NUR120 Case Study: Ethical and Legal Issues in Nursing Practice

This case study delves into the ethical and legal complexities within the nursing profession, using a scenario involving a student nurse, a registered nurse, and a patient. The analysis examines breaches of patient confidentiality, medication errors, and unprofessional conduct. The case highlights the importance of adhering to the nursing code of ethics, respecting patient rights, and maintaining professional boundaries, especially concerning social media use. The study explores principles of autonomy, beneficence, non-maleficence, and justice, emphasizing their role in ethical decision-making. It also addresses the legal ramifications of violating patient privacy and the significance of informed consent. The document references relevant literature and provides a comprehensive overview of ethical challenges faced by nurses, offering insights into how to navigate these challenges to ensure quality patient care and uphold professional standards.

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Law, Ethics and Guidance in the Nursing Profession
Name of student
Institution affiliation

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Laws are a set of rules and regulations that protect the people. It determines what is right
or wrong. Ethics on the other hand is a set of rules that describes what it acceptable to the society
and provide a guide as to people’s behavior. Ethics are important in every profession and they
detail on how people interact with each other, how they act, what they ought to do and why. In
the nursing profession ethics ensures fairness and equity in treating patients. According to
Dehghani, Mosalanejad and Dehghan-Nayeri (2015) professional ethics is the use of constant
communication, knowledge, skills and values in the nursing profession. Professional ethics
provide guidance to the nurses and offer protection in the patient by detailing the values and
principles that that regulate their relation to patients, colleagues and other professions. Various
ethical questions arise e.g. patient’s informed consent, end of life decision making and
confidentiality. The ethical code provides guidance to these issues and others arising at all levels
of the profession (Epstein & Turner, 2015)
There are four principles of ethics that improve patient care. They include autonomy,
beneficence, non-maleficence and justice. Autonomy is the patient’s right to have control on
what happens to their body. The duty of the professional is to offer advice and in the end the
patients makes his own decision even if the nurse does not agree except in some situations.
Beneficence means that all the actions of the professional must be for the benefit of the patient.
Non-maleficence refers to do no harm intentionally or unintentionally. Finally, justice refers to
fairness of the professional in their decision making including the distribution of resources
equally in distributive justice and equal rights in services provided by the nurses in social justice.
Justice ensures that there is trust between public and the nurses. Together these principles ensure
the right decision is made with regards to the patient and that it benefits him and the society.
(Butts &Rich, 2019)

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In the case study provided, there are various transgressions that have occurred and might
occur. The registered nurse, Jane, took panadol from the medicine room. There is a possibility
that she might take the medications again. She also had forgotten names of the patient and made
the wrong decisions regarding the medications due to the intoxication prompting Dan the student
to correct her to the best of his knowledge. This might lead her to giving patients the wrong
medication and also overdosing the patients. She wanted to carry out a complex dressing on a
patient while still having a headache and also called Dan to assist her and he might not have the
knowledge about it. Dan on the other hand took a picture of the patient’s wound without consent.
He posted the pictures of the wound in social media and revealing the name of the patient and
that the attending nurse had a hangover leaving him to do the complex dressing.
Photography of patient’s illness is considered invasion of privacy hence one has to
follow the nursing standard of ethics in order to avoid legal implications. The code of ethics of
nurses requires them to value respect for self and for others. In this case study, Dan the student
does not respect the patient Freddie and he posts pictures of his illness on social media and
includes his name. This goes against the nursing code of ethics. The code of conduct of nurses
requires them to practice confidentiality to their patients by protecting the patient’s right to
privacy in their care. Dan took pictures of Eddy without consent and shared the photos with his
friends hence going against this (Wang, Anderson, Jones & Evans, 2016).
According to Halcomb, Stephens, Bryce, Foley & Ashley (2016) The Australian Nursing
standard of practice guides the nursing profession by providing guidelines on the clinical practice
and used as to ensure that nurses having appropriate working habits. Nurse Jane did not fit this as
she came to work with a hangover and this affected her work. This is evident when she got the

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patients names wrong as she couldn’t remember them and as well gave the wrong medicine to
patients hence requiring the assistance of the student nurse Dan.
In the case of Dan various measures should have been taken in regards to photography of
an illness of a patient. First of all, he should have sought permission from the patient before
taking the photo. While seeking for person he should also explain to the patients the reasons as to
why wants to take a photo. The patient must have a clear understanding of accepting the photo to
be taken and implications it would have in the future. Some of the reasons include as part of the
confidential medical records in order for the doctor access the treatment of the patient, it can also
be for a project in which one should mention if a consent form needs to be signed. The photo can
also be for learning purposes or even to be used as a reference to patients with the same illness
(O'connor, 2017). Patients can however refuse to be photographed and hence should respect the
patient’s wishes. It is important to note that patients can’t be coerced into giving consent for
photographs to be taken. In case one is unconscious, a photograph can be taken but consent must
be obtained from a relative or one responsible for the patient. In small children consent is
obtained from their parents or legal guardian.
Not all photographs can be taken. Some are taken during exceptional circumstances for
example photos of the genital area where there has to be a clear defined clinical need and should
be stated in the patient’s medical records as to the reason why the photos were taken. Patients
have a right to privacy and hence authorized publication of the patient’s conditions can lead to
social and legal implications for the nurse and for the hospital as well. Posting of photography of
patient’s illnesses on Facebook and other social media platforms and including their names on
the posts violates this right of privacy and also the code of conduct in the nursing profession.
Palacios-González (2015) was for the opinion that in order to post a patient’s picture on social

