Ethical and Legal Considerations in Nursing Practice: A Case Study

This essay critically examines legal and ethical issues in nursing through a case study involving a 70-year-old retired nurse, Mavis, in a surgical ward. The essay explores the scenario of Mavis experiencing altered vital signs and confusion post-surgery, focusing on ethical dilemmas such as medication non-adherence, patient autonomy, and the nurse's responsibilities in safeguarding patient well-being. It references various ethical principles, including beneficence and respect for autonomy, and discusses the legal implications of nursing actions under UK health law. The essay emphasizes the importance of communication, documentation, and adherence to the Nursing and Midwifery Council code of conduct, highlighting the complexities of decision-making in healthcare, especially when dealing with incapacitated patients, and the need for ongoing education and training for nurses to navigate these challenges effectively. The essay concludes by stressing the importance of ethical and legal principles in ensuring patient safety, comfort, and recovery.

Running head: LEGAL AND PROFESSIONAL ISSUES IN NURSING 1
Legal and professional issues in nursing
Student’s name
Professor’s name
Institutional Affiliation
Date

LEGAL AND PROFESSIONAL ISSUES IN NURSING 2
Introduction
According to Duffy & Gillies (2018), nurses advocate, promotes, and make strenuous
efforts in protecting the safety, wellbeing, and the rights of patients. The accountability of the
nurses should be conducted with a higher standard considering the ethical, professionalism, and
legal obligations. Healthcare practitioner's judgment and deductions in the wellbeing of the
patients and also considering the rights of the patient is one of the significant components in
nursing. Nurses at all times should maintain high personal standards to reflect their
professionalism and enhancing public confidence. A comprehensive realization of the current
legal and ethical code of conduct will strengthen the delivery of proper skilled nursing services.
This essay will critically give an account of a scenario encountered in the line of duty in the
surgical ward. The scenario involves one of the patients by the name Mavis, a 70-year-old retired
nurse. The discussion of this particular scenario will mainly consider the ethical and legal issues
in nursing practices.
Non-adherence to medication is one of the critical issues within the healthcare, so far-
reaching ramifications for healthcare practitioners and patients. Fisher (2017) has indicated that
approximately 60% o the mentally affected individuals are faced with difficulties in adhering to
the plan of their medication. The highly influenced group is the elderly patients whose number
has significantly increased from 50% to 70% recently. In such instances, where mentally affected
patients fail to adhere to medication plan, healthcare practitioners can sort to disguising
medication.
According to the World Health Organization (2017), the nursing guidelines and code of
conduct regarding confidentiality, the patient is Mavis. Mavis is one of the retired nurses of 70

LEGAL AND PROFESSIONAL ISSUES IN NURSING 3
years old service user, who has undergone laparotomy and placed in the surgical ward. It is her
first-day post-up whose recovery is uneventful and her fundamentals signs in a reasonable limit.
This particular morning her essential vital signs were altered where the heart rate had increased,
decreased blood pressure, 38oC temperature, and looked a little pale. Mavis had not passed the
urine for 9 hours despite having IV infusion in situ. Her condition seemed anxious, confused, and
disoriented when taking her vital signs. Her current situation looked significantly different when
compared to the last time she was attended.
The nursing and midwifery council code of act suggested by (Polanczyk, Salum, Sugaya,
Caye, & Rohde, 2015) as an approach of deontology indicates that it’s the duty of the nurses in
promoting and safeguarding the wellbeing of patients. Therefore, the nurse should act in the best
interest of Mavis despite the consequences of her action, which means the bleaching of the
patient's autonomy. The operation of the nurse is to safeguard, promotes the well-being and
health of Mavis. Concerning (Brothers & Rothstein, 2015) violating the independence of a
patient in some instances is necessary for promoting patient's best interest. In such a scenario, its
ethically allowed the nurse to review her medication with no consent of Mavis. The review is
vital to affirm if she had been administered the medicines that could have interfered with her
behavior.
The beneficence principle is one of the ethical principles derived from the roles to offer
benefits as well as consider the advantages of actions against certain risks. Abbasi, Kiani,
Ahmadi & Salehi (2018) a nurse has a professional role of and an ethical duty in carrying out a
significant action to safeguard the wellbeing and health of the patient. With this kind of norm, it
was necessary to guide Mavis to the bathroom and attend to her hygiene necessities.

LEGAL AND PROFESSIONAL ISSUES IN NURSING 4
The freedom of expression guaranteed by an ethical principle of respect is a fundamental
right. The nursing and midwifery council states in the code of act that a nurse professional,
ethical, and legal roles are to uphold and respect patient's decisions. If in any case the nurse goes
against the decisions of the mentally affected individual, the nurse might be disregarding
autonomy and bleaching the law. Hence, it's professional, ethical, and legal in respecting the
autonomous wishes of every patient. Mavis is not ready for a wash, but as a nurse, you have to
encourage her to accompany you to the bathroom with no force.
The guidelines contained in NICE states that the healthcare practitioner has a legal role in
investigating and taking into account the wishes of the patient. Thus, consulting with the right
parties is vital in coming up with the best decision for the mental or physical health of the
patient. According to Ozair, Jamshed, Sharma & Aggarwal (2015, decisions that are based on
the wishes of the patient are more ethical when compared with the isolated choices. In the case of
Mavis, it was right for the nurse to review her medication and to take the report to the shift
coordinator before acting on it.
Failure to consult appropriate parties enact in breaching of ethical, legal, and professional
roles as shown in the (Sykes, Harryparsad, Evans & Gani, 2017). A research conducted by
(Morris, 2018) indicates that some nurses administer medication to patients with no
consultation. Such practices have led some healthcare practitioners being charged and disciplined
with certain offenses. Under the United Kingdom health law, nurses administering medication
can be considered unethical and legally justified, especially if the patient is mentally affected. It
can as well be justified in case the patient shows lack capacity with the mental capacity act.
The communication should be appropriate in such that it's accurate, complete, understood, and
timely by the patient to minimize errors and improve her safety. Various studies have shown

