Apply legal and ethical parameters to nursing practice
Apply legal and ethical parameters to nursing practice
Q1.
In your own words, why is the Code of Professional Conduct for nurses in Australia important and where would you find this document?
The codes define the minimum standards of conducts to which the professional nurses are to uphold in their duties. The codes inform the Australian communities what is expected of the professional nurses. Also, the regulations allow the regulatory and professional bodies in Australia to effectively evaluate the professional conducts of nurses (Nursing & Council,2008).
The document can be obtained from the link:
Q2.
What is the role of the Australian Health Practitioners Registration Agency (AHPRA)?
The AHPRA work jointly with fourteen other National Health Practitioner Boards (NHPB) to help develop and implement the National Registration Scheme (NRAS). Also, the AHPRA help sets national health standards in Australia, register over six hundred and thirty thousand health practitioners and protect the public through quality and affordable health care within the health facilities (Nursing & Council,2008). The AHPRA also accredit, train and educate the professional nurse in Australia.
Q2A. On the 1st of January 2016 a new “enrolled nursing standards for practice” was introduced, in your own words describe what the purpose of these standards are.
The standards function to provide a framework through which the enrolled nurses are assessed (Scanlon et al., 2016). The standards also communicate to the public the standards expected from the enrolled nurses. Additionally, the standards can be used to develop and implement curricula for the nurses, assess the new graduate nurses and assess and evaluate nurses educated in foreign countries and those from holidays (Cashin et al., 2016).
Q2B. When reading the standards for practice for enrolled nurse list other relevant documents that should be used in conjunction with the standards.
Other relevant documents used include Code of Professional Conduct for Nurses in Australia (NMBA 2008), Codes of Ethics for Nurses in Australia (NMBA 2008), Professional Boundaries for Nurses in Australia (NMBA 2010) and Nursing Practice Decisions Summary Guide (NMBA 2010)
Q2C. Refer to Standard 5 in the “enrolled nursing standards for practice” and identify how you met each point within the standards during your clinical placements given an example for each one.
5.1. I would respectfully conduct myself around the multi-disciplinary team and members and accomplish duties as instructed by the RN. For example, engage in turn talking during working hours with the team.
5.2. I would keep in consultation with the multi-disciplinary healthcare team when attending to the patient.
5.3. I would participate actively during care plan development within the facility and ask patients what they would like included in their care.
5.4. I would carefully conduct my duties as per the care plan developed within the workplace.
5.5. Every time the instruction seems unclear, I would diligently ask for clarification from the RN.
5.6. When seeking solution to medical issues to the patients as a team, I would actively patriciate in decision-making process
Q3.
What nursing care can an EN delegate to a Registered Nurse? Please explain your answer.
Feeding the patients when required, support patients with exercise, administer first aid during emergencies and provide education to the patients on required health and lifestyle matters (Nursing & Council,2008). Additionally, enrolled nurses can take and record body temperature, blood sugar levels, and report changes in patient’s body (Paranaguá, Bezerra, & dos Santos, 2014). These care to patients does not require detailed medical care to patients hence can easily be administered by the EN under the supervision of the RN.
Q4.
Explain the role of the EN in contributing to the formulation of patient care plans?
The EN can participate in assessment such as collecting, organizing, documenting and validating data to be used to develop new plans for patient’s care. Developing patients care plan relies on information gathered from the patients (Nursing & Council,2008). Therefore, the EN actively participate in collecting and documenting such data and present to the RN and the entire team for evaluation and development of new care plans as per the patient’s clinical needs.
Q5.
In the context of enrolled nursing, what does direct and indirect supervision mean?
Direct Supervision occurs when the RN is present, observe and directs the procedure undertaken by the EN on a patient (Paranaguá, Bezerra, & dos Santos, 2014).
Indirect Supervision occurs when the RN is absent at the scene the EN is performing the clinical practice to the patient (Nursing & Council,2008). Therefore, the RN may be contacted to provide direction and procedures to the EN. For indirect supervision, both electronic and telephone communication systems must be active and employed (Paranaguá, Bezerra, & dos Santos, 2014).
Q6.
