Legal Issues in Nursing: A Case Study of Ally at Lakewood Drive

This case study examines the legal and professional issues arising from the medical intervention of Ally, a 17-year-old patient at Lakewood Drive Medical Centre. The analysis focuses on three key legal issues: the legal issue of duty, the legal implications of social media use, and age consent. The case highlights breaches in the duty of care, including failures in patient monitoring, communication, and documentation by the nurse, Sharon. It discusses the importance of accurate and timely communication of patient health changes and the impact of inadequate documentation. The case also explores the legal ramifications of using social media to discuss patient information, specifically violations of patient confidentiality and HIPAA regulations. The essay emphasizes the need for secure communication platforms in healthcare. Additionally, the case touches upon the issue of age consent regarding medical procedures, particularly in relation to blood transfusions, highlighting the importance of patient autonomy and informed consent. The essay concludes by emphasizing the significance of adherence to professional standards and the potential legal consequences of non-compliance.

Running head: LEGAL AND PROFESSIONAL ISSUES IN NURSING 1
Legal and professional issues in nursing
Student’s name
Professor’s name
Institutional Affiliation
Date

LEGAL AND PROFESSIONAL ISSUES IN NURSING 2
Introduction
Health professionals are focused on collaborating and promoting the wellbeing of the
patients (Flo et al,2016). The collaboration involves a wide scope of health practitioners, or inter-
professional with multiple members of the healthcare professionals in delivering quality
healthcare across or within a setting. Legal and professional considerations should be understood
by the nurses to assist them in recognizing instances of the needs of the patients while making
decisions (Matt, 2012).
The legal issues have a key role in health decision making. For instance, the legal right
allows the patient to make individual health care decisions (Andrew et al, 2014). Although
unsuitable healthcare might jeopardize the ability of these patients to excising their legal rights,
proper planning, and thinking critically is essential in safeguarding the rights of the patients.
Certain illnesses or conditions can result in confusion and weaknesses, which creates difficulties
and could lead to unconsciousness (Aliakbari, Hammad, Bahrami & Aein, 2015). Making
personal health wishes known, and carrying out individual affairs can be difficult for individuals
to a certain category of age. However, adults of any age can protect their own lives and those of
their siblings from getting out of control.
The advanced directives of healthcare should reflect a discussion between the patients and
individuals who are close to the patient. The directives should incorporate the preferences
discussed. However, the directives might differ from one state to another, but approximately, 50
states allow the wishes of the patient concerning their decision in medication (Smith, Klaassen,
Zimmerman & Cheng, 2013). For example, several states in the United States allow the patient
to appoint individuals who can communicate on their behalf in case they are incapacitated.

LEGAL AND PROFESSIONAL ISSUES IN NURSING 3
The implications of legal issues of nursing operations are linked to federal licensure, state
law, public expectations require every nurse to practice a high professional level. The set
standards, health institutions, and licensing bodies offer a directive framework that every nurse is
expected to practice. Failure to adhere to the set standards can get a nurse exposed to litigation if
he or she fails to meet the accepted competence and standards (Leufer & Cleary-Holdforth,
2013).
Barry & Hardiker (2012) suggest that litigation can be applied based on failure to exercise the
acceptable standards of healthcare, professional negligence, and malpractice. The act of
commission and omission can as well contribute to the review of license and litigation, thus
resulting in loss of nurse’s license or reprimand. Medical intervention should, therefore, be
provided in the interest of the patient. The main objective of this essay is to identify and discuss
the three legal issues in the health case study of Ally’s medical intervention at Lakewood Drive
Medical Centre. These legal issues include the legal issue of duty, legal issue of social media,
and the age consent as discussed below.
The legal issue of duty
The legal issue of duty is one of the easiest aspects to prove for registered nurses who practice in
hospital set-ups. Under the common laws principle, wrong act of 1958, the nurses must conduct
their duties reasonably to prevent the patients from foreseeable damages. A registered nurse can
therefore, be charged due to recklessness. All that is required is to prove the existence of a
relationship between the patient and health professionals at the period of medical interventions
(Kumar, Gokhale & Mathur, 2013). This kind of link exists merely when the patient is on the
unit regardless of whether the patient is assigned with one or more nurses. Bleaching of duties

