Nursing Laws and Ethics Case Study

This essay discusses a case study on nursing laws and ethics, focusing on ethical issues, principles involved, and actions to be taken. It explores a decision-making framework and the importance of following a code of conduct in nursing practice.

Nursing laws and ethics case study
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Table of Contents
INTRODUCTION...........................................................................................................................3
MAIN BODY..................................................................................................................................3
CONCLUSION................................................................................................................................3
REFERENCES................................................................................................................................5
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INTRODUCTION
In nursing there are several ethical laws which needs to be followed while providing health
and care services to patients. also there are several standards and principles that needs to be
followed. along with this there are certain code of conduct that is applied on registered nurse
during their practice. also it is necessary for nurse to take effective decision so that proper care
services is provided to patients (Ahenkan, , Afari,. and Buabeng, 2018).
In this essay it will be discussed about a case study and how three stages (Step 1-3) of
decision making framework of McDonald and Then 2019 is applied in it. also it will be
discussed about incidents and use of each step to help nursing taking correct course of action.
MAIN BODY
In health and social care it is necessary to take effective decision so that high quality care
services is provided to patient. Moreover there are certain code of conduct and practices which
needs to be followed in nursing practice. These ensure that practice is being followed any take
away. There is a decision making framework which is being proposed by McDonald and then. In
this there are various stages of decision-making in case of ethical issues that arise in nursing
practice.
In the case study it has been evaluated that a registered nurse is working in intensive care
unit and looking after patient Juliet. she is diagnosed with colon cancer. however after surgery
she is experiencing intense pain as many surgical procedures were followed. but it is found that
before surgery Juliet was asked to sign a consent form for revision of her colostomy and
removing of scar tissue. but she didn't want to sign it and asked to be left alone. Nurse informed
doctor about her wishes, but doctor prescribed sedation for Juliet so that consent form can be
signed once she is calm (Harrison, 2018).
Step 1 – What are ethical/ legal issues
In the first stage of decision making framework is related to identify what are the ethical and
legal issues that arise in case study So here it is analyzed that the ethical and legal issues are
ethical violation and ethical dilemma (Hewitt, and et.al., 2020). That is ethical violation
because the doctor is giving sedation to Juliet for signing a consent form. so it is a wrong
practice which is being followed. Even when Juliet said that she doesn't want to sign consent
form so this shows her wishes. Moreover even when doctor is informed about Juliet wishes he
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want to sign the consent form by wrong means. thus it clearly describes the violation of ethics by
doctor.
Along with that it is found from case study that the ethical dilemma is legal issue also
arises in it (Page, and et.al., 2020). This is because before surgery it might be necessary to sign
consent form from patient. but here it is found that the approach which is being followed by
doctor for taking concern form is not idle. he is giving sedation to Juliet (Hewitt, , and et.al.,
2020). Hence it is clearly seen that there is ethical dilemma which is arising from this process.
However for some people this may be an ethical process so that surgery can be performed. but in
terms of clinical practice it is violation of ethics. Therefore it is necessary to take the decision
which is in the best interest of Juliet and also consent form can be signed an ethical way.
Who are involved
Thus, step one also consist of who is involved in the ethical issues which is identified above.
from case study it has been stated that Juliet is given sedation by doctor to sign consent form. so
it is found that the doctor and Juliet are being involved in ethical issues. besides that nurse has
informed doctor about Juliet wishes. so nurse is also involved in ethical issues. Furthermore, the
rationale of beneficence may have not have been met as being held down may not be considered
as in the resident’s best interests, thereby failing a key underpinning of this principle. NMBA
Codes of Conduct Principle state that nurses are expected to provide safe and person centred
care to individuals and should adhere to the standards of the profession at all times as outlined by
the aforementioned Australian Commission on Safety and Quality in Health Care and the Aged
Care Quality Agency Standards.
Step 2 Evaluate the issues- What ethical principles are involved in this case
In the second stage of decision making there is evaluation of ethical issues done which is
occurred. in this there are four principles which is applied that is autonomy non maleficence and
justice. Also the ethical and legal principles occurred within situation are determined these are
the principles which is included in international council of nurse code of ethics 2012 (Juujärvi,
and Häkkinen, 2020). Autonomy is principle which is defined as right to make own decision
about what is best.