Once you have completed this course what do you need to do to get your licence as an EN as stated by AHPRA?
Upon completion of the course, I can undertake online application to obtain the license as an EN. The request for the license is made through the National and Midwifery Board of Australia (NMBA) (Scanlon et al., 2016). The AHPRA supports the board. By the time of application, the mandatory registered standards such as criminal history must be assessed and language.
Q7.
What is the function of a nurse’s licence to practice and what is the purpose of an annual renewal?
The nurse’s license to practice allows the board to determine the professional codes that the nurse should uphold. The license allows the boards to identify each nurse operating within a facility for accountability. In a case of breach of conducts the nurses can be withheld accountable and in an extreme case, the license can be withdrawn to prevent unrecognized clinical operations by the nurse in question. Licencing also allows only those with qualification to practice nursing and not the quacks
Annual renewal is of the essence to enable the board identify the population of nurses still in practice and meet their needs (Scanlon et al., 2016). The annual renewal also allows the plan for the nurses including transfers and promotion activities.
Q8.
What is the goal of the Office of the Health Ombudsman?
Office of the Health Ombudsman ensures that the health practitioners conduct quality and safe medical procedure to the patients. The office also ensures that every nurse should acknowledge Code of Professional Conduct for Nurses and upheld to ensure safe clinical practice. The department provides that the complaints of the of health facilities users are heard and addressed with speed to improve service delivery to the patients.
Q9.
A nurse administers a drug via an incorrect route. As a result, the patient dies. The nurse misunderstood the drug order. Do you think this is a criminal matter, a civil matter or both and why? Do you think the nurse would be found negligent and why? What are the elements that are required for negligence to be proved?
Do you think this is a criminal matter, a civil matter or both and why? This is both criminal and civil matter because the relatives of the patients would demand justice for their loved one and the medical facility may be held accountable for failure to implement the codes of professional practices to the nurses hence making medical errors (Scanlon et al., 2016).
Do you think the nurse would be found negligent and why? The nurse would be found negligent for failing to adhere to the rights of medication administration.
What are the elements that are required for negligence to be proved? The order and appropriateness of the route through which the drug to be administered. The condition of the patient to take the drug through the ordered route.
Q10.
Describe the difference between an Enduring Power of Attorney and a General Power of Attorney?
The enduring power of attorney enables one to a person or a legal agency of choice to precisely make a decision on behalf of the person. Therefore, the agency or the person become the attorney. The attorney must at all occasions act in the best interest of the donor. While the general power of an attorney would give a board authorization towards the agents to make decision, but the powers ceases to be operational upon losing the mental capacity to make decisions (Yeager & Hargrave, 2000).
Q11.
You (EN) escort a resident with dementia to the doctor and he wants to take a biopsy of a suspected skin cancer on their arm. The client is unable to give informed consent so the Dr asks you if it is OK to go ahead. What is your response and why?
The client is unable to give informed consent so the Dr asks you if it is OK to go ahead. What is your response? Yes, it is OK.
Justify your response. The law under the requirement to obtain valid consent from patients, make exceptions in some cases where consent cannot be obtained. One is in the case of mental illness such as dementia hence the patient is considered not to have the capacity to give valid consent (Scanlon et al., 2016).
Q12.
Mr Burgess has advanced liver cancer and tells you that he is considering her quality of life and is thinking about telling his doctor he does not want to be resuscitated if he has an ‘arrest’. What document does Mr Burgess need to complete and why?
Do-Not-Resuscitate (DNR) Orders is the document to be signed by Mr. Burgess. The DNR orders the medical practitioner not to carry out Cardiopulmonary resuscitation. The documents are legal and can be produced in a court of law if the family of Mr. Burgess may seek legal action for the medical team for failing to act to prevent death.
Q13.
Your community client, Jenna lives on her own but has not been managing well. Her 2 daughters are often present and can never agree on anything. Lately one daughter has been pushing for her mother to go into care while the other wants to use some of her money to build on a granny flat so she can look after her mother. You advise your supervisor and she states she is going to contact the Office of the Adult Guardian. You know this is going to upset the daughters so why would she do this?