LEGAL AND PROFESSIONAL ISSUES IN NURSING 4
can be regarded as a failure in adhering to the health standards set by the nursing professionals.
Evidence of bleaching duty can be presented to a jury that includes circumstantial proves and
testimonies by the patient. The legal laws that can be applied in such instances are when the
defendant is responsible for the injuries that occurred due to the negligence of duties.
The healthcare standards have been established to protect the patients from substandard
caring (Rai, Acharya & Dave, 2013). The legal issue of duty has been designed in a manner that
ensures reasonable and ordinary care is adhered to protect the client from any damage. One of
the negligence experienced in the case of Ally is the failure in accessing, monitoring, and
ignoring to communicate. Sharon had realized that the observations for Ally were behind
schedule. She immediately took her pulse and noted that it was slightly tachycardic. The level of
Ally’s pulse was 108, and some tachypnoea were as well noted, but Sharon could not chart the
observations. Ally’s abdominal pain had increased to 7/10, and the blood pressure had also
decreased to 90/50 when compared with the period of admission. Ally had also indicated that she
had a slight light-headed, but Sharon ignored and suggested that it could be a result of bowel
preparation and fasting.
Sharon failed to realize that the health conditions of the patient could be sudden or
gradual, and as a nurse, she should be the first person to identify them and communicate.
According to (Peirce& Smith, 2013), the accuracy of a nurse in monitoring and accessing and
communicating the health changes of a patient can make a big difference between his or her
death and life. The key elements of communication include observing and reporting the health
transformations to the relevant physician.
Secondly, Sharon failed to document the observed health changes of Ally. Nykanen,
Kaipio & Kuusisto (2012) documentation serves a key purpose in communicating the patient’s

LEGAL AND PROFESSIONAL ISSUES IN NURSING 5
information to the next nurse on the shift and other healthcare providers. The documented
information should, therefore, be accurate and reflecting the diagnosis, the planned intervention
and the response of the patient. Such documentation is essential for the quality, evidence-based
and safety practices of the nurse (Moss & Forman, 2015). Documenting Ally’s health condition
was vital for the administration and the registered nurse since they are responsible for nursing
documentation.
The chart document which Sharon failed to prepare could play a vital role in sharing the
information with Jane and forward the same information to other medical professionals. Other
groups that could get assistance from the same document is the organization’s management and
the research team (Dowie, 2017). The issue of Ally concerning the blood transfusion was never
recorded on the consent form but only the biopsy and colonoscopy. However, the information
was recorded in the notebook instead of recording in the consent form.
The chart document was to help registered nurse Jane in sharing the medical information
about Ally with the organization. RN Jane shared the information when she noted an increase in
pain score and abdominal distension. Ally’s vital signs by then had deteriorated, and
immediately, she told the doctor and initiated a medical emergency team with regards to NSQHS
standard 9.
The use of social media related to legal issues
The application of social media, like Twitter, Facebook, and YouTube, are growing every day
where Facebook alone has more than 800 million subscribers (Naslund, Aschbrenner, Marsch &
Bartels, 2016). The relationship between healthcare and social media can be characterized by the
sharing of information and searching health-related data. The use of social media can be
governed by the privacy act derived from information privacy act of 2000 one of the Victoria

LEGAL AND PROFESSIONAL ISSUES IN NURSING 6
acts. Privacy act requires the RN nurse to disclose patient’s health data for the key purpose
which it was recorded. A large number of individuals are using online platforms to connect with
medical experts, individuals with medical experiences, asking health-related questions and
understanding diagnosis procedures. According to (Grajales, Sheps, Ho, Novak & Eysenbach,
2014) approximately, 74% of individuals utilize social media in seeking medical advice in the
United States. Many of these individuals mainly use Facebook in building their business
organization and increasing its visibility.
The main business which has been greatly affected by the wave of social media is the
health sector (Househ, Borycki & Kushniruk, 2014). However, the key issue of concern within
the healthcare sector is how to engage using them. Integrating social media in health
organizations is one of the issues which has constantly affected the patients, nurses, and doctors
(Spence, Lachlan, Westerman & Spates, 2013). Therefore, social media regulatory institutions
should come in to counter such an impact. One of these institutions is the Health Insurance
Portability and Accountability (HIPAA) which plays a key part within the realm of social
platforms. The regulatory body should pose an alarm to all medical personalities on how risk ii is
to friend or expose a patient on social media platforms. Nurses and other medical professionals
should take a step back and comprehend with the basis of Health Insurance Portability and
Accountability. The Health Insurance Portability and Accountability is all about standardization
and portability of the sharing information to protect the security and privacy of the users. More
focus on Health Insurance Portability and Accountability is on fear of discussing private, and
confidential issues of individuals like patients.
According to (Courtney, 2013), the fundamentals of PHI (personal health information)
states that health status belongs to the patient despite their establishment by the health

