Professional Development Exercises :
- Read the case study presented at the end of Chapter 8 (Guido, p. 150)
- A patient is admitted to your surgical center for a breast biopsy under local anesthesia. The surgeon has previously informed the patient of the procedure, risks, alternatives, desired outcomes, and possible complications. You give the surgery permit form to the patient for her signature. She readily states that she knows about the procedure and has no additional questions; she signs the form with no hesitation. Her husband, who is visiting with her, says he is worried that something may be said during the procedure to alarm his wife. What do you do at this point? Do you alert the surgeon that informed consent has not been obtained? Do you request that the surgeon revisit the patient and reinstruct her about the surgery? Since the patient has already signed the form, is there anything more you should do?
Now consider the ethical issues that such a scenario raises. Which ethical principles is the husband in this example most portraying? Which ethical principles should guide the nurse in working with this patient and family member?
- Jimmy Chang, a 20- year- old college student, is admitted to your institution for additional chemotherapy. Jimmy was diagnosed with leukemia 5 years earlier and has had several courses of chemotherapy. He is currently in an acute active phase of the disease, though he had enjoyed a 14- month remission phase prior to this admission. His parents, who accompany him to the hospital, are divided as to the benefits of additional chemotherapy. His mother is adamant that she will sign the informed consent form for this course of therapy, and his father is equally adamant that he will refuse to sign the informed consent form because “Jimmy has suffered enough.”
You are his primary nurse and must assist in somehow resolving this impasse. What do you do about the informed consent form? Who signs and why? Using the MORAL model, decide the best course of action for Jimmy from an ethical perspective rather than a legal perspective. Did you come to the same conclusion using both an ethical and a legal approach?
Please combine all of these responses into a single Microsoft Word document for submission
Please submit only complete assignments (not partial or “draft” assignments). Submit only the assignments corresponding to the module in this section.
You are not required to adhere to the 500-1000 word count for each of the responses, but please be thorough in your responses so that you adequately address all aspects of each question. have an introduction and conclusion
Assignment: Professional Development Exercises : Read the case study presented at the end of Chapter 8 (Guido, p. 150)A patient is admitted to your surgical center for a breast biopsy under local anes
SUSPENDED ON SUSPICION 7 Suspended on Suspicion Author Note E. Javier RN Legal and Ethical Issues in Health Care N520-5 Dr. Carmen Herbel Spears Suspended on Suspicion This assignment covers the cases in chapters 11, 12, and 16. The case in chapter 11 concerns a nurse who was suspended on suspicion that she diverts narcotics for her personal use. The suspicion was based on the discrepancy between electronic data on narcotic usage and hand-written documentation of the same (Guido,2014). The case on chapter 12 concerns three defendants, the ANP, preschool teacher, and a caseworker who was sued by parents. In the case, a child who appeared to have vaginal infection was taken for examination by the teacher to the ANP who discovered a vaginal tear. The matter was reported to a caseworker and the father who was subsequently listed as a sex offender (Guido,2014). The case on chapter 16 concerns a charge nurse who delegated duties to a licensed practical nurse (LPN) whom precisely administered medication as ordered by the charge nurse but later noticed that the condition of the patient was getting worse which led to the death (Guido,2014). Chapter 11 The facility lacked enough evidence to warrant a suspension. To begin with, it was not a formal organizational policy to have hand-written documentation on the administration of narcotics. The nurse admitted that she used to fill the document from time to time unless when busy. Therefore, the facility should have considered that. Failure to have manual documentation should not be a substantial ground to validate suspension. The testimony of other nurses is essential in this case as it demonstrated that other nurses are not perfect in maintaining manual records on the administration of narcotics. In the testimony, the nurses claimed that depending on the occasion, they either documented before or after treatment (Guido,2014). The nurse did what all the other nurses were doing. If it was wrong, the facility should suspend all nurses for doing that, but not handpick only one. Thus, the case shows no good reason for the suspension. The facility should question themselves on whether the nurse violated any nursing practice and code of conduct or went against the facility traditions before the ruling on this issue. They should also determine if they have substantial evidence to prove their case given that maintain hand-written documentation of narcotic administration is not a formal