Nursing Ethics, Legal Frameworks, and Case Study Analysis of Practice

This report provides a comprehensive analysis of ethical and legal considerations in nursing practice, using three case studies to illustrate key issues. The report explores the violation of informed consent, the importance of maintaining professional conduct, and adherence to healthcare laws and ethical guidelines, specifically referencing the Nursing and Midwifery Board of Australia (NMBA) and relevant legislation. The first case study examines a student nurse's breach of patient autonomy, highlighting the need for ethical training. The second case study focuses on a registered nurse's failure to maintain hygiene standards, emphasizing the importance of infection control protocols. The third case study addresses substance abuse by healthcare professionals and its implications. The report also includes reflections on personal experiences, evaluations of actions, and action plans for future practice, emphasizing the need for ethical decision-making, respect for patient rights, and adherence to professional standards. These case studies highlight the significance of ethics in nursing, emphasizing how nurses must balance patient care with legal and ethical responsibilities to ensure safe and effective healthcare practices. This report also discusses the ethical principle of non-maleficence and the importance of maintaining a healthy working environment.

Running head: NURSING ASSIGNMENT
NURSING ASSIGNMENT
Name of Student:
Name of University:
Author’s Note:

1NURSING ASSIGNMENT
Introduction
Globalisation and advancement in healthcare processes has changed the healthcare
system around the world as these development and improvements now serves huge number of
patients every day (Clough and Bird 2015). Advancement has improved the healthcare
interventions and therefore, the healthcare is now more affordable and achievable (Elcock and
Lewis 2016). Therefore, it is critical for healthcare professionals, especially nursing
professionals as they are supposed to care for multiple patients at a single time, and comply with
all the ethical and professional codes of conducts (Pich, Kable and Hazelton 2017). The
healthcare systems around the world has also developed these ethical and professional code of
conducts so that people could believe on the care process and understand the effectiveness of it.
In this paper, with discussion of three case scenarios, discussion of their code of conduct,
healthcare laws and ethical considerations would be conducted.
Case study 1.
The case study is highlighting the ethical consideration and issue in nursing practice. The
key issue is violation of nursing ethical principle of informed consent. The nursing and
midwifery board of Australia (NMBA) has developed a standard, guideline and professional
code for nursing practice. According to code of professional conduct for nurse in Australia the
minimum standard for student nurse need to be maintained is related to ethical conduct (Snelling,
2016). The code of ethics for nurse in Australia highlight that student nurse shall follow the
principle of autonomy which is related to giving respect to the patient and maintain their dignity
(Preshaw et al. 2016). As per the health ombudsman act (2013) Queensland legislation, deals
with the health complaints if any student nurse who has been reported for violation of code of

2NURSING ASSIGNMENT
ethics shall be suspended or will not get registered (Franklin and Peden 2017). According to
health ombudsman act (2013) student registered nurse are answerable for any violation of ethical
and legal responsibilities (Faithfull-Byrne et al. (2017). It is mentioned in the standards of NHS,
that student nurse are supposed to ask consent for starting medical procedure for care of patient.
Australian Health Practitioner Regulation Agency (AHPRA) has also set safety practice in
health care setting which has prosecuted the student nurse for ethical practice (Spittal et al.
2016). Therefore, from the review of case study as per the legal law and safety practice, student
nurse should not enter the room although he was in state of anaesthesia.
Looking into the implication for health facility and education provider, the case study is
highlighting the requirement and importance of them. In the case scenario, there is the need of
education provider that will give knowledge and education to the registered nurse as well as to
the student nurse regarding ethical and legal principle of nursing (Elcock and Lewis 2016). As
the registered nurse insisted the student nurse to enter the room despite the patient has not given
consent for it, there is violation of principle of autonomy and will lead to disrespect of the
patient. Therefore, the case study reflects the importance of ethics in nursing practice which is an
implication for safety practice for the health facility (Hurlbutand Elkins 2018).
Reflection
I was assigned to give care to an elderly patient having diabetes and I was supposed to
take vital signs and blood sample of test. However, he refused to undergo any test with the fear
of being diagnosed with other disease. He was not giving his consent, but still I insisted him and
took his blood sample and noted the vital signs.
Feeling

3NURSING ASSIGNMENT
I was tensed and worried in the situation as I was not having enough experience that
would have helped. I was being anxious in my attitude and took the vital sign without his
consent. I thought it is important for him to be diagnosed otherwise it can lead to lethal
consequence. It was a very difficult situation for me.
Evaluation
I evaluated that my action in care of patient was not justified. I have acted against the law
of ethics. The senior registered nurse has took a note of it and escalated the issue to
administration. I was suspended for two months as sign of warning for violating the law.
Analysis
I analysed that I should not work against the wish of the patient, instead I should have
made him understand about the need of need for his health. From the study of Lepping et al.
(2016) ethics in nursing of giving respect and maintaining dignity of patient will help in giving
effective care to the patient. Therefore, I also analysed that it is important for the nurse to
maintain morals in nursing as it help to gain trust from the patient regarding the care plan and
treatment which bring faster recovery.
Conclusion
It can be concluded by saying that every nurse should work as per the set
guideline and code of professional, which is necessary for healthy and safety practice.
Action plan
For my future action, I will take training of ethical practice and try to gain knowledge by
reviewing the peer review journals and academics books (Creswell and Poth 2017).

