HLT54115 Diploma of Nursing: Legal and Ethical Case Study Analysis

This assignment presents four case studies focusing on legal and ethical issues encountered in nursing practice. Case study 1 explores the challenges of caring for an elderly couple, addressing issues of patient neglect, duty of care, and mandatory reporting. Case study 2 centers on an elderly patient's refusal of medical treatment, highlighting informed consent, patient advocacy, and the role of an interpreter. The assignment requires students to analyze each scenario, identify legal and ethical dilemmas, explain their duty of care, determine appropriate courses of action, and consider documentation requirements. The assessment emphasizes applying legal frameworks, ethical concepts, and supporting patient rights and needs. The student demonstrates understanding of professional nursing practice within the legal and ethical parameters. The document also provides a deep dive into the challenges faced by nurses in a variety of situations, including the importance of communication and patient autonomy.

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l壱Task No. 3Task TitleLegal and ethical case studies Unit / Module detailsQualification/Course CodeHLT54115 TitleDiploma of
NursingUnit/Module CodeHLTENN008 TitleApply legal and ethical parameters to nursing practiceAssessment detailsElements /
Learning outcomesFor successful completion of this assessment students must demonstrate the ability to:
.
壱Perform within scope of professional nursing practice
.壱Apply knowledge of the legal framework to nursing practice
.壱Apply ethical concepts to clinical practice
l壱Support the rights, interests and needs of the person and their familyTask overview
l壱(see below for specific instructions and criteria)This assessment consists of four case studies containing different legal
and ethical issues related to nursing practice. Each case study is followed by a series of short answer questions which
the student is required to answer.Assessment conditionsThis assessment will be completed in student’s own time or in
class as directed by the facilitator
l壱Students will complete this assessment individually
l壱The due date of this assessment is listed at the top of this page
l壱The student must complete their assessment using the templates providedResourcesLearning materials on
MyLearning
l壱Staunton, Patricia J & Chiarella, Mary, (author.) (2017). Law for nurses and midwives (8th edition). Chatswood, NSW
Elsevier Australia https://www.clinicalkey.com.au/nursing/#!/browse/book/3-s2.0-C20150018792
l壱Johnstone, Megan-Jane (2016). Bioethics: a nursing perspective (6e). Chatswood, NSW Elsevier.
https://www.clinicalkey.com.au/nursing/#!/browse/book/3-s2.0-C20150005615
l壱Keeping Children Safe in The Workplace - http://www.worksafe.vic.gov.au/pages/forms-and-publications/forms-and-
publications/keeping-children-safe-in-the-workplace
l壱NMBA Professional Codes and Guidelines - http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-
Statements.aspx
l壱Government Legislation and Regulations - http://www.austlii.edu.au/databases.html
l壱LaTrobe University APA referencing guide - http://www.lib.latrobe.edu.au/referencing-tool/apa-6/book#single-authorHow to
submitUpload a completed copy of this assessment document to MyLearning by the due date.
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Assessment instructions and criteriaWith competency based assessment all assessment requirements for each assessment task
must be assessed as satisfactory (S) for a competent (CA) result to be recorded. If an assessment result for any task is assessed
as not satisfactory (NS) a resubmission will be required for the outstanding (NS) assessment task.Instruction/TaskCriteria that
you will be assessed onSLegal and ethical case studies
Review each of the four case studies provided, and provide responses to the questions that follow.
See further details below.Your ability to:
.
壱Perform within scope of professional nursing practice
.壱Apply knowledge of the legal framework to nursing practice
.壱Apply ethical concepts to clinical practice
.
四Support the rights, interests and needs of the person and their family?
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Case study 1: Dr and Mrs Jones
An aged care health service provider you work for as a community nurse has received a request from Dr Jones, 80-years-old, for
support to maintain his 78-year-old wife, Mary, at home. Mary was diagnosed with Alzheimer’s disease 10 years ago.
Dr Jones is a former GP, who retired to care for his wife.
Along with the aged care health service provider’s social worker, you recently conducted a home visit to assess Mrs Jones and
discuss support options with Dr Jones. On arrival, you found the house was unclean and in disrepair. Both Dr and Mrs Jones were
unkempt and unclean.
Mr Jones is fully dependent on Dr Jones for all of her personal care needs. The assessment found she was emaciated,
malnourished, dehydrated and constipated. Mrs Jones’ skin was yellow and she also appeared lethargic and depressed.
Despite her obvious state of poor health and need for care and treatment, Dr Jones vehemently rejected any suggestion of
admission to hospital. He insisted his wife remain in his care at home. Dr Jones became agitated when you insisted that a
hospital admission was required.
