NNNS5806 IHM Essay: Ethical and Legal Issues in Nursing Practice

This essay delves into the ethical and legal dimensions of nursing practice, focusing on a case study involving a 70-year-old retired nurse, Mavis, in a surgical ward. It meticulously examines various ethical principles such as autonomy, beneficence, and freedom of expression, illustrating how nurses must balance patient rights with their responsibilities. The essay explores critical issues like medication adherence, communication and cultural competence, and respectful treatment, highlighting the importance of adhering to nursing codes of conduct. It emphasizes the significance of legal and ethical considerations in patient care, advocating for comprehensive patient assessment, documentation, and communication within the healthcare team to ensure patient safety and well-being.

Running head: NURSING CODES OF CONDUCT 1
Legal and Ethical Issues
Student’s name
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Introduction
The primary responsibilities of nurses are to encourage, advocate, and protect the health,
safety, rights, and wellbeing of the patients. Professional nurses have to conduct their duties with
high standards so that to ensure legal, ethical, and moral accountabilities in their professional.
Some of the significant components of nursing professionals are to make ethical and moral
judgments towards promoting wellbeing, considering the rights of the patients while taking care
of them. There is a need for all nurses to maintain high personal standards to protects and reflect
their careers and gain confidence from the public (Urden, Stacy, & Lough, 2019). This essay
involves an incident that occurred in the surgical ward while a nurse was taking care of the
patient called Mavis, who is a 70 years old retired nurse. A comprehensive revision of the new
ethical and legal codes of conduct according to the experiences of Mavis in the case study will
enhance the delivery of efficient and effective nursing skills. This will demonstrate the use of
standard nursing skills while accounting for the situation of Mavis in the case scenario. The
discussion and demonstration in this essay, according to the case scenario, will consider the use
of legal and ethical issues in the nursing practice (Hem, Gjerberg, Husum & Pedersen, 2018).
Description and Explanation of some of the legal and Ethical Issues
Monitoring and ensuring they Adhere to Medication
It is the responsibility of a nurse to ensure that the patient takes the medication as
prescribed by the doctor and at the right time, whether in the ward or home, according to where
the patient is being nursed at. Adherence to medication is among the legal issues that a nurse has
to maintain to ensure confidence in the treatment of patients (Lorem, Hem, & Molewijk, 2015).

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Non-adherence to medication is a critical concern that affects the services offered in the
healthcare centers. It is the responsibility of the nurse to monitor and ensure that the patient takes
all the medications as prescribed. This is because some patient refuses to take medicines with the
claims of the nasty taste, smell, and bitterness of the drugs. Some patients can even decide to
take overdose as a method of suicide, especially when they have mental problems or are stressed.
If a patient kills her/himself while in the hospital, a nurse can be accountable for the death and be
charged in the court according to the nursing code of conduct. This case of drug adherence
becomes difficult and cumbersome to nurses when dealing with patients with mental disorders.
Fisher’s studies (2017) shown that approximately 60% of the patient who fails to obey
doctors' medical prescriptions have mental disorders. The group of patients with more cases of
psychological issues is the old population, and the rate has increased from 50 to 70 percent. One
of the significant issues that they face is forgetting to take medication and the inability to
distinguish the dosage. Even though older people have difficulties in taking medicines due to
their mental issues, nurses and other healthcare practitioner have a considerable task of
differentiating drugs for older adults (Danzer & Rieger, 2016). Mavis is 70 years old, and she is
behaving in a manner that seems abnormal. When Mavis started displaying strange behaviors, it
is the responsibility of the nurse to review her medication without her consent to try and
determine the problem. The importance of reviewing her medicine is to confirm that she took the
correct drugs because the wrong medication could alter her behavior (Stevenson, Jack, O'Mara &
LeGris, 2015).
Autonomy Right

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The midwifery and nursing code of conduct suggested that the deontology of the duties of
a nurse in safeguarding, promoting, and provision of the quality services to ensure the wellbeing
of the patient. A nurse taking care of Mavis has to involve his family members of her behavior
and the changes of her signs and symptoms to enable him/she offer the best health services
without breaching the patient’s right (Ihalainen‐Tamlander et al, 2016). There are some
instances where nurses are forced to violate the right of patient’s independence to promote their
wellbeing, like when Mavis starts showing unethical characters of smearing feaces at her
wounded parts publically. A nurse has to take the responsibility of even using force and call for
help from other nearby supporting staff to assist in protecting the privates’ parts and portray of
unethical behavior within the healthcare center (Fisher, 2017).
Beneficence principle
This is an ethical principle which a nurse applies to ensure the roles of offering the
beneficial and advantageous codes of action to avoid some immediate patient's risks. Guiding
and encouraging her to go to the bathroom to attend her hygiene while helping her is a
demonstration of the legal and ethical codes of a nurse in ensuring the safety and wellbeing of
the patient (Konrad, & Müller, 2015).
Freedom of Expression
The freedom of expression is a fundamental right of every citizen, and a nurse has to
maintain it as it is an ethical principle of respect. According to the council of nursing and
midwifery, it is stated in the council’s code of action that a professional nurse should utilize legal
and ethical roles to ensure respect for the patient's decision. A nurse can suffer the consequences
of breaching the law if he/she acts against the right of freedom of expression of a patient even if