4NURSING ASSIGNMENT
Therefore, from the experience, it has made easy to give response to the case study,
where I think student nurse should not enter the operation room.
Conclusion
Lastly from the above discussing it can be said that, the nursing principle of ethics aims
to construct a friendly and hospice environment of care in health care setting. Nurse are
responsible to maintain and follow the ethic in their work which is crucial in giving effective
care to the patient. They adhere to the principle of autonomy and non-maleficence while care or
assisting the patient. From the case study, it can be said that student nurse are at the stage of
learning where they come across harsh situation and act positively to it. This makes them
competent enough in their field. Nurse should respect the decision of their patient and maintain
their dignity and protect their right. As seen in the case study, though the patient was in
anaesthesia, it is the legal duty of student to follow the autonomy of care process.
Case study 2.
For the registered nurse, there is ample responsibility and guideline in their working
mechanism. From the review of nursing and midwifery board of Australia, which aims to
protect the public by developing professional codes and standard of practice (Nursing and
Midwifery Board of Australia 2018).
As per the code of ethics for nursing, registered nurse is supposed to value the culture of
health care and take important steps if there is identification of any unhealthy practice (Birks et
al. 2016). It can also be said that by reviewing. Work health and safety act (2011) Queensland
legislation, that registered nurse are responsible to maintain the healthy working atmosphere and
take immediate action in account of it. NMBA expect the registered nurse to work in consistent

5NURSING ASSIGNMENT
in with the codes and relevant standards (Nursing and Midwifery Board of Australia 2018). From
the study of Clough and Bird (2015) it was analysed that registered nurse maintains the
capability for practice and provide safe, responsive and appropriate quality nursing practice. The
ethical principle of non- maleficence is relevant to the case study which aim to not harm the
patient by action of nurses. Further Healy and Walton (2016) suggested that important effort of
registered nurse rely on evaluation of the outcome and inform nursing practice. From review of
case study, it was analysed that it is the legal requirement of the registered nurse to implement a
healthy practice protocol and educate the staffs about proper hand hygiene.
The case study has posed implication for health to maintain standard protocol while
assisting the patient. There is the need for education provider that will make the working staffs
aware about hand hygiene and control measure for cross contamination. It is the responsibility of
health care staffs to adapt healthy practice hence it implies to health facilities regarding standard
working protocol. The health facilities should implement infection control measures in every
department by the mean of regular sessions and distributing memorandum to every health care
staffs.
Reflection
Description
When I was working in team in assisting the patient with daily living activity undergo
mental illness. In my hour I was assigned to administer IV antibiotic as he was having high
fever. I administer the medicine but forget to do proper hand hygiene due which I encountered
bacterial infection. When my activity was communicated to nurse leader, she gave me a proper

6NURSING ASSIGNMENT
guidance for healthy practice but still I was questioned for my activity in front of health
organization.
Feeling
At the moment when I was administering drug to patient I was in huge pressure and
feeling very distress. I was not conscious enough to maintain standard working protocol and fails
to follow the set protocol. I was feeling guilty for my action.
Evaluation
After the few day when I develop the symptom of bacterial infection I came to know
about by wrong practice. The care plan did not go well however, I was little stress free that the
patient did not encounter infection from me.
Analysis
It is seen from the study of Lulé, Kübler and Ludolph (2019) that registered nurse are
responsible for maintaining health practice in health care unit. However, I being a nurse fails to
execute my duty with perfection. I analysed that if I should have being conscious towards my
role and outweighed the work burden I would have not forget to do proper hand hygiene. It was
purely my fault which implies for healthy practice
Conclusion
It can be concluded that for a nurse it is important to do hand hygiene as it will lower the
risk of cross contamination in health care setting. Further, it can also be said that for the healthy
practice, certain rules and protocol are set which need to be followed by every health staffs.
Action plan

7NURSING ASSIGNMENT
To improve my practice and skills, I will involve myself in training session and online
course related to healthy practice. It will help me to acknowledge my weak point and gain
knowledge. Further I will also review my academics books to learn about hand hygiene. I will
involve in healthy practice under the supervision of senior registered nurse to improvise myself.
Conclusion
While concluding this discussion it could be said that the primary role of nursing and
midwifery board of Australia is to develop ethical and practice related codes so that the nursing
professionals could conduct their job roles effectively. In this process, they implemented the care
process with effective measures and hygiene aspects. Further, as per the Australian nursing and
midwifery board it is the primary role of the nursing professionals to achieve quality healthcare.
However, in this reflective study, I mentioned about the care experience in the healthcare facility
due to which the risk of contamination increased in the care facility.
Case study 3.
As per the Australian Health Practitioner Regulation Agency, it was mentioned that the
nursing professionals that are associated with active or inactive healthcare services should refrain
from using alcohol or drugs as it could affect their abilities as a nursing professional (Australian
Health Practitioner Regulation Agency 2018). As per the Australian Health Practitioner
Regulation Agency (2018), this regulation helps in the drug and alcohol screening protocol due
to which if any healthcare professional is associated with any substance abuse, then they would
be provided with ongoing advice and education so that they could prevent themselves from their
substance abuse condition (Murphy et al. 2017). Further, upon failing to do so, they would be
suspended from their duties as a nursing professional.