Earlier in her life, Mrs Jones had devoted herself to Dr Jones and raised their six children almost single-handedly while her
husband worked in his GP practice. The social worker surmised that for Dr Jones to allow his wife to be cared for by others would
be an admission that he had failed as both a husband and a GP.
Dr Jones was also very thin and stated he lacked sleep because his wife was restless and wandered at night time. Further
discussion with Dr Jones revealed he had been prescribing medications for his wife and administering large doses of analgesics.
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1QuestionResponseIdentify the legal/ethical issues in this situation.Answer 1- There are the various
issues, legal and ethical while taking care of the adult patient of the Alzheimer’s.
Such the major issue is keep confidentiality of patient data so that they can be safe
at community. Then providing the effective intervention and care along with the
consideration of patient choice in care process (Vryonides, S. and et. al., (2018).
Justification and paternalism, where nurse have to provide the care by concerning it
to patient. Providing them soft and hard lying in order to help Mrs. Jones to
remember the good things and forget the bad things. Providing best and selective
evidence based practices or interventions.
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1Explain your duty of care and likely course of action as a nurse in this situation. In your response, explain your reasoning and
decision making process.Answer 2- As a community care nurse in the care support role of the Mrs Jones and Mr. Jones, in the
situation of unclean home and unhygienic condition of Mr and Mrs Jones, That is the responsibility of nurse to provide them
healthy environment with different course of action according to the legal criteria of care and environment management. Along
with the consideration of their personal needs, I should provide the clean and healthy health care environment by the help of
cleaning staff and as a nurse that is my responsibility to manage the patient hygiene , who's role is to provide the clean and
infection free investment to the patient and this action should be done due to the government policy of providing the infection
free care environment, that policy is NHS plan(DH 2000). Patient Environment Action Team inspections (PEAT) the health care
policy which providing cleaning standers in order to maintain the infection free environment, so their I will assure that cleaning
should be done according to the instructions of this policy (de Cordova, P. B. and et. al., (2019). Along with the environment
cleaning Mr and Mrs Jones will be clean with proper bathing and cleaning, because it is the role of nurses to analyse the
cleaning requirement and monitor the process of cleaning along with the quality. Such as nurses have to deal with the body
substances spillages and cleaning of that along with the wash bowl cleaning. So cleaning should be done on the routine basis by
cleaning staff and equipment’s and all this process should be done according to the requirement of patient. Explain whether
this situation could require mandatory reporting and why. Who would you need to disclose this situation to?Answer 3-
1 There is the need of mandatory reporting due to the unwell condition of Mrs
Jones and Mr. Jones is also not well so they have to be treated and diagnose at the
hospital by the help of senior authority's. So have to consider this with some of their
family members and doctors. I will first conduct some test and consider that with
doctors. Then is situation will be serious and require hospital care then this will be
consider with their children's so that we can provide the best care according to their
requirements. Describe the documentation that needs to be completed in this situation. What information needs to be
included in this documentation?Answer-4 there are the some documentation process which
should be done by the community care nurses in order to provide the best care with
legal rights and practices. That start from the assessment of the patient situation by
considering their past and present condition along with some medical tests. Then
planing for the evidence based practice's which can be effective for care. Net
documentation include implementation of the interventions and practice's for care.
Then final documentation is involving the data of care effects evaluation, this involve
the analysis and illustration of the improvement and control in patient situation
(Monteverde, S. (2017).
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Case study 2: Mrs Yiannopoulos
Mrs Yiannopolous is an 88-year-old Greek woman who has lived in Australia for over 50 years, however she only has basic
English skills. She has been hospitalised this week with anaemia, gastric pain, lower leg oedema and ascites. She had been
referred to the hospital by her GP.
Mrs Yiannopolous lives alone in a small unit in a country town and receives care in a day care centre for aged members of the
community. Her only close family member is her 68-year-old daughter, Maria, who lives in the same town. Mrs Yiannopolous
was admitted by a care worker from her day care facility.
The physician who reviewed Mrs Yiannopolous provided her with the following information:
“Your haemoglobin level six months ago was 12 and now it is only four. Your anaemia may be caused by bleeding in your
stomach, so a thorough examination is absolutely necessary. To confirm this, we’ll need to undergo a gastroscopy where a
camera is inserted down your throat, into your stomach. If your condition is not treated, serious problems might occur and the
consequences could be life threatening.”
Mrs Yiannopolous has refused to accept this advice and the treatment, saying she is too old and the thought of the gastric
camera terrifies her.