LEGAL AND PROFESSIONAL ISSUES IN NURSING 5
communication as one of the factors contributing to medication errors. However, in the case of
effective communication, the nurse understood Mavis and was able to act effectively in
providing solutions and suggestions. The nurse affected the communication skills in listening
and negotiating with Mavis by encouraging her to move to the bathroom and assist her to wash.
The nurse in charge made it open that right way in making decisions is through complying with
the ethical and legal framework.
The patient is accorded respectful treatment for European Convention of Human Rights. In the
case of Mavis, the nurse established that her gown was opened, the dressing from her surgical
wound was removed and smeared faeces around the abdomen (McKeown, 2016). The nurse had
to make a decision considering the risks concerning the European Convention of Human Right
needs. European Convention of Human Right states that any medication attention provided to
patients should not be given in a degrading, cruel, and inhuman manner. The nursing and
midwifery guidelines as well indicate that risks that will result from inappropriate administration
of drugs would be more significant. An investigation had to be conducted first in the case of
Mavis to ensure the mental problem did not result from the previous medication. Then the nurse
had to discuss the report with the shift coordinator before attending Mavis.
Roberts, Fisher, Trowbridge & Bent (2016) have highlighted various issues linked to
thinking critically. In their research, registered nurses might evaluate the quality of life of the
patient differently. This is because certain cultures, beliefs, values, and professional experiences
might go contrary to the expectation of the patients. Ignoring the believes and values of the
patients has been seen as mutual occurrences. The research conducted recently has shown that
18% of the registered nurses are willing to administer treatment without considering the beliefs
and values of the patient as long as the procedure was critical for their health. The legal and

LEGAL AND PROFESSIONAL ISSUES IN NURSING 6
ethical framework within the United Kingdom was created to a primary objective to safeguard
the wellbeing of incapacitated individuals. Although, it's not clear to an extent in which the
registered nurses should adhere to legal and ethical needs. Mental Health Foundation needs to be
reformulated to give room to the more practical decision by the social care and health staffs. The
foundation conducted research which showed that a wide range of registered nurses vital in
considering the autonomy and safeguard the patient with less capacity. In the case of Mavis, the
nurse closes the door without minding the beliefs and values of the patient and attempted to
cover her. Approximately 63% of the medical practitioners felt the complexity of mental
capacity definition in encompassing capacity assessment practices (Azizi, Hajibagheri & Adib,
2015).
Lack of understanding in many instances has made several patients to be wrongly treated
depriving the rights and incapacitating the patients (Currey, Eustace, Oldland, Glanville & Story,
2015). That means many nurses should be given further education and training concerning
practicalities and legality of medication. When the drug is administered with no appropriate legal
and ethical safeguards, that medication can be extremely unethical and paternalistic unlawful
practices. In an effort to best interest decision, Mavis previous medication had to be reviewed to
ensure a transparent decision process was put in place. An accurate record and documentation
are vital in safeguarding the rights of the patient and provide the legal and ethical framework
were followed.
Public hearing and fairness are critical in the clinical recording. Such records should be
concise, comprehensible, and clear so that they can be referred to when a need arise (Rothnie et
al. 2016). The nurse reviewed the medication plan of Mavis with accordance to guidelines and
policies stipulated in the nursing and midwifery council code of conduct. The instructions

LEGAL AND PROFESSIONAL ISSUES IN NURSING 7
indicate that its vital to frequently review the patient's medications (DeAngelis, 2015). This is
because every person is different, and a person's capacity and mental condition may change with
time. Conducting the regular review by the professional medical safeguard the right of their
patients will ensure the medication was the appropriate, ethical, and lawful approach of
administration (Westrick, 2016).
Conclusion
Registered nurses have certainly a complicated system of healthcare. Thus, they need to
have a good knowledge of ethical and legal principles which supports the proper procedures in
nursing. Nurses are always described as the moral elements within the healthcare systems. That
means they should consider the ethical and legal acts when acting and reasoning in such that they
can balance the best and good intentions to bring the best results. Through appropriate ethical
thinking, a nurse can facilitate the safety, comfort, ease the suffering, and enhancing the recovery
of the patient. Handling of the mentally affected patients like Mavis should never be treated as an
isolated case but should be in a position of complying with guidelines, policies, legislation,
ethical, and legal procedures. Therefore, a high need for equipping the registered with good
knowledge of ethical and legal according to the regulatory body of nursing and midwifery
council.

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