HLTENN008: Nursing Practice Case Study - Legal and Ethical Concerns

This nursing practice case study focuses on En Rose Baxter's handling of two patients, Mr. Smith and Mr. Smythe, highlighting legal and ethical considerations. The case examines duty of care, consent, and the nurse's responsibilities in ensuring patient safety and preventing errors. It ad...Read More

Running head: NURSING PRACTICE 1
Nursing Practice Case Study
Name
Institution

NURSING PRACTICE 2
Nursing Practice
Question 1
The Enrolled nurse standards of practice may be described as the standards that offer the basis
for evaluating the practice of the enrolled nurses (Brown, Edwards, Seaton & Buckley, 2017).
Generally, they are used to develop the nursing curricular, assess new graduates and students,
and evaluate nurses seeking to work in Australia but having been educated overseas.
Question 2
The duty of care may be defined as the obligations that are placed on an individual to perform
their duties in accordance with some set standards (Cornock, 2014). The enrolled nurse had a
professional duty of care to take care of both Mr. Smith and Mr. Smythe. This duty of care was
supposed to ensure the safety of both of the patients. There was, however, a possible breach of
the duty of care when there was a mix up in the theatre documentation.
Question 3
Mr. Smith consents by holding out his hand ready to have his finger pricked for the blood
glucose level test. This type of consent is described as implied consent in that his act of holding
out his hand clearly indicates his wish to the health practitioner.
Question 4
The enrolled nurse acted in a safe and competent manner in the scenario involving Mr. Smith
and Mr. Smythe by placing an alert band on each of the patients. Additionally, the nurse places
an alert notation on the clients’ medical records. These alerts help in differentiating the patients
and ensuring patient safety.

NURSING PRACTICE 3
Question 5
After realizing there is a mix up in the documentation of the two patients, the first thing En
Baxter should do is to report to her supervisor or consultant. After making the report, she should
proceed to fill an adverse reporting form after which she needs to familiarize herself with the
procedures of the complaints (Sellman, 2011). It is also important to document all the details
involving the erratic incident as soon as it happens to avoid any misreporting of the facts around
the incident. She then needs to apologize to the patient to gain the trust of the patient once again.
Question 6
En Baxter prepares both the patients for surgery by completing the necessary procedures. She
recognizes that both Smith and Smythe have similar names and similar dates of birth and acts by
placing alerts on both of them for differentiation purposes. She additionally organizes all the
workload and presents them to the lead doctor.
Question 7
En Baxter fulfills her professional duty of care by appropriately undertaking the enrolled nurse
practice. Additionally, she provides nursing care in accordance with the accepted plan of care,
procedural guidelines, and professional standards. Furthermore, we notice that she works in
liaison with the doctor to ensure patient care is appropriately delivered.
Question 8
The value statement ensures that the nurse appreciates the fact that safety is the responsibility of
everyone. She, therefore, needs to ensure patient safety by detecting and preventing errors within
the healthcare setting the may jeopardize patient safety. The nurse should additionally promote

NURSING PRACTICE 4
the provision of equitable and culturally responsive services to all people (Masters, 2015). She,
therefore, should not use analgesia on Mr. Smythe because his culture does not support the use of
this anesthetic. En Baxter can, therefore, look for a different alternative that will ensure quality
delivery of patient care.
Question 9
During the handover of Mr. Smythe to the theatre staff, it is important to design and implement
plans for future care. These plans ensure that the quality of service in the theatre is improved for
the sake of patient safety. Additionally, implementing plans for future care encourages ethical
practice in the theatre to ensure that the rights of Mr. Smythe are respected (Fairman, Rowe,
Hassmiller & Shalala, 2011). The result is that the quality of care is improved and patient safety
guaranteed.
Question 10
Open disclosure may refer to the act of openly discussing with a patient the incidents that may
harm him/her while receiving healthcare. This discussion can also be done with the family of the
patients (Eaves-Leanos & Dunn, 2012). Open disclosure falls under the scope of practice of the
nurse. Discussing the near-miss error with Mr. Smythe may be beneficial to him in a number of
ways. Some of the benefits of open disclosure may include; amending feelings of guilt, grief,
helplessness or anger, restoring the patient-nurse trust, and it also encourages the patients to take
part in processes that ensure the improvement of the quality of healthcare. Hiding the
information from the patient may ruin trust if he finds out later.
Question 11

NURSING PRACTICE 5
En Baxter prepares both her patients for the theatre by taking the measurements for blood
glucose level for Mr. Smith and presents the test results to the theatre staff. Additionally, she
places an alert band and an alert notation on each of the patients and their medical records
respectively. From the scenario, En Baxter notices there is a mix up in the details of the two
patients in the medical documentation. She notices that it would be inappropriate for Mr. Smythe
to have the order because it has Mr. Smith’s details.
Question 12
The principles of confidentiality, veracity, and autonomy ascertain that any patient who is
capable of making informed decisions must be given the opportunity to accept or deny a
recommended plan of treatment. Additionally, the principle of confidentiality prohibits sharing
the details of the patient’s condition with anyone who is not involved in the patient care. Finally,
the principle of veracity demands that a patient that possesses the ability to make informed
decisions must be given the whole truth regarding their condition (O'connor, Coates, Yardley, &
Wu, 2010). From these principles, it is obvious that the nurse should alert Smythe’s wife about
the near-miss.
Question 13
i. Communication between the healthcare practitioners and providers by ensuring that
everyone can gain access to the necessary information.
ii. Attaining all the possible legislative requirements.
iii. Facilitation of quality improvement in the healthcare setting.
iv. Documentation can serve as a source of future research (Jefferies, Johnson &
Griffiths, 2010).

NURSING PRACTICE 6
v. A chronological order of documentation in the patient’s health record.
Question 15
As an enrolled nurse, I will demonstrate knowledge of the common laws and legislations
appropriate in the practice of the enrolled nurses. Additionally, I will express my knowledge of
the procedures and policies of the organization applicable to the nursing practice of the enrolled
nurses. This is to ensure that I maintain compliance with my responsibilities as a professional.

NURSING PRACTICE 7
References
Brown, D., Edwards, H., Seaton, L., & Buckley, T. (2017). Lewis's Medical-Surgical Nursing:
Assessment and Management of Clinical Problems. Elsevier Health Sciences.
Cornock, M. (2014). Duty of care. Orthopaedic & Trauma Times, (24), 14-16.
Eaves-Leanos, A., & Dunn, E. J. (2012). Open disclosure of adverse events: transparency and
safety in health care. Surgical Clinics, 92(1), 163-177.
Fairman, J. A., Rowe, J. W., Hassmiller, S., & Shalala, D. E. (2011). Broadening the scope of
nursing practice. New England Journal of Medicine, 364(3), 193-196.
Jefferies, D., Johnson, M., & Griffiths, R. (2010). A meta‐study of the essentials of quality
nursing documentation. International journal of nursing practice, 16(2), 112-124.
Masters, K. (2015). Role development in professional nursing practice. Jones & Bartlett
Publishers.
O'connor, E., Coates, H. M., Yardley, I. E., & Wu, A. W. (2010). Disclosure of patient safety
incidents: a comprehensive review. International Journal for Quality in Health
Care, 22(5), 371-379.
Sellman, D. (2011). Professional values and nursing. Medicine, Health Care and
Philosophy, 14(2), 203-208.