Later in the afternoon, Mrs Yiannopolous’ daughter Maria arrives at the hospital and speaks with her mother.
Maria meets with the care team, including yourself, and explains:
“I want to respect my mother’s decision. I knew that her legs and abdomen were swollen, but because of her age I didn’t want
her to be brought to hospital. My mother and I remember the terrible experience my father had at this hospital and she does
not want to be treated like that. I agree with her, and think she is making the right decision.”
1QuestionResponseIdentify the legal/ ethical issues in this situation. Ethical and legal issues to
manage and provide care to Mrs Yiannopolous is that physical condition should
be good in order to provide the particular treatment. Confidentiality has to be
their (Ågotnes, G.and et. al., (2019). Patient choice is can be a issues in terms of
providing care as that is the legal rules to provide particular treatment to
patient after getting their permission.Explain your duty of care and likely course of action as a nurse
in this situation. In your response, explain your reasoning and decision making process.Here the my role and
action as the nurse should be that, I should provide all necessary information
with medical and emotional care (Hoffmann, E. and Olsen, P.R., (2018). I have to
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manage that situation by following the doctors instructions and suggesting
them best option. Explain whether Mrs Yiannopolous is in a position to make an informed decision about her
treatment.
How could you advocate on behalf of Mrs Yiannopolous to help her with her decision around the proposed treatment?
Mrs Yiannopolous can take their own decision for medical care because she is
mentally fit and according to human right she can take their own decision. only
the mentally ill people who can heart the other can not take their own decision
according to metal health act.
1As per the legal rules of the legislation which support the people interest
and respect at the health care and nurse responsibility to support the patient
choice and welfare, I will advocate on behalf of Mrs Yiannopolous and support
her on her decision according to the standards of Government commissioned
Health Education England )(Shepherd, V. and et. al., (2018). Later that day, Mrs
Yiannopolous’ daughter, Maria, makes a complaint to you about her mother not being provided with an interpreter.
She tells you she wants her mother’s medical records so she can seek a second opinion elsewhere. Maria does not have
power of attorney for her mother.
How do you respond to this situation?AS a nurse I have to consider this situation with authority
and proceed according to the legislation and help her out with the right solution.
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Case study 3: Joey
You are a community health nurse who visits and case manages Joey, a 31-year-old man who lives with his parents in the
community.
Joey has a paranoid illness that became acute and caused him to act violently towards a local shopkeeper. Joey was arrested
and then taken to a local acute mental health unit and made an inpatient under mental health legislation.
His condition was stabilised and with the help of regular injections of anti-psychotic medication he was discharged. These
medications are administered by you in his home. In hospital the care team recommended Joey for discharge to a supported
accommodation unit run by a local charity. However, Joey’s choice was to return home and continue living with his parents,
who have taken on the role of his legal guardians. This was a significant sacrifice for his parents. They now rarely have breaks
from caring for Joey, and their friends feel awkward in Joey’s presence when visiting the home.
When you visit Joey, you often find him a bit non-communicative although his parents – with whom you have a good rapport –
say he is usually affable when he is alone with them.
As part of his aftercare plan, Joey agreed to continue to receive his scheduled injections. Recently though, he has refused an
injection you came over to administer. You know from his medical records that this is an indication that Joey is rapidly
becoming acutely paranoid again.
You ask Joey if you can advise his parents that he has not had his injection. You feel that in their role as Joey’s carers, his
parents need to know of his decision. Joey says he does not want his parents to know.
1QuestionResponseIdentify the legal/ ethical issues in this situation. In this case study legal and ethical
issues is related to the confidentiality management and discloser of the information. Lace of
the the mental health forensic information, Absconding behaviour of the patient who don't ready to
share their problem. psychiatrist attendance in the Court, Outcome of psychopathy (Johnstone, M. J.
(2019).Explain your duty of care and likely course of action as a nurse in this situation. In your response, explain your
reasoning and decision making process.As community care nurse I have to assess the Joey mental health, I
have to make the good communication with him, in order to build the strong relationship with patient
through which he can be mentally supported (Phillips, S. J. (2020). Provide the effective community
services and centre care by considering this with heath professional. Explain whether this situation could
require mandatory reporting and why. Who would you need to disclose this situation to? Yes there is the requirement of
mandatory reporting because this case is of mental illness and patient is not at the position to take their own decisions so this
has to firstly discuss with professional and then to their parents (Karami, A., Farokhzadian, J., & Foroughameri, G.
(2017) .Explain how you would approach obtaining consent from the relevant parties to provide Joey with his injection.I will try
to use the relevant support of health care professional and his parents so that he can be mentally and emotionally encourage to
take his injections.