8NURSING ASSIGNMENT
The Health Practitioner Regulation National Law (2009) mentions about such situations
and states that after receiving complaints about substance abuse by nursing or care professionals,
a preliminary assessment is conducted so that evidences and conditions that forced the healthcare
professionals to attempt drug or alcohol overdose could be analyzed. Further, the student nursing
professionals should understand the fact that this legislation strongly opposes the idea of using
drug and if the professional is found to be guilty of substance abuse, their registration could be
suspended. Further, the Controlled Substance Act 1984 also limits the use of substance abuse
among the nursing professionals in Australia. Besides these, the part 5 of the South Australian
regulation mentioned that it is important for the nursing professionals to comply with their
professional and ethical code of conduct so that they could provide their patients with effective
and quality healthcare. Hence, it also regulates the role of educational institutes to aware all the
student nurses about all these legislations so that their professional career could be free from any
substance abuse related incident.
This case study analysis has provided an effective insight that people were associated
with nursing professionals were regulated and analysed through the AHPRA regulations so that
if they are associated with any substance abuse, then they would be provided with help and
finally, if not been able to overcome, then would be suspended (Spittal et al. 2017). This is
because of their legal law and the standards of the nursing working professionals. Further, it also
affected their ethical principles so that nursing professionals understand their ethical and legal
job roles and refrain from substance abuse related habits (Snelling 2016).
Reflection
Description

9NURSING ASSIGNMENT
While undergoing my first clinical experience in the healthcare facility, I came across one
incident which dragged my attention to know about the regulations, and legislation provided by
the Australian government, using which the hospital authorities could prevent substance abuse.
While receiving my job role briefings from my supervisor on my first day of clinical placement,
I felt that the clinical supervisor is unable to focus on the induction process and was continuously
fidgeting. Despite the fact that I sensed some abnormality in his behaviour, I was unable to
escalate the issue as it was my first day at work. The later day, I came to know that the
supervisor has been suspended from his duties and legal action has been taken against him.
Feelings
After the news of his suspension and legal actions taken against him, I felt relieved that
all the patients and student nursing professionals that could fall in serious problem due to such
actions, would be safe. I was concerned the entire day about the hospital environment and the
news of his suspension made me feel that the rules and regulations developed by Australian
government is worthy making the healthcare environment effective.
Evaluation
While evaluating the condition, I would mention that majority of the healthcare acts and
Queensland legislations and the AHPRA regulations help in preventing and controlling the
substance abuse related incidences to occur with healthcare professionals. Hence, this incident
made me hopeful about the care process and the way the government regulates it to increase its
quality.
Analysis

10NURSING ASSIGNMENT
While analysing the condition, I would mention that I was able to understand that all the
legal and legislative laws mentioned that all the healthcare professionals should not carry or
consume any drugs so that they could conduct their job roles effectively. It was seen that
majority of the legislations mentioned about the provision of cancellation and prevention of the
healthcare professionals so that they could conduct their roles perfectly, due to their involvement
in the critical healthcare conditions.
Conclusion
While concluding it could be said that majority of the healthcare professionals that are
associated with substance abuse or unethical aspects, should be provided with effective care so
that they could conduct the process effectively and perform their job without any critical
healthcare condition.
Action plan
To overcome the critical condition associated with substance abuse of nursing
professionals, the nursing professionals should be screened through the processes so that they
could understand the effectiveness of it. Further, if they are unable to overcome their critical
health condition, then they would be punished by implementing suspension, as per the nursing
ethical code of conduct.
Conclusion
Upon concluding this paper, it could be said that the Nursing and Midwifery Board of
Australia (NMBA) is the association which helps in the analysis and identification of substance
abuse related cases in nursing professionals. This case study analysis also mentioned about the
legal aspects of Health Practitioner Regulation National Law 2009 and the way it determines a

11NURSING ASSIGNMENT
preliminary process so that healthcare professionals and their substance abuse related incidences
could be regulated. As per Pullen, Gilje and Tesar (2016), this legislation helps people to
understand that substance abuse among nursing professionals is an ethical and legal obligation
due to which majority of the people could suffer from adverse conditions. This case study
discusses about one such experience in which I faced critical condition related to substance
abuse. With legal and ethical aspects it was evident that if the healthcare professional is unable to
overcome their addiction, then suspension would be the step taken by the Australian nursing and
midwifery board.