LEGAL AND PROFESSIONAL ISSUES IN NURSING 7
professionals. The individual has the ultimate right concerning the platforms where his or her
health status is shared. In many cases, healthcare professionals are the custodians of personal
health information and have the privilege of protecting their relationship with their clients. Such
kind of relationship can only be created through interactions (Ventola, 2014). The relationship
arises by the fact that a particular point of care never offers health services; thus, a system of
medications is involved. The medication system overwhelms the primary care, physician,
hospital, laboratories, and specialists; thus, sharing of patient’s information can be critical.
Protecting the confidentiality, security, and privacy of PHI (personal health information) is one
of the key focus of federal policies. The federal policies only allow the involved healthcare
parties to participate in accessing and sharing confidential information of the patient.
The sharing of information electronically between patients and doctors is a trending
issue; hence, the need for secure social media marketers need to be put into place. Securing the
messages as one of the stand-alone tools of relaying health information. The security of such
information can be enhanced by linking the information with HER-PHR which is a practice
fusion and patient fusion trending in the market.
Therefore, social media like Facebook can be good in the engagement between patients
and their doctors. However, Facebook pages can sometimes be inappropriate places for
engagement, especially Facebook friends. When the basis of health matters is exposed to other
people in the media, rather than social-friendship or family members, it’s not a wise opinion.
Health professionals are, therefore, encouraged to engage in more secure platforms (like secure
web messaging platforms and combined EHR-PHR tool) while conducting the health
consultations. Posting the health status of patients on Facebook, as witnessed in the case of
Lakewood Drive Medical Centre, can be termed as Health Insurance Portability and

LEGAL AND PROFESSIONAL ISSUES IN NURSING 8
Accountability violation. Sharon should act as the custodian of Ally’s health information and
shouldn’t disclose it in that manner since such exposure comes with a lot of implications.
Several implications can be attributed to social media-related legal issues. The social
media related legal issues involve the patient-physician in sharing very sensitive information
comprising the questioning, direct contact with the patient as well as discussing the treatment
options. Information on medications, making appointments or disease can also be discussed on
social media, although this form of communication is attributed to privacy, trust, and
confidentiality. Nevertheless, Sharon fails to adhere to these attributes and posted in the social
media her reflection of her day and sarcastically thanked both Ally and Mr. Jones. Sharon
thanked Mr. Jones for giving her a miserable shift and Ally as a failure to withstand the
abdominal pain after simple colonoscopy procedures.
That information was expected to be Confidential within Ally’s records, inaccessible as
protected by the law. Badzek, Henaghan, Turner & Monsen (2013), with the establishment of
technologies, monitoring and sharing of information in the healthcare centers, have started to be
shared on social platforms. The sharing of data includes exposing the medical results, health
status and other information regarding the medical personnel. Distributing information can,
therefore, be compared with social media becoming icebreakers due to conflicts that arise with
several ethical issues (Webb, Welsh & Whiting, 2013). Social media related legal issues also
result when the technology impacts the security and data privacy. Guidelines following patient-
health, professional communication advices the sharing of information through the website to
protect consent, confidentiality, and privacy of the patient (Valiee, Peyrovi & Nikbakht
Nasrabadi, 2014).

LEGAL AND PROFESSIONAL ISSUES IN NURSING 9
The HIPAA (Health Insurance Portability and Accountability) has a set of standards that
regulates health information with respect to the patient’s privacy (McGraw, 2013). Regarding the
privacy of the patient, the rule governs Ally’s demographic information, her past, her provision
to healthcare, present, and the future provision of her care. Hence, according to Health Insurance
Portability and Accountability, Sharon was not allowed to post Ally’s health conditions as a
reflection on social media. For instance, about her whining, about her abdominal pain, and after
going through a colonoscopy procedure.
Based on Health Insurance Portability and Accountability regulations and rules, there an
extensive violation of Health Insurance Portability and Accountability by Lakewood Drive
Medical Centre. Sharon has an unsuitable character that calls for a formal investigation as well as
suspending her duties. Sharon violated HIPAA by posting Ally’s health information on
Facebook. Concerning the social media legal issues, a nurse is subjected to fine when he or she
discloses the identifiable information of the patient (Huang, Sun & Lien, 2015).
In addition, Sharon violated the code of conduct for nurses by disrespecting the rights of
Ally to privacy and confidentiality. She went against the provision 1 code of conduct set with
regards to nursing and midwifery (Karasz, Eiden & Bogan,2013). According to the nursing and
midwifery council code of conduct, Sharon is required to practice professional relationships with
patients, treat them with inherent dignity, and value their uniqueness. She also violated provision
1 and section 1 which regards respecting the dignity of a patient and also ignoring the roles of the
nurses in protecting, advocating safety, rights, and health of the patient.
Regarding the confidentiality, Sharon dishonored sharing the information regarding Mr.
Jones and Ally on Facebook without their Knowledge. The nurse in this Ally’s case violated both

LEGAL AND PROFESSIONAL ISSUES IN NURSING 10
the Health Insurance Portability and Accountability and code of action with respect to the
America Nursing Association.
It’s very clear that social media requires monitoring by the health professional and
nurses. Sharing of any impropriety regarding patient’s confidentiality and privacy on social
media might become a big legal issue globally. What individuals view as a minute problem could
turn into a bigger issue that will call for legal investigations, implications and civil lawsuits in
the future. For this reason, nurses must consider the patient’s privacy before posting or sharing
anything concerning their clients on Facebook or any other media platform.
The legal issue of Age Consent
Health practitioners should act as per the law. According to the Health Practitioners regulation
national law act 2009, Rn nurses are required to comply with the guidelines, standards and health
policies. The national law act 2009 allows the situational or conditions which clients or patients
can make personal decisions concerning their health care. For instance, filling the consent form
is one of the processes within healthcare professions (Henry & Powell, 2015). A piece of correct
and truthful information regarding the patient’s treatment to allow the health systems to make
health decisions is made with no fraud or convictions (Coleman & Rosoff, 2013). Age consent is
one of the ways that allows nurses and doctors to exercise respect, legal and moral rights to their
clients. The consent provides the patient with freedom and independence to choose what he or
she wants. According to the Royal College of nursing, it’s an important practice that allows the
patient to access critical information that concerns their rights (Grady, 2015). Such information
should be availed in an essay and simple to comprehend as well as making it more honest and
correct. Consent should incorporate the patient in decision making with no guidance and

LEGAL AND PROFESSIONAL ISSUES IN NURSING 11
pressure from friends, family members or health professionals. It is legal in seeking appropriate
consent before the start of any medication or offering any crucial healthcare to the patient.
Regarding (Reamer, 2013) seeking the legal authority allow the medical practitioner to
show the right respect which is one of the key fundamentals in health care practices. Any
healthcare individuals who fail to offer respect to the patient regardless of their age can be liable
to both the professional legal authorities and the patient. The health organization is as should be
held accountable in case they fail to take legal action for their employees.
The Nursing and Midwifery Council instructs the nurses to advocate for the rights of their
patients by completely involving them in decision making. It is critical to give patients sufficient
information to allow them a room of accepting or refusing their treatment procedures. Mostert,
Bredenoord, Biesaart & van, (2016) health caregivers must support and respect consent before
treating the patient. If a patient feels his or her rights of consent have not been adequately met, he
or she can lodge aa complain to the Nursing and Midwifery Council or take any other legal
action. The basis of many legal actions is negligence because nurses should make sure they share
health information.
Providing health care for adolescents’ individuals poses a big challenge to health care
professionals. These challenges include; legal issues, consent, and confidentiality. The age
consent legal is very clear for individuals of above 18 years and children. Although the age
consent of individuals might vary from one state to another, every country has legal health laws
which regulate the instances in which adolescent individuals can consent their healthcare, and the
consent remains confidential. During the admission of Ally, the consent formed was signed and
checked as part of the medication procedures. Later, Ally says she was not ready for blood

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transfusion from other individuals. Sharon records the consent made by Ally on the notebook
without involving the parent since she was 17 years old.
The age consent for adolescent individuals to treatment can only be defined by the state laws,
and a certain age can vary with respect to certain health requirements (Whang, Baker, Patel, Luk
& Castro, 2013). For instance, in Lakewood Drive Medical Centre, Ally was allowed to give
consent when she was returned to the theatre for the second time in the absence of her parents.
The decision was made after the emergence of a complication where she had partial colectomy
due to her perforated colon. Ally’s father could not be contacted; thus, Ally provided written and
verbal consent once her doctors explained the situation.
However, individuals with less than 18 years might be considered as emancipated in certain
countries in case their parents, or there is evidence of independence (Sherlock & Brownie, 2014).
Sometimes defining mature and emancipation can be more confusing. For instance, in the case of
Ally, she is considered with the capability of making her own medical decision due to her
maturity and not emancipation. The doctors were required to ignore her decision since they knew
Ally had a father and not living away from him. Hence, she was not supposed to make the
treatment decision by writing consent for herself.
State laws can as well expand or limit the Lakewood Drive Medical Centre case in which
17 years old Ally can consent her medication. The public health commission of every state
requires hospitals to provide confidential information regarding the health of patients below 18
years to their family members or guardians (Nijhawan et al, 2013). Secondly, the Health
Insurance Portability and Accountability has established certain incidences in which individuals
of adolescent age can be given the right to control their health information. Such incidences, the
medication can be accepted with respect to state law, and adolescent individuals are allowed to