University Nursing: Legal and Professional Issues in Nursing Report

This report presents a reflection on a nursing student's experience with a needle stick injury during a clinical placement. The student recounts an incident where they were instructed by a registered nurse to recap a needle, against established protocols, leading to a skin puncture. The report employs the Driscoll model of reflection to analyze the ethical and legal complexities of the situation, highlighting violations of nursing standards and potential risks to patient and healthcare worker safety. The student discusses the application of deontology, professional responsibilities, and the importance of following guidelines to prevent needle stick injuries. The report emphasizes the need for improved communication, adherence to safety protocols, and the importance of continuous professional development to ensure ethical and safe nursing practices.

Running Head: LEGAL AND PROFESSIONAL ISSUES IN NURSING
LEGAL AND PROFESSIONAL ISSUES IN NURSING
Name of the student:
Name of the university:
Author note:

1LEGAL AND PROFESSIONAL ISSUES IN NURSING
Needle stick injuries are the wounds that are caused by the needle which punctures the
skin of the individual accidently. It is considered as hazard for the individual who work with the
syringes or the hypodermic needles (Marjadi et al., 2017). It is mainly observed in the healthcare
setting among the nurses while assembling or disassembling and disposing of the needles.
According to (Health.Gov.Au, 2019), there are certain protocols which should be followed while
handling the needles or the sharp objects, such as avoid the recapping of the needles after use,
proper assembling and disassembling, appropriate disposal (Tarigan et al., 2015). This essay
focusses on the ethic-legal complexities which are observed in the case study. The reflection is
based on the experience during the PEP. According to the deontology ethical theory, action scan
be considered good or bad according to the clear set of rules. The actions that obey the rules are
considered to be ethical where those actions which do not follow the rules are considered to be
unethical. In this case study, the actions showed by the nurse are consider to be unethical (Rich,
2016)
Reflection in the healthcare field is one of the most effective tool to analyze own
weakness and strength. It helps the nurse and the other health care staff to improve their clinical
practice to deliver quality care to the client (Fragkos, 2016). To reflect experience in the nursing,
several reflective models were used. One of which is Driscoll model of reflection. Driscoll model
of reflection consist of three steps such as, what, so what and now what?” It is one of the easiest
models that gives a brief idea about the incident and based on that the action plan is formulated
(Driscoll et al., 2019).
What?

2LEGAL AND PROFESSIONAL ISSUES IN NURSING
This is the first step of the Drsicoll model which provides a discussion of the event. In the
beginning of the PEP, I was assigned to work in an urban area. In the practice unit, I gained
knowledge regarding the clinical practice skills by the help of tutors and the lecturer. In the
practice unit, I was educated about the handling strategies of the needle and the sharp objects. I
was told not to recap the needle after using and instead of recapping the needle should be
disposed in the kidney dish and then after treating the patient, the needle is discarded into the
designated sharp container. We are directed by our tutor to go through the website of the
Australian website to gather information regarding the management strategies of the needle and
the sharp objects. In the website also it is written that the nurse or the other healthcare staff
involved in the treatment of patient should not recap the needle after using it. Along with that
from the site we also learned that the needle or the syringe should net be bent or broken after
using it and instead of that should be directly disposed in the kidney dish and then into the
container.
During the clinical placement, I was allocated to work along with a registered nurse,
where I was asked to give injection to the patient.
During the treatment of the patient, I was asked to give an insulin injection to the patient.
According to the instructions of the nurse, I had to recap which lead to puncture in the skin. The
nurse should have cared for my injury but she did not. The act that the nurse showed at that time
was unethical as firstly she was not supposed to force me to re-cap the injection needle, secondly
when I was injured because of the injection needle, she should gave helped me but she did not. I
might have acquired infections because of the skin puncture but the nurse did not bothered about
this matter. According to the NMBA standards of nursing practices, the nurses must maintain
both the therapeutic and professional relationships, however in this case the nurse could not

