NURS13140

Law and Ethical Considerationsin the Profession of Nursing

Edition 2025, Term 1

Published by Central Queensland

University Queensland, Australia.

COMMONWEALTH OF AUSTRALIA

WARNING

This workbook has been developed on behalf of Central Queensland University pursuant to section 195AVB of the Copyright Act 1968 (Cth) (the Act).

The contents within the workbook may be subject to copyright laws under the Act.

CRICOS Provider Code: 00219c

Academic Authors:

Developed by: Craig Morris

Reviewed by: Dr Katrina Lane-Krebs and Emma Wood

Table of Contents

Module 4 Professional Negligence & Duty of Care .... 6

Module 5 The Nursing Profession: Care, Interventions & Consent 8

Module 6 Risk Management: Workplace Health & Safety, Indemnity & Insurance .......... 9

Module 7 Legal and Ethical Implications of Skill Mix, Scope of Practice & Staffing Practices .. 11

Module 8 Back to Basics: Documentation, Confidentiality, and Mandatory Reporting ... 12

Module 9 When Things Go Wrong: Coronial Inquiries 13

Module 10 Applying Ethical Behaviours in Different Contexts ... 14

About this Workbook

The workbook forms Assessment Item three for NURS13140. The content in this workbook is divided into seven modules covering material from week 4 to week 10. The exercises in the workbook will require you to undertake your own research and locate relevant academic resources to complete each module.

The due date: Wednesday, 28 May 2025, at 1600 hours (AEST), Week 11.

Assessment Item 3: Written assessment.

Weighting: 60%

Length: Maximum word limit: 1500 words (+/- 10%). References, questions and scenarios are not included in the word count.

Aim:

The aim of this assessment is for you to demonstrate your knowledge of ethical and legal issues in Australias nursing practice.

Instructions:

Please follow the steps below to complete your assessment task:

1. This workbook consists of seven modules representing the learning material from weeks 4 to 10. Each module consists of several tasks/activities.


2. You must download the workbook document and complete all tasks/activities using this document as your template. Please do not alter the template.


3. Some activities require short answers to questions; others require the application of the theory to a given scenario. A suggested word count for the activities has been indicated.


4. All your responses must be based on credible evidence from peer-reviewed literature, Federal or Queensland legislation, Queensland case law or credible websites. Please provide references as indicated.


5. Please abide by the rules of academic integrity and work independently. This is NOT a group assessment. Limited use of AI that complies with ethical standards is expected.


6. Please submit your completed workbook as an MS Word document.

Literature and references:

In this assessment, as noted below, you must use contemporary references (<7>

Requirements:

• Use a conventional and legible size 12 font, such as Times New Roman, with 2.0 line spacing and 2.54cm page margins (standard pre-set margin in Microsoft Word).


• Use formal academic language.


• Use the seventh edition American Psychological Association (APA) referencing style. The CQUniversity Academic Learning Centre