CNA153 Healthcare Assignment: Ethico-Legal Analysis of a Case Study

This report presents a reflection on a healthcare scenario encountered during a nursing student's clinical placement in an urban hospital. The student experienced a situation involving a registered nurse's violation of safe practice guidelines concerning sharps disposal, leading to a needle-stick injury. The report uses Driscoll's reflective framework to analyze the events, addressing the 'What?,' 'So what?,' and 'Now what?' aspects of the experience. The analysis highlights ethical and professional code of conduct violations, including the RN's negligence, lack of duty of care, and failure to uphold patient and student safety. The student reflects on the importance of ethical principles, effective communication, and the need to address unethical practices to improve future clinical experiences and patient care. The report emphasizes the critical role of experienced nurses in guiding and supporting new nursing professionals and the significance of adhering to ethical guidelines, such as the Health Practitioner Regulation National Law (WA) Act 2010, to ensure high-quality patient care. The student concludes that the experience reinforces the importance of speaking up against unethical practices and the need for continuous improvement in nursing education and practice.

Running head: HEALTHCARE ASSIGNMENT
HEALTHCARE ASSIGNMENT
Name of the student
Name of the university
Author note

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Nursing profession is termed as one of the noblest profession in the world as it deals
with the compassionate care and wellbeing of the patients (Kangasniemi, Pakkanen and
Korhonen 2015). While caring for patients, there are multiple rules and regulations that the
nursing professionals are required to abide by so that the care process becomes effective and
comply with the ethical principles of healthcare process (Milliken and Grace 2017). These
factors are known as the ethico-legal aspects which are implemented in the healthcare facilities
so that every nursing professional could abide by the rules and perform their jobs effectively
(Clark 2017). However, there are multiple aspects which are violated while practicing in the
healthcare facility due to the lack of knowledge, negligence or improper duty of care. In this
paper, discussion about one such case study would be conducted and with the help of one
Driscoll’s reflective framework the important incidences happened in the case scenario would be
assessed and analyzed.
What?
During my professional experience placement, I experienced this case situation which
questioned the implementation and compliance to the healthcare aspects due to which the safety
and security of patients as well as nursing professional were affected. During my professional
experience placement in an urban hospital I was provided with few tutorials that deals with
proper usage and handling of sharps in the healthcare process and it was also mentioned that
after using the sharp injury associated instruments, I was supposed to place the needles in kidney
plate, in spite of re capping it. This was associated with the safe and secure disposal of sharp
injury associated materials so that several blood borne related infections could be prevented.

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However, the registered nurse under whom I was asked to commence my professional
experience placement asked me to provide one of the patients with insulin dosage and in the
process I became very nervous as the RN seemed very strict. However, while providing the
patient with insulin dosage, I found that I have forgotten to bring the kidney plate and if I
provide the patient with dosage, I would not be able to throw it anywhere. However, after I
provided the patient with insulin, my RN saw me standing still and asked me to recap it. Upon
rejecting her order two times, she started shouting at me and this nervousness and distress caused
me to puncture my right thumb and with that she also commented several personal comments
due to which I was affected. This is the complete scenario that happened in the clinical
experience.
So what
While working in the healthcare facility, there are multiple ethical and professional code
of conduct that every nursing professional should abide by and complied with for sound and
proper conduction of care process. These professional codes of conducts asks nursing
professionals to be logical, effective and clear with their communication skills, their clinical
knowledge and should be able to uphold the values of nursing profession to increase the trust and
belief of the common service users. This was completely violated by the registered nursing
professional in the given case study and the process that she implemented while communicating
or guiding me was very confusing and harsh. She was completely negligent with the fact that
reuse of cap, or recapping the cap would be dangerous for me as I might face a sharp injury at
any point of time and I did face a sharp injury. Hence, this is the aspect which indicates towards
her improper duty of care and her negligence. Further, it also questions the tutorials or guidance
that was provided to me at the time of the commencement of the clinical program and hence I

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started doubting that authenticity and usability of it. With that it also affects the patients and
breaks their trust that the usage of broken needles and reused needles could also affect their
health and increases their risk of infection. Further she also was not at all compassionate to her
care process as after I faced my clinical injury, she started commenting about me harshly, that
indicates towards her inability to comply with the professional code of conducts.
Further I also came to know that the RN is violating the code of ethics and most
specifically, she violated beneficence related ethical code of care as per which nursing
professionals should not commit any action that can affect any person or harm any person.
Hence, she was not at all complying with the nursing code of ethics as she asked me to perform
tasks which could lead me to suffer from blood borne injuries. This could be a reason of serious
ethical dilemmas within the healthcare facility as I and the registered nurse were both aware of
the nursing ethical codes and codes of professionals. However, she was not letting me follow
these rules and regulations due to which the patient as well as my safety and security was
hampered in the clinical scenario and hence, she made me disobey my ethics of autonomy
and utilitarianism (Huang et al. 2016). As per Maier (2015), the ethics of utilitarianism is
the moral actions that the person’s personal morality or ethics allow him to do and due to
this nobody is harmed. Further, it was also mentioned that autonomy is the ethical right as
per which, any responsible person is free to take steps which would help to improve the
process and would not harm any person in the process. The action of RN did not allow me
to follow both of these ethical as pects as I did not want to recap the needle and without my
will, I recapped it and in the process involved in sharp injury, increasing the risk of blood
borne infection. Hence, both of my ethical rights such as autonomy and utilitarianism were
violated respectively. Therefore, it is important for every nurse to abide by these regulations so