Non maleficence is the ethical principle which means to protect people from harm. therefore it is
the duty of health care provider to protect patients from any harm and acting good way. False
imprisonment is doing of civil wrong when a person is detained against their will or without their
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consent. Professional negligence in Australia there are certain professional code of conduct
outlined in NMBA (2008) for nurses. it states that there are several legal obligations in providing
nursing care to patients. professional negligence occur when health care provider is not able to
provide quality care an instead of that it harms patient.
As mentioned in step one it is found that Juliet has made decision of not to sign consent form and
to be left alone. so in this ethical principle of autonomy is applied. it means that a person is
having right to make their own decision about what is best for them. However she has also
informed about her wishes to nurse (Ko, , Koh, . and Lee, 2020)
It is said that if Juliet does not want to sign concert then she is able to do so as she is
having right to autonomy . This is because the decision is being made by her for her own body
and values. Moreover it is found that the values are involved in this ethical principle. It is
because Juliet as informed Nurse about her wishes that she does not want to undergo any further
procedure. also nurse has informed about Juliet wish to doctor.
As stated in international code of ethics is to guide and ethical decision making for all
registered nurse. it also says that register notes must respect decision of patient half their right to
life and choice. Besides that another article principle that applies in case study is non
maleficence. in this principle the nurse must prevent unnecessary harm and injury which is being
done to patient. Therefore, it is duty of care to welfare of patient (Page, , and et.al., 2018).
Thus, this principle is applied in case study as the doctor decided to give sedation to
Juliet for obtaining her consent and signing the consent form. so the doctor believe that he is
taking consent of patient before surgery and avoiding any major harm. Also the doctor believed
that he is doing good my taking her consent. but on contrary it is necessary to follow this ethical
principle. This is because by giving sedation to Juliet it may result in harm or further injury to
her before surgery. So it is studied that giving sedation to Juliet may be harmful for her health
and can even result in death. Even if nurse has followed ethics to inform the doctor about wishes
of Juliet. Moreover, doctor had been followed the principle of non maleficence
Apart from it false imprisonment legal principle is applied. This is because in case study
it is clearly discuss that Juliet did not want to sign consent form and undergo any further
procedure. but doctor gave him sedation and is planning to obtain consent. so it is clearly a civil
wrong ask Juliet consent is taken by giving him sedation. Furthermore the any standard one state
that registered nurse need to comply with policies and guidelines in taking decision.
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The professional negligence means that there are certain professional code of conduct
mentioned in NMBA 2008 which needs to be followed by registered nurse. it enables nurse to
provide quality care to patient. but in this case study the doctor is not providing quality care
service to Juliet as he is giving sedation to her. This may arise in occurring of risk in health care
setting. so the doctor needs to be answerable to law if any harm occurred very providing sedation
to Juliet.
Step 3 Action - what should be done
The step three of decision making framework is what action should be taken to resolve
the ethical principles which has occurred in the case. Also there is need to suggest some
strategies or alternatives in order to prevent giving sedation to Juliet to obtain her consent.
Therefore here mandatory reporting can be done which is the legislative responsibility for
registered nurse.
So as a registered nurse it is the moral duty to protect the unethical action which is being
undertaken by doctor by giving Salvation to Juliet an obtaining her consent. besides that as per
the standard 6 criteria in nursing and midwife free standards for registered nurse it has been said
that there must be appropriate process to report actual and potential risk (Shiells,, and et.al.,
2020).
Hence, nurse must research and find out what is the process of reporting risk. So nurse can
also approach supervisor and discuss that what is the concern which is being observed. so in this
he may perform a duty of care and report anything which may cost potential harm or injury to
patient in giving health and care services. Apart from this, nurse may discuss the ongoing
concerns with hospital management and other officials. this will be beneficial in taking correct
action and measures buy them to stop doctor in giving sedation to Juliet for obtaining her
consent. Apart from it there are many other actions which can be taken in order to take consent
of Juliet in performing of surgery. here, the doctor and nurse along with the family members of
Juliet can make her understand about what is the necessity of signing a consent form and how it
will benefit her in future. Besides, doctor may directly talk to her without giving any sedation so
that Juliet is able to take decision with calm and cool mind. in addition to that nurse can identify
Juliet needs so that it can be fulfilled. Also, another action that can be taken is by not giving
sedation to Juliet and obtaining her consent in normal way. so it will be beneficial for both doctor
and Juliet. in this there will be no consequences occurred as well. Also legal action can be taken
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against doctor if sedation is given to Juliet. so in this way it will help in preventing any harm or
injury to her. besides that it will also ensure that high quality care services he’s given to Juliet
and there is no ethical issues which is occurring in it (Strube, , and et.al., 2018).