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Case study 4: Tom
You are a nurse working in an oncology adolescent unit.
You have been providing nursing care for Tom, a 15-year-old boy, for the last six months. Tom is an only child, and his mother
and father have really struggled to come to terms with his cancer diagnosis. Tom’s mother has given up her job as a teacher to
care for Tom and support him through his treatment.
Tome went into hospital recently for a routine tonsillectomy and was found to have an oesophageal tumour. Further scans
revealed Tom had a secondary tumour in his stomach. Tom has undergone radical surgery resulting in short-term
tracheostomy, radiotherapy and chemotherapy. Tom underwent further scans at the end of his last chemotherapy cycle.
Yesterday, you sat in on a consultation with Tom and his family while his oncologist discussed his progress. It was revealed
that Tom has developed another tumour, in his small intestine. The oncologist proposed prompt radical treatment of further
surgery and chemotherapy. Tom’s parents were keen to start the treatment program as soon as possible. You noticed that
Tom looked uncomfortable during the discussion and did not add much to the conversation or decision-making process.
Later in your shift, you take the opportunity to talk to Tom by himself after his parents have left the ward. Tom informs you
that he doesn’t want any more surgery or chemotherapy. He tells you he just wants to get out of hospital and be a teenager as
long as he has time left to enjoy it. Tom states that he feels his mother was very pushy about getting the treatment, but he has
made up his mind. He wants you to help convince his parents and the doctor to honour his wishes.
1QuestionResponseIdentify the legal/ ethical issues in this situation.Ethical issues in that situations is that it is a children's care
case which has to be done on the basis of children's safety act. Then there is the requirement to provide the evidenced based
care along with consideration of patient interest and choice (Schroeder, D. and et. al., (2019). Explain your duty of care and
likely course of action as a nurse in this situation. In your response, explain your reasoning and decision making process.As nurse
I have to provide the holistic care to patient along with the medical care, social, emotional support. According to the medical
situation and guidelines I have to manage the situation of tom. Describe what you would say to Tom’s parents to advocate on
Tom’s behalf. There is need of advocacy which is regarding Tom which he wants to enjoy the life and as a consultant there is
knowledge that there in no long time for him. So, there is need to free him to do what he want to do last.
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REFERENCES
Books and journals
Vryonides, S. and et. al., (2018). Ethical climate and missed nursing care in cancer care
units. Nursing ethics, 25(6), 707-723.
de Cordova, P. B. and et. al., (2019). Effects of public reporting legislation of nurse staffing: A
trend analysis. Policy, Politics, & Nursing Practice, 20(2), 92-104.
Monteverde, S. (2017). Nursing and assisted dying: Understanding the sounds of silence.
Ågotnes, G.and et. al., (2019). An international mapping of medical care in nursing
homes. Health services insights, 12, 1178632918825083.
Hoffmann, E. and Olsen, P.R., 2018. Like an ace up the sleeve: an interview study of nurses’
experiences of the contact with relatives in a somatic emergency ward. Scandinavian
journal of caring sciences, 32(3), pp.1207-1214.
Shepherd, V. and et. al., (2018). Healthcare professionals’ understanding of the legislation
governing research involving adults lacking mental capacity in England and Wales: a
national survey. Journal of medical ethics, 44(9), 632-637.
Johnstone, M. J. (2019). Bioethics: a nursing perspective. Elsevier Health Sciences.
Phillips, S. J. (2020). 32nd Annual APRN Legislative Update: Improving access to high-quality,
safe, and effective healthcare. The Nurse Practitioner, 45(1), 28-55.
Karami, A., Farokhzadian, J., & Foroughameri, G. (2017). Nurses’ professional competency and
organizational commitment: Is it important for human resource management?. PloS
one, 12(11), e0187863.
Schroeder, D. and et. al., (2019). Equitable research partnerships: a global code of conduct to
counter ethics dumping (p. 122). Springer Nature.
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l壱Student detailsUnit/Module detailsUnit/Module CodeHLTENN008 TitleApply legal and ethical parameters to nursing practice
Task titleAssessment task 3: Case studiesAssessment feedback / comments Re-submission (where applicable) Unsatisfactory
tasks are to be re-submitted according to the details below. Type NA if not applicable.Task (or component of task) to be re-
submittedAdditional evidence requiredRe-Submission dateS???Result for this assessment taskYour final result for this unit
will be provided on the Unit Result Record at completion of all assessment tasksResultChoose an item.Assessor’s signatureDate
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