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media, one must seek the patients consent for the post even though the patient can be recognized
or not and that special considerations must be taken if it is to be posted.
Other ways of breaching patient confidentiality on social media is by posting patients
medical records and their treatment. Instead Dan and other nurses can use social media in a
different way. For example, they can use social media to hold discussion groups. Here they can
discuss about the challenges they are facing and can also support each other in the challenges
they are facing and also ways to develop the profession. They can also blog to write about health
care and educate the public as well (O’Connor, 2017)
Nurses are expected to practice according to the rules and regulations established to
protect the public and promote good health care provision as well as good professional conduct.
Shaikh (2019) was for the opinion that posting patients pictures and revealing the identity on
social media without their consent is illegal. The ethical implication for this is punishment and
even deregistration of the nurse. It can also lead to termination of Jane’s employment who is the
nurse in charge of the patient. In termination of one’s employment it would be hard to get
another job as some offences can lead to the license of practice to be taken away. I will also be
hard for patients to trust you as well. The law keeps up to date with the nursing practice at all the
stages of patient care. All nurses are expected to comply with the ethical guidelines.
One of the legal implications that Dan might face is that the patient might sue him and
the hospital as well leading to a damaged reputation in the profession as well as the hospital. If
the hospital is made to pay fines, the nurse might also be required to pay a particular fee.
According tom Westrick (2016), there has misuse of social media leading to disciplinary actions
and legal actions against the student. This is due to breaching of patient’s confidentiality and

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sharing of patient’s information which may hinder adequate treatment. Policies need to be set for
their expectations on the use of social media and consequences of its use in an inappropriate
way.
In the case study, the student nurse, Dan, should have asked for consent from the patient,
Freddie for him to take the photo. He should have clearly stated the reasons to the patient as to
why he wanted to take the photo. He should not have posted the patients picture on social media
accompanied by his name as this violates his rights to privacy.
In conclusion it is evident that professional ethics are required in nursing profession in
order to guide the behavior of nurses with their colleagues as well as their relationship with the
patients. The four principles of ethics enhance the patient relationship with the nurses and hence
improved health care. The role of professional ethics is to as well guide the nurses on how to
contribute to a healthy society. The ethical code of conduct helps in understanding and dealing
with some of the ethical issues that arise in the profession. At the work places nurses are required
to carry out themselves in a dignified manner and not engage in habits that may cause harm to
themselves as well as to the patient. For instance, nurse taking of medication from the medicine
room. Other nurses should report such cases by notifying their leader who will then see fit the
necessary course of action. Jane had a hangover and couldn’t be able to recall patients name and
was giving the medications. This could lead to serious legal and ethical implications where one
can lose their job, be sued, or can even lead to the death of a patient due to overdose or wrong
medication hence going against the Hippocratic Oath and the core principle of do no harm.
With the advancement of technology, it is good for the nurses to use it for good by
encouraging each other and developing the profession. Posting of patients pictures as well as

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names of the patient on the internet, whether or not the patient can be identified or not goes
against the code of conduct. In order for one to post a patient’s picture of their illness, consent
from the patient is required. Other than posting the pictures on the internet, the pictures can be
used for learning purposes, for monitoring the progress of treatment of a patient and also as a
guide for treatment of patients with the same illness. It is therefore important for nurses to treat
the patients with compassion, dignity and respect ensuring that patient confidentiality is upheld
in the nursing profession.

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REFERENCES
Butts, J. B., & Rich, K. L. (2019). Nursing ethics. Jones & Bartlett Learning.
Dehghani, A., Mosalanejad, L., & Dehghan-Nayeri, N. (2015). Factors affecting professional
ethics in nursing practice in Iran: a qualitative study. BMC medical ethics, 16(1), 61.
Epstein, B., & Turner, M. (2015). The nursing code of ethics: Its value, its history. OJIN: The
Online Journal of Issues in Nursing, 20(2), 1-10.
Halcomb, E., Stephens, M., Bryce, J., Foley, E., & Ashley, C. (2016). Nursing competency
standards in primary health care: an integrative review. Journal of clinical nursing, 25(9-
10), 1193-1205.
O'connor, S. (2017). Using social media to engage nurses in health policy development. Journal
of nursing management, 25(8), 632-63
Palacios-González, C. (2015). The ethics of clinical photography and social media. Medicine,
Health Care and Philosophy, 18(1), 63-70.
Shaikh, Z. (2019). Legal and ethical considerations in posting clinical images on social
media. Research & Humanities in Medical Education, 6, 43-48.
Wang, S. C., Anderson, J. A., Jones, D. V., & Evans, R. (2016). Patient perception of wound
photography. International wound journal, 13(3), 326-330.
Westrick, S. J. (2016). Nursing students’ use of electronic and social media: Law, ethics, and e-
professionalism. Nursing education perspectives, 37(1), 16-22.

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