
were subject to regular evaluation and had been reported to have frequent changes in their health
condition. She failed to exercise her duty and did not even assess the medical records of Bruce;
instead instructed the less experienced enrolled nurse verbal instruction to observe his condition,
demonstrates lack of decision-making ability (Anderson, Malone, Shanahan, & Manning, 2015).
An enrolled nurse is required to assist the clinical nurse in decision-making using
reflective and critical skills. It is an ethical responsibility of nurses to promote effective health
care, and in case of aged parents whose health conditions changes frequently, it is important to
give more attention to them (Parahoo, 2014). The residents of residential age care facilities are

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entitled to receive care and services whenever they require them. Moreover, the nurses also share
an informal relationship with the patients so that the patients share their fear, doubts regarding
their health and it is ethical responsibility of the nurses to pay attention to their needs and attempt
to resolve their issues.

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