Report: Healthcare Scenario from an Ethico-Legal Perspective Analysis

This report presents a detailed analysis of a healthcare scenario from an ethico-legal perspective. The scenario involves a nursing student's experience during a clinical placement, where they are pressured by a registered nurse to recap a used needle, leading to a needle stick injury. The report explores the ethical and legal implications of this situation, including the violation of established protocols for sharps disposal and the potential risks of exposure to bloodborne pathogens. It examines the student's emotional and psychological responses, the knowledge gap between theoretical training and practical application, and the importance of adhering to ethical guidelines and government regulations. The report also discusses the ethical responsibilities of healthcare professionals, the importance of patient safety, and the need for improved training and adherence to safety protocols within healthcare settings. The report concludes with reflections on the student's changed perspective and commitment to upholding ethical standards in future practice, emphasizing the importance of patient and provider safety.

HEALTHCARE
SCENARIO FROM AN
ETHICO-LEGAL
PERSPECTIVE

Table of Contents
WHAT ?...........................................................................................................................................1
SO WHAT ?.....................................................................................................................................1
NOW WHAT ?................................................................................................................................3
REFERENCES................................................................................................................................5

WHAT ?
I have just started my PEP in an engaged urban hospital. During the practice unit I was
taught by my lecturer, importance of managing sharps correctly which includes needles, scalpels,
syringes, blades and some plastics which is contaminates. Workers related to nursing and
healthcare must take careful steps to prevent abrasion or wounds caused by blades and needles:
while performing procedures with them, while cleaning any such type of instruments and while
disposing of the used needles (Aseweh Abor, 2013). In many of the instances I was taught by
my tutor not to recap the needle once used, rather it should be placed in the kidney shaped dish
and after work is done dispose it in the allotted sharp container. It is mentioned in AS 4031 that
after single use of needle and scalpel blades they should be placed in a proper container and
these containers should be labelled and leak proof (Loveday and et.al., 2014).
Our tutor guided us to go through an Australian Government website that provide us with
certain recommendation regarding proper use and disposal of the needles. One day on my
placement with registered nurse (RN) I was asked to give patient his insulin injection. I was quite
nervous at that moment and after giving the injection I come to know that I forgot bringing that
kidney shaped dish and start to get panic. Then suddenly my RN told me to re-cap the needle, but
I refused at the first as my lecturer taught me about disposing the needle once used. After
denying once he again instructs me to re-cap but I stand with my decision not to re-cap it. Now
finally RN started screaming on me to re-cap the needle and I become anxious and started trying
to recap. It was totally illegal task and my hand were shaking severely and accidental I got
punctured by this needle in my left thumb. Then irritated RN informs the patient that his blood
sample is to be checked to know what kind of serious diseases I come in contact with.
SO WHAT ?
I, was quite shocked at first when the RN forced me to re-cap the needle as it was
completely illegal and against the norms. Being on placement with him I was compelled to
follow the instructions given by him. But my ethics were not allowing me to this task and in this
dilemma my hands started shaking and coincidently that needle pierce my left thumb. After this I
got panicked and started thinking of disease that I may come in contact with due to that prick.
It was an obvious response, as the RN was forcing me to do an illegal work which was
completely unethical and was against the norms issued by the Australian government. Also, I
was scared about medical history of patient that what kind of disease he might be suffering from,
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as I was pierced by that needle and my body come in contact with blood of that patient which
make me prone to the diseases he is already suffering from.
Yes, this situation challenged my values and thinking. As before joining this profession I
was acknowledged with some principle of nursing that were totally smashed during this
situation. I was forced to break the rules and do the unlawful work. This whole scenario created
the knowledge gap in my mind as whatever is mentioned in books with the name of rules and
regulations are actually not followed in the practical field.
I was completely distressed with this situation as it left me with an negative impression
that we are forced to do unauthentic work rather finding an alternative to the present situation.
The RN only wants the task to be done without caring about other safety aspects. This do not
depict a true professionalism.
Through this whole situation one can easily interpret that, by forcing the students of
placement to indulge in a lawbreaking activities may change the thinking aspects of freshers.
They might set a mentality to include false working techniques in their profession which break
the main motto of hospitals i.e. to maintain proper safety and hygienic conditions for the patients.
Such type of working experience do not set a benchmark for the people who are willing to
pursue this profession as a career in near future.
During the college time we were taught many standard measures provided by the
Australian government like: one must be verbally communicate while giving away the used
sharps to handle, also to use the gloves while dealing with sharps, single used blades after being
used should be disposed first (Lakbala and Lakbala, 2013). These are some norms we come