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he/she shows some signs of unusual characters. As in the case study Mavis had started acting
strangely, and when the nurse tries to stop her she yells "go away." It is her right to act that way,
but after noticing some mental problems, as a nurse, one has to apply the contemporary nursing
skills and act in a manner that portrays nursing and professional codes of conduct (Norvoll, &
Pedersen, 2016).
Since Mavis is not ready to bathe, it is the responsibility of a nurse to encourage and use
any possible way, but according to the nursing codes of conduct to help Mavis to bathe. As a
nurse in such a situation, it is advisable to report the matter to the healthcare manager or the
shifting coordinator for more help. Consulting with the correct parties is a necessary action to
account for the wishes of the patient and to come up with the most appropriate decision while
taking care of an older adult with mental disabilities. Making decision with the consent of the
patient and with proper consultation from the right practitioners are a more ethical and legal
issue in the society than making independent decisions (Beaupert, 2018). This is demonstrated
the case study where the nurse decided to review Mavis’s medication while sorting the issue and
had thought of informing the matter to the shift coordinator.
Communication and cultural competence
Communication is the most appropriate way of interacting with the patients, and the best
method a nurse can use to gather information from the patient. A nurse, especially when dealing
with mentally ill clients, should sharpen his/her skills of communication to understand the
client's needs. A caregiver should ensure that his/her conversation is complete, simple, accurate,
and timely to the patient's attention so that to capture the fast-hand information (Aydin Er, &
Ersoy, 2017). Communication between the patient and the healthcare practitioner determines the

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safety and quality of the care delivered to the patient. Improper conversation and understanding
of each other may lead to errors such as dosage errors, injuries, risk of contracting diseases, and
even death. However, communication depends on the cultural background of both the healthcare
practitioner and the patient. If the patient and the nurse come from different backgrounds or
tribes with different languages, It can lead to problems associated with language barriers
(Betancourt et al, 2016).
Since the cultural background in the health services delivery is very important, the
registered nurse has to utilize the skills of cultural competence in handling patients from different
cultural backgrounds. The language barrier can lead to critical issues such as misunderstanding,
which may bring conflicts, distortion of the information, and medication mistakes that may harm
the clients. This case of cultural differences and communication should be handled with a lot of
seriousness within the healthcare center to avoid violation of the patient's rights and for the
preservation of the nursing codes of conduct. These incidences are vital in departments of
patients with mental problems, especially older adults (Brown et al, 2016).
Some of the older adults are arrogant and may completely refuse to converse using a
common and understandable language. This is because older people develop some mental issues
as they grow older. In this case, Mavis showed some of these problems and required a nurse who
understands her language very well. Mavis's nurse seems to understand her language, and he/she
was able to address Mavis accordingly. Mavis's mental issues made her not comply with the
nurse's instructions as she was insisting on her commands to go home while undressing her
surgical wounds. These were some of the signs which show that she had some mental
complications. For a nurse to act legally and ethically, it is essential to explain Mavis's issue to
the manager or the coordinator or the doctor, and if the nurse does use the same language with

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Mavis should report the immediately after handover from the previous nurse (Koester & Lustig,
2015).
Respectful Treatment
According to the European Convention on Human Rights, each patient is accorded to get
quality and respectful treatment. Respectful treatment includes; proper documentation of the
patient records and disease information, quality medicine, patient’s privacy of information, and
quality and safe nursing care. The case shows that the nurse was applying his/her skills to the
best of her knowledge by trying to pre=vent Mavis, to get out the surgical ward while removing
the dressing on her wound site and smearing feaces on her surgical wound. Mavis also pulled out
the IV cannula, which led to bleeding on the insertion site. She was doing all this while at the
visitor's room. Closing the door and covering her to hide her private part is a proper exercise of
ethical and codes of conduct. It is unethical to allow the patients, whether mentally ill or not, to
expose his/her private parts public under the influence of medication while in the hospital. This
portrays a bad picture of both the nurse and the healthcare sector, and may lead a nurse into
prosecution due to breaching of patient’s rights (Alizadeh, & Chavan, 2016).
Patients' information should be protected and should be issued only when the clients ask
for it. It the responsibility of the nurse to keep the patients' information private and confidential
as well as recording the information inappropriate manner. Proper recording of the patient is the
best and legal way of ensuring the quality and respectful treatments. It creates a clear, accurate,
and consistence approach to guide the doctor and other healthcare providers an efficient and
effective progression of the disease (Molewijk, Hem & Pedersen, 2015).

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The clinical recording should be comprehensive, concise, clear, and transparent to all the
healthcare providers involved. In the case of Mavis, there is a need for proper investigation due
to the sudden change of her behavior, which should include all the healthcare providers who
have been involved in taking care of her. Since the beginning of her illness. After the case, legal
action will be taken on the healthcare practitioner once proven guilty according to the legal acts
of the healthcare services. An investigation should be conducted on her medication, too, and her
family members should be involved in the case to determine where there was any case of mental
disorders from both her medical and family history (Scholten et al, 2017).
Conclusion
This essay has demonstrated the roles of nurses in accordance with the legal, ethical, and
nursing codes of conduct. It has been elaborated that a registered nurse does not have an easy
job, especially when dealing with a patient who has mental problems. The nurse requires to have
a broad knowledge of legal and ethical principles to enable them to deliver the safe and quality
nursing intervention to their clients. Nurses are described, and the moral and mirror of the
healthcare sector. Handling complicated cases like Mavis's case requires a nurse with competent
skills so that to avoid misleading or errors, which may cause harm to clients in the future.
Compliance with the legal and ethical procedures and understanding of the codes of conduct of
the nursing and midwifery council gives a nurse the competent skills to handle such complicated
issues as those on the case study.

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