In this essay it can be also studied that there is need to identify and engage stakeholders such
as doctor patient nurse government etc. so that an effective decision can be taken. Moreover, a
policy can be form that how consent of patient needs to be taken and what other actions are to be
followed in such type of situation. also it can be identify that working in an ethical way or ethical
dilemma issues need to be solved. For that a framework can be developed by NMBA and ICN.
So by discussing it with stakeholders and developing a framework it will be a best corrective
measure earn action that can be taken To solve the ethical issue. it will not only provide famous
but also guidelines that need to be followed while taking consent of patient. With this it will
result in providing high quality care services two patient (Wilburn, 2018 ). A registered nurse is
needed to work in ethical way and also follow decision making framework in order to provide
high quality care services to patient. there may occur several ethical issues in it but this needs to
be resolved so that duty of care is followed in it. so, here certain code of conduct and practices
can be developed as well which needs to be followed in nursing practice. It will guide nurse and
other professionals to work in ethical way and make sure that ethical working in followed. here,
ICN standards and guidelines can also be considered in developing a framework. This will be
useful in including certain criteria as well on how to take decision. In health and social care it is
necessary to take effective decision so that high quality care services is provided to patient.
Moreover there are certain code of conduct and practices which needs to be followed in nursing
practice. These ensure that practice is being followed any take away. There is a decision making
framework which is being proposed by McDonald and then. In this there are various stages of
decision-making in case of ethical issues that arise in nursing practice. also there are several
standards and principles that needs to be followed. along with this there are certain code of
conduct that is applied on the registered nurse during their practice. also it is necessary for nurse
to take effective decision so that proper care services is provided to patients (Wilburn, 2018).
CONCLUSION
From essay it can be concluded that it is essential for nurse to find out ethical issues and take
corrective action. there are three stages of decision making framework. First is what are ethical
issues second is what principles are involved and the third is what action needs to be taken. It has
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been found that in case study the ethical issue which occurred was ethical violation and ethical
dilemma. also the principles red were involved in case was autonomy non
maleficence ,professional negligence etc. this is because Juliet consent was taken by giving
sedation to her even when she decline to sign consent form and undergo further procedure. There
are certain actions which can be taken. The nurse should inform superior and discuss with it.
Also, various stakeholders can be involved and a framework is developed that contains
guidelines in it.
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REFERENCES
Books and journals
Ahenkan, A., Afari, M.B. and Buabeng, T., 2018. Ethical Dilemma of Health Professionals in
Ghana: Experiences of Doctors and Nurses at the Korle-Bu Teaching Hospital. African
Journal of Management Research, 25, pp.29-44.
Harrison, H.C., 2018. New graduate registered nurse practice readiness for Australian
healthcare contexts: A collective instrumental case study (Doctoral dissertation, James
Cook University).
Hewitt, J., and et.al., 2020. Voluntary assisted dying in Victoria: Why knowing the law matters
to nurses. Nursing Ethics, p.0969733020944457.
Juujärvi, S. and Häkkinen, M., 2020. The ethics of care and justice in nursing education. Ethics
as a resource. Examples of RDI projects and educational development.
Ko, C.M., Koh, C.K. and Lee, Y.S., 2020. An ethical issue: nurses’ conscientious objection
regarding induced abortion in South Korea. BMC Medical Ethics, 21(1), pp.1-9.
Page, A., and et.al., 2020. Clinical holding: ethical guidance for children’s nurses working in the
UK. Nursing children and young people, 32(3).
Shiells, K., and et.al., 2020. Staff perspectives on the usability of electronic patient records for
planning and delivering dementia care in nursing homes: a multiple case study. BMC
medical informatics and decision making, 20(1), pp.1-14.
Strube, P., and et.al., 2018. The role of the nurse educator in sustaining compassion in the
workplace: a case study from an intensive care unit. The Journal of Continuing Education
in Nursing, 49(5), pp.221-224.
Wilburn, A., 2018. Nursing informatics: Ethical considerations for adopting electronic
records. NASN School Nurse, 33(3), pp.150-153.
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