through during our lecture session in college. What I learned there was, no matter what situation
you are in the work should be done in systematic manner. In extreme situation act optimistically
and instead of applying the false technique we should focus mind on norms and start thinking of
alternative practice which are legal and helpful in raising and enhancing the level of our working
(Disposal of single-use sharps, 2010). In present I was forced to perform the illegal work which
completely disapproved whatever we learned earlier during classes.
Yes I was completely surprised with the situation I went through. It put an impact on my
mind and states that present scenario contradict all the things that we were taught earlier. I am
completely worn out with fact that whatever is written in books is limited to that only and there
is no practical application at the work place. It reveals that there is much wider gap between the
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theoretical knowledge that we are taught during our college time and the practical application
during the placement session. I was also astonished with the behaviour of the RN that rather
being concerned about the puncture I got through the needle he was getting irritated.
Many nurses and healthcare workers face problem related to the injury by needles and
such accidents mostly happen after the use of the blades and during its disposal. There are certain
ethical consideration which are given by the National Health and Medical Research Council that
should be considered in this situation. A person who is using the sharp needles and blades is
responsible for its proper disposal (Handling of sharps, 2010). After using them, it should be
placed in a proper container which is especially provided for them. The container should be
checked before being used. It should be properly labelled and leek proof. Container which we
use should be placed near the practical working area and in the mounted position so keep away
from the children (Kumar, Samrongthong and Shaikh, 2013). We can also use instruments to
hold the sharps rather holding them by the hands and verbally communicate with other's while
transferring them. In fact Australia is only country which has well developed techniques of
prevention from infections but health and safety department has still not instructed use of safety
devices (Ikeda, 2014). I should always keep in mind all these ethical consideration and follow
them in the practical area.
NOW WHAT ?
After, getting through this situation I have come up with many conclusions. First and the
foremost is to never forget about the limits in which we have to work i.e. always follow the given
norms in whatever situation you are. Try not to give up in circumstances and think of the new
alternative techniques that are legal. All illegal practices always lead to bad results as I suffered
from the puncture by the used needle. Be loyal to your profession as it depicts the true
professionalism in you (Mbarki and et.al., 2013).
I haven't changed my opinion with regards to the new information as it was not the
proper way of coping up with ongoing condition. Such practices are against the concept of
hospitals i.e. providing proper safety to the patients. It not only have harm for the patients but
also for the service providers. Small mistakes may be converted into life threatening event.
Yes the new perspective changed the way I am currently working as I was forced to
perform the task and I did it. This means I am also equally responsible for the illegal work done.
I should have opposed it but at the end I did it which make no difference between me and the
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RN. But there are some norms which are issued by the Australian Government and is necessary
to practice them like: to protect everyone in the premises both patients and the nurse have
responsibility in respect to prevention from infections (Liao and Ho, 2014). In the upcoming
future I will follow these principles and will not let me down again if such situation arrives
again. I will try hard to serve the patients with services under the defined rules.
With this learning I have gained a lesson of not involving in false practices in the
profession. Further, it might happen that with the help of this experience I will come up as one of
the best nurse of the particular hospital.
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REFERENCES
Books and journals
Aseweh Abor, P., 2013. Managing healthcare waste in Ghana: a comparative study of public and
private hospitals. International journal of health care quality assurance,. 26(4). pp.375-
386.
Kumar, R., Samrongthong, R. and Shaikh, B. T., 2013. Knowledge, attitude and practices of
health staff regarding infectious waste handling of tertiary care health facilities at
metropolitan city of Pakistan. Journal of Ayub Medical College Abbottabad,. 25(1-2).
pp.109-112
Lakbala, P. and Lakbala, M., 2013. Knowledge, attitude and practice of hospital staff
management. Waste Management & Research,. 31(7). pp.729-732.
Liao, C. J. and Ho, C. C., 2014. Risk management for outsourcing biomedical waste Disposal–
Using the failure mode and effects analysis. Waste Management,. 34(7). pp.1324-1329.
Loveday, H. P. and et.al., 2014. epic3: national evidence-based guidelines for preventing
healthcare-associated infections in NHS hospitals in England. Journal of Hospital
Infection,. 86., pp.S1-S70.
Mbarki, A. and et.al., 2013. Medical waste management: A case study of the souss-massa-draa
region, morocco. Journal of Environmental Protection,. 4(09). p.914.
Ikeda, Y., 2014. Importance of patient education on home medical care waste disposal in
Japan. Waste management,. 34(7). pp.1330-1334.
Online
Disposal of single-use sharps. 2010. [Online]. Available through
<https://www.nhmrc.gov.au/book/australian-guidelines-prevention-and-control-infection-
healthcare-2010/b1-3-3-disposal-single-u>. [Accessed on 23rd August 2017].
Handling of sharps. 2010. [Online]. Available through
<https://www.nhmrc.gov.au/book/australian-guidelines-prevention-and-control-infection-
healthcare-2010/b1-3-2-handling-sharps>. [Accessed on 23rd August 2017 ].
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