The Office of the Adult Guardian has the authority to investigate various allegations on adults such as neglect, exploitation or abuse to adults with an impaired capacity to make decisions about their health condition (Chesterman, 2013). Even if the daughters are upset but it is the right thing to do because it is the goal of the Office of the Adult Guardian to ensure that everyone more so the adults are treated equally irrespective of their mental or health status.
Q14.
Judy needs 2 fillings. Judy does not have decision making capacity and the dentist asks you for the details of Judy’s statutory health attorney to discuss the procedure and gain consent. Outline the primary role of a statutory health attorney and list, in order of priority, who could this be?
A statutory health attorney has the primary role of making health decisions for adults whose ability to make informed decisions about their health are temporary or permanently impaired.
A statutory health attorney can be
- A spouse de facto partner in the case the relationship is continuing.
- A person responsible for the primary car of the adult but not a paid carer.
- A relative or a close friend above the age of eighteen.
- If the people named above are absent, the Office of the Adult Guardian acts as the last resort.
Q15.
A patient has been admitted to hospital for involuntary treatment as per the Mental Health Act (2000). What does this mean?
According to the Mental Health Act (2000), individuals can be treated without consent under the involuntary treatment order. Conducting the involuntary treatment requires that the medical practitioner undertakes an involuntary assessment fact sheet documentation as per the involuntary assessment order. The patient under involuntary treatment must meet the following criteria (Chesterman, 2013). The person has a mental illness, the mental illness requires immediate treatment, and the treatment must be under an authorized mental health service.
Q16.
What is the primary role of a Coroner and what four things does a Coroner need to establish?
Upon receiving information from police or medical practitioners of the death of a person, the Coroner has legal provision to take control of the body of the deceased (Chesterman, 2013). The coroner established the following
• The manner in which death arose
• Cause of death,
• Identity of the deceased
• The documents are needed to register the death.
Q17.
An inquest is being held into the death of a hospital patient. You were one of the nurses rostered on the ward in the days before his death. You are asked to attend and give evidence at the inquest.
Q17.1 What is an inquest?An inquest is a judicial process of inquiry to verify the facts relating to an occurrence such as death of a person.
Q.17.2 Why would you be asked to give evidence?
As nurse before the death of the patient, the Coroner has questions to ask to which I can respond to provide leads to the course of death (Studdert, 2016). And since inquest is meant to find out the facts that surround an incident as opposed to laying blames, there is no harm in responding to questions as a witness.
Q.17.3 Another nurse who has also been called to give evidence reminds you of a conversation you shared in regards to this patient. You don’t recall all of the details but your colleague is sure of what was discussed and advises what you need to tell the Inquest about this conversation. What do you do? Please explain?
At the inquest, own opinion or inappropriate context is dangerous to include. Therefore, it is necessary to answer the question asked by the Coroner directly. Discussing the conversation in the case the family lawyers are present may lead to complicated situations. Hence it is necessary only to answer question asked directly and precisely (Studdert, 2016).
Q18.
Using correct legal documentation principles reword this entry from a patient’s progress note that meets legal requirements and reflects good practice “she appeared angry today when I was doing her dressing. When I went back to his room she had ripped the tape off the dressing and thrown it in the bin and went off at me. I told her not to be rude and I left the room” (as you do not have any other information about this patient, it is OK to add additional details in your reworded progress notes to make them clear)
Shift Assessment
Patient Number: 2335A
Room 23
Morning hours’ assessment
medical History: Admitted for would infection
General appearance: The patient looked agitated and moody
Vital signs: temperature, 38.0 oC
The wound is about five-centimetre-wide
Colour of the wound red with middle areas containing little pus
Surrounding are of the wound are clean.
Wound dressed and bandaged using tapes
Afternoon Assent
General appearance: The patient looked agitated and violent and in pain
Vital signs: temperature, 39.0 oC
Bandage and tapes removed by the patient.
The wound bleeding and the patient unsettled.
Q19.
Provide an example of how you have met Statement 2 of the NMBA Code of Ethics for Nurses in Australia.