organizational policy. As the judge, my decision would favor the nurse because it would be unfair to prosecute the nurse for a mistake that is committed by all nurses and still not a violation of any policy. Chapter 12 In this case, the ANP admits that there is a possibility of the vaginal tear being caused by a self-scratch, but she went ahead to report to the caseworker without credible information and evidence (Guido,2014). The ANP should have consulted the childs physician to get the childs medical history or seek another opinion from another emergency facility before making a conclusive judgment as it could have led to false accusation. There could be many causes of the vaginal tear found in the child that should raise several questions. The nature of the injury should be keenly considered to determine if it is a mere scratch or a tear resulting from forceful penetration. According to (SANE Program Development , n.d.), the ANP had a legal obligation to report the perceived sexual assault of the child to the relevant authority. Thus, the ANP had a duty to report the injury to the child protective services worker. However, as a medical practitioner, she is mandated to examine a patient and provide possible care. Since the diagnosis was not conclusive, the ANP should have examined the injury keenly and consult reliable sources to understand and determine the probable cause of the injury to provide an accurate report to the relevant authority. If the trial court found liability against the three defendants, my determination on this case would place no liability to the preschool teacher because the teacher did what a responsible person ought to do. She suspected vaginal infection in a child and took her to hospital for examination. The caseworker and the ANP would bear the liability. The caseworker filed charges against the father without enough evidence leading to his wrongful listing as a sex offender. The ANP should take the most significant liability as she reported the matter in a very unprofessional manner as she failed to conduct a thorough examination of the child before reporting the issue. Chapter 16 Case Despite delegating duties to juniors, the nurse manager is obliged to supervise the care of a patient to ensure that everything proceeds as planned. Since a nurse manager is presumed to be more skilled and knowledgeable, they ought to pay close attention to what other staff are doing to ensure that everything is done right. Based on the matters of this case, the care for the patient was not appropriately assigned because not all information regarding the patient were forwarded to the LPN. The LPN was just instructed on the medication of the patient, which she duly performed as instructed. Furthermore, no assess was conducted to the patient in the evening by the charge nurse, meaning that she did not reveal the accurate condition of the patient to the LPN. The charge nurse had an obligation to ensure that the condition of the patient is accurately assessed in the evening to obtain the health status of the patient. In this case, the charge nurse delegated duties to the LPN who supposedly took over the care of the patient. Despite delegating responsibility to the LPN, the charge nurse is mandated by the principles of delegation to play the supervisory role to ensure that optimum care to the patient is maintained. My determination, in this case, would render both the LPN and the charge nurse liable. The LPN is liable because she failed to inquire about the patient’s condition to make a professional judgment on how to handle the patient. She followed instructions from the charge nurse blindly with no prior information about the condition of the patient. The charge nurse would have a significant liability because she failed to ensure that optimum care is given to the patient. First, she was unable to assess the patient in the evening and subsequently was unable to provide that the LPN conducted the assessment. Second, she failed to supervise and follow up on the condition of the patient. Conclusion These cases demonstrate different scenarios when nursing professions may be deemed liable for damages in the court of law. The case in chapter 11 demonstrates that a nurse is only liable for breaching formal organizational policies and professional standards and code of conduct. In this case, failure to have hand-written documentation of administered drugs is not an offense. Chapter 12 demonstrates the right to report a sexual offense against a child. At the same time, the case shows that the nurse should conduct a thorough investigation to ensure that she has adequate facts while making such a report to avoid false accusations. Chapter 16 illustrates the concept of delegating duties and subsequent supervisory duties. A nursing practitioner should ensure that care to patients are adequately followed even after delegating duties because it is always their responsibility to ensure that patients receive optimum care. References Guido, G.W. (2014). Legal and ethical issues in nursing (6th ed.). Upper Saddle River, NJ: Pearson. SANE Program Development and Operation Guide (n.d.). Retrieved from https://www.ovcttac.gov/saneguide/legal-and-ethical-foundations-for-sane-practice/state- laws-and-the-nurse-practice-act/