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that the healthcare facility could be balanced and the chances of ethical complication could be
removed. Further, in this aspect, the role of older and experienced nurses becomes critical as they
would be able to lead the student and new registered nursing professional so make the care
process effective and impactful for the next generation. Further this would lead the new
registered nurse to act as per their defined roles that is according to the code of ethics.
It is important for the nursing professionals to be aware of the ethical principles and
professional code of conducts so that they could understand the implication of it and then with
the help of healthcare professional they understand the fact that they could be able to provide
effective and better service to the people. Hence, healthcare management and planning would be
beneficial if all these aspects are known by the nursing professional. Therefore the mission of
nursing professional should be to comply with the regulations such as the Health Practitioner
Regulation National Law (WA) Act 2010 so that with ethical and professional code of practice,
they could provide the patients with improved and high quality care and in the process could
implement aspects that could help in the upliftment of the community and provide holistic care
to the patients (Coenen et al. 2017). As per Maier (2015), ethics are also associated with nursing
professionals moral behaviour with their fellow nursing professionals so that while providing
care to the patient they could maintain harmony and teamwork among each other. This was also
affected in this case scenario as the registered nurse was using improper names and this affected
my abilities as a nursing professional. Therefore, it is discussed that application of ethical and
moral principles would be an effective process so that while providing care to the patients, they
could understand the implication of it; however positive patient experience becomes more
critical during this timeline (Scanlon et al. 2016). Hence, the nursing professionals should show
high level of clinical competence so that while providing care to the patients they could

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effectively maintain the clinical professional codes and duty of care. Further the healthcare
organisations should monitor various patient experiences in order to evaluate and also to improve
the quality of care (Gadbois et al. 2015). Therefore to maintain and evaluate the different factors
of nursing practice that occurred to me in the clinical scenario, I was able to understand that the
practice that the registered nursing professional practiced in the clinical scenario should have
been modified or changed so that the future nursing students could attain a better and develop
experience for their professional placement (Huang et al. 2016).
Now what
Hence, ultimately it should be considered that all the positive or negative experience that
I collected from my clinical practice placement would remain an important lesion in my nursing
career. This experience helped me to understand the important of the nursing ethical codes and
professional codes that I learned in my theoretical papers and the importance of communication
due to which I ended up having a sharp injury in my clinical placement (Aitamaa et al. 2016). I
was also able to understand that effective communication is important within nursing
professionals as well as with the patients so that the nurses who are working in the hospital could
work in a stress free and relieved environment and hence could provide holistic care to the
patients (Huang et al. 2016). Further, I was able to identify the loopholes in the practice as I
found one of the experience nursing professional to disobey the safe practice related regulations
and the way she becomes responsible for my sharp injury indicates towards her lack of duty of
care and negligence towards professional code of conduct (Kangasniemi, Pakkanen and
Korhonen 2015). Finally, I was also able to understand that as nursing professional, it is
important to voice against the unethical practices and aspects so that future practices could be
corrected and the medical errors could be reduced.

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References
Aitamaa, E., Leino-Kilpi, H., Iltanen, S. and Suhonen, R., 2016. Ethical problems in nursing
management: the views of nurse managers. Nursing ethics, 23(6), pp.646-658.
Clark, C.M., 2017. An evidence-based approach to integrate civility, professionalism, and ethical
practice into nursing curricula. Nurse educator, 42(3), pp.120-126.
Coenen, P., Gilson, N., Healy, G.N., Dunstan, D.W. and Straker, L.M., 2017. A qualitative
review of existing national and international occupational safety and health policies relating to
occupational sedentary behaviour. Applied ergonomics, 60, pp.320-333.
Gadbois, E.A., Miller, E.A., Tyler, D. and Intrator, O., 2015. Trends in state regulation of nurse
practitioners and physician assistants, 2001 to 2010. Medical Care Research and Review, 72(2),
pp.200-219.
Huang, F.F., Yang, Q., Zhang, J., Khoshnood, K. and Zhang, J.P., 2016. Chinese nurses’
perceived barriers and facilitators of ethical sensitivity. Nursing ethics, 23(5), pp.507-522.
Kangasniemi, M., Pakkanen, P. and Korhonen, A., 2015. Professional ethics in nursing: an
integrative review. Journal of advanced nursing, 71(8), pp.1744-1757.
Maier, C.B., 2015. The role of governance in implementing task-shifting from physicians to
nurses in advanced roles in Europe, US, Canada, New Zealand and Australia. Health
Policy, 119(12), pp.1627-1635.
Milliken, A. and Grace, P., 2017. Nurse ethical awareness: Understanding the nature of everyday
practice. Nursing ethics, 24(5), pp.517-524.

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Scanlon, A., Cashin, A., Bryce, J., Kelly, J.G. and Buckely, T., 2016. The complexities of
defining nurse practitioner scope of practice in the Australian context. Collegian, 23(1), pp.129-
142.