During the semester we visited the hospital and attended to patients under the supervision of the RN. HIV/AIDs patients were our assignments, and some of the patients were known to us. I had to keep the information about the patient medical conditions secret and only known to relevant people and doctors (Nursing & Council 2008). Therefore, I met the ethical code that requires nurses to manage patients’ information ethically.
Q20.
As an Enrolled Nurse, what framework can you (or others) use to assess your competence?
I can assess my competence by attending to patients successfully in critical conditions such as during emergency and the feedback from the patients I attend. Others such as the RN can assess my competence by delegating duties to me (Nursing & Council 2008).
Q21.
What is vicarious liability?
Vicarious liability would occur when an individual is held and accountable for the actions and omissions of a second party. In a medical context, the RN can be liable for the actions or omissions of the ER in the facility.
Q22.
What type of consent is most often gained by nurses and why?
Most nurses gain explicit consent because the patients are clearly presented with option to disagree or agree to a procedure (Nursing & Council 2008). Since most nurses would not wish to take the blame of a procedure that may fail, they often present the patient with consequences of an action, and the patients chose to agree or disagree by himself or herself.
Q23
Can a legally competent person refuse treatment even if this refusal leads to permanent injury or death?
Yes, because with a legally competent person he or she can be explained to the options and allowed to make consent (Nursing & Council 2008). In the case, the medical procedure is undertaken for such a person, and it goes wrong, the families would hold the medical team accountable for conducting the procedure without the patient consent.
Q24.
A child is visiting in your ward. She has bruising to her face, arms and legs. She has very obvious tooth decay. She is thin. You suspect the child is being abused. What is your responsibility?
The child receives tooth treatment in the first place. The presence of bruises on her face, arms and legs denote physical abuse to the child. Upon completion, call Child Protection Australia and report the allegation of child abuse. The organization will carry out the investigation through a legal channel to assist the child to live without abuse.
Q25.
Identify the four principles of ethics and then provide an example of how you apply each principle to your nursing practice.
The four principle of ethics includes the principle of respect for autonomy, non-maleficence, beneficence and justice.
For the principle of respect for autonomy, I would ensure that I express I express all treatment options to patients as a way of respecting peoples’ rights.
For the principle of beneficence, I would provide vaccination whenever a need arises to the general population.
For the principle of Non-Maleficence, I would rather administer oral drug rather than intravenous drugs if a similar oral drug performs same function as the intravenous hence avoid injuries by injection to the patient.
For the principle of justice, I would attend to patients equally irrespective of gender or financial status to promote justice for all patients (Nursing & Council 2008).
Q26.
What is ‘Open disclosure’ and what is the role of the EN in ‘open disclosure?
Open disclosure defines an open discussion that between the nurses and the patients, their families or other support persons, on the incidents that results to harm to the patients while receiving treatment,
Open disclosure is important to EN as it promotes both national safety and quality healthcare service to patients and the medical practitioners.
Q27
You are working in a residential aged care that is part of a national organization. You notice bruises and finger marks on the arms of a 75-year-old female who tells you the female nurse doesn’t like her and pinches her to make her hurry.
Q27.1
What relevant amendments to the Aged Care Act 1997 came into effect in July 2007?
The Age Care Act of 1997 did not have sufficient measures to stop elder abuse by the clinicians. For the Age Care Act 2007, the patients have the rights to call helplines whenever they feel abused in any way by the caregivers (Nursing & Council 2008). Upon investigation of the allegation, legal actions are pursued as per the Act provision.
Q27.2
As an EN do you have a legal obligation to report this?
The EN has an obligation to report the matter to the relevant group. Under the NMBA, the laws allow for notification to either be made in writing r a phone call to any office of the AHPRA for action to be taken by the board members (Nursing & Council 2008).
Q28
Write a definition for the following:
Ethics, bioethics and nursing ethics
Ethics: define the standard and moral principles that control the behaviour of an individual
Bioethics: describe the study of the emerging controversial ethical issues from new situations as a result of advances in medicine and biology
Nursing ethics: define the moral principle that controlled nurse’s behaviours about human dignity and collaborative care (Nursing & Council 2008).