3LEGAL AND PROFESSIONAL ISSUES IN NURSING
maintain the professional relationships. Another ethical issue created by the nurse was that
nursing students are not allowed to administer injections to patients while the PEP is going on,
but here the senior nurse forced the nursing student to administer injection to patient. The nurse
showed such actions which are unethical according to the deontology ethical theory and are also
considered according to the standards of nursing practices.
So what?
Though I had knowledge which is required to give injection to the patient, when the nurse
asked me to inject the patient I got nervous. It was because of the behavior of the nurse as she
gets irritated and angry when anyone refuses to act her way. During the PEP, I had learned that
the needle or cannulas should be discarded in the kidney dish and afterwards discarded into the
sharp containers. Hence, according to that knowledge after injecting the patient I started
searching for the kidney dish and then grasped that I disremembered to carry the kidney dish and
hence started panicking, which I later realized is my weakness. Panicking at the time of the
patient treatment can lead to reduced patient outcomes (Lee et al., 2019).
By observing my behavior the nurse got angry and asked me to recap it. According to
Health.Gov.Au (2019), the needle after using should not be recapped as it enhances the hazard of
needle stick injury. The needle stick damage can lead to the transfer of blood borne disease
between the healthcare staff and the patient (Rapisarda et al., 2019).. Hence to avoid such
adverse effects, the needles after using are directly discarded and should not be recapped, bent
and broken. According to Gristo et al. (2015), each and every healthcare staff and the nurse
should follow the guidelines formulated by the Australian government, but the nurse in this case

4LEGAL AND PROFESSIONAL ISSUES IN NURSING
does not follow the guidelines herself and is forcing me to do the same. It can lead to ethico-legal
complexities.
It is not ethical for a registered nurse to force her perspective on another healthcare staff
or the nurse practitioner. It is the responsibility of the nurse to provide correct information to the
nurse practitioner in order to enhance the patient outcomes as well to provide safe working
environment for the other healthcare staff (Smolowitz et al., 2015). However, in this case the
nurse is providing false information to the nurse practitioner and along with that she is also
forcing every one around her to work according to her information. The registered nurse should
be approachable, so that the nurse practitioner working under them should approach them
whenever required, which is not done in this case.
The rules and regulations formulated by the Australian government should be followed
by every healthcare staff and if it is not followed, it can lead to adverse health effect. As
observed in this case, the nurse ordered me to recap the needle which is against the guidelines
that has been developed by the Australian Government to handle the needles and any sharp
objects.
As the needle punctured my skin, it may give rise to any contagious blood borne disease,
which can involve the ethical and legal complication for the nurse (Hanif et al., 2018). Hence,
the incident involves the ethico-legal complications.
Now what?
From the above incident it is analyzed that the incident involves certain ethical and legal
complication which should be addressed.

5LEGAL AND PROFESSIONAL ISSUES IN NURSING
In the incident it is observed that the nurse is quite critical and gets irritated, when
someone refuses her order, which is not ethical. The nurse should educate the nurse and the other
healthcare staff about the correct ways to manage the patient, but should not force anyone to act
according to her instructions (Wiechula et al., 2016). In order to avoid that, the nurse should be
educated about the team handling strategy. Apart from that, the nurse should also be educated
about the professional rules, regulations and the standard of the registered nurse. Conferring to
the standard 1 of the registered nurse, the nurse should critically analyze the nursing practice
(Nursingmidwiferyboard.gov.au, 2019). The standard 1 of the registered nurse states that the
nurse must follow all the legislation, policies, guidelines and the other standard, which is
followed by the nurse.
The other legal complication that is observed in the incident is that the nurse is providing
false information regarding the disposal of the needle stick. According to Health.Gov.Au (2019),
the needle should not be recapped after using as it upsurges the risks of the needle stick damage
which can lead to pernicious disease. According to the Nursingmidwiferyboard.gov.au (2019),
standard 6 of the registered nurse standard, the nurse should deliver safe, responsive and
appropriate environment. As per standard 6, the nurse should provide quality nursing practice to
enhance the patient outcomes. It is the responsibility of the nurse to provide accurate information
to the enrolled nurse which can help in their future (Nursingmidwiferyboard.gov.au, 2019). The
nurse should also be educated that the registered nurse must deliver quality administration to
ensure that the practice is safe. Along with that the nurse should also be educated about the
legislation and rules which are to be followed while training an enrolled nurse.
The nurse is acting herself against the guidelines and is passing that false information to
the other nurse, which is illegal and unethical.

6LEGAL AND PROFESSIONAL ISSUES IN NURSING
In addition, I should also enhance my clinical practice skill in order to deliver quality
upkeep to the patient without getting nervous. I should also enhance my coping skill in order to
avoid panicking while treating a patient and should be patience. Panicking or getting nervous
with small things while treating patient might lead to adverse health outcome (Tariman &
Szubski, 2015). With the enhancement of the clinical practice skill, the patient outcome will also
be enhanced in the healthcare setting.

7LEGAL AND PROFESSIONAL ISSUES IN NURSING
Reflection:
Driscoll, J., Stacey, G., Harrison Dening, K., Boyd, C., & Shaw, T. (2019). Enhancing the
quality of clinical supervision in nursing practice. Nursing Standard, 34(5).
Fragkos, K. (2016). Reflective practice in healthcare education: an umbrella review. Education
Sciences, 6(3), 27.
Gristo, P., de Santa Ana, H., Martino, R., Tomasini, J., & Blánquez, N. (2015, July). Application
of best practices and evaluation of the performance in health, safety and environment
management for a large seismic programme offshore Uruguay. In SPE Latin American
and Caribbean Health, Safety, Environment and Sustainability Conference. Society of
Petroleum Engineers.
Hanif, F., Khurshid, U., Khan, H. S., & Mirza, M. Z. E. H. (2018). Needle Stick And Sharp
Related Injuries-Ethical Considerations, Prevention, And Management.
Health.Gov.Au (2019). [online] Www1.health.gov.au. Available at:
https://www1.health.gov.au/internet/main/publishing.nsf/Content/36D4D796D31081EBC
A257BF0001DE6B7/$File/nat-guidelines-work-bbv.pdf [Accessed 11 Aug. 2019].
Lee, S. H., Kim, J. H., Jung, D., & Kang, S. J. (2019). Educational needs for new graduate nurses
in Korea. Nurse education in practice, 34, 167-172.
Marjadi, B., Nguyen, J. D., Hoppett, P., & McLaws, M. L. (2017). Needlestick injury among
medical students in an Australian university. Journal of Infectious Diseases and
Epidemiology, 3(2).

8LEGAL AND PROFESSIONAL ISSUES IN NURSING
Nursingmidwiferyboard.gov.au (2019). Nursing and Midwifery Board of Australia - Registered
nurse standards for practice. [online] Nursingmidwiferyboard.gov.au. Available at:
https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-
standards/registered-nurse-standards-for-practice.aspx [Accessed 11 Aug. 2019].
Rapisarda, V., Loreto, C., Vitale, E., Matera, S., Ragusa, R., Coco, G., ... & Ledda, C. (2019).
Incidence of sharp and needle-stick injuries and mucocutaneous blood exposure among
healthcare workers. Future microbiology, 14(9s), 27-31.
Rich, K. L. (2016). Introduction to ethics. Nursing ethics: Across the curriculum and into
practice, 3-30.
Smolowitz, J., Speakman, E., Wojnar, D., Whelan, E. M., Ulrich, S., Hayes, C., & Wood, L.
(2015). Role of the registered nurse in primary health care: meeting health care needs in
the 21st century. Nursing Outlook, 63(2), 130-136.
Tarigan, L. H., Cifuentes, M., Quinn, M., & Kriebel, D. (2015). Prevention of needle-stick
injuries in healthcare facilities: a meta-analysis. infection control & hospital
epidemiology, 36(7), 823-829.
Tariman, J. D., & Szubski, K. L. (2015). The evolving role of the nurse during the cancer
treatment decision-making process: a literature review. Clinical Journal of Oncology
Nursing, 19(5).
Wiechula, R., Conroy, T., Kitson, A. L., Marshall, R. J., Whitaker, N., & Rasmussen, P. (2016).
Umbrella review of the evidence: what factors influence the caring relationship between a
nurse and patient?. Journal of Advanced Nursing, 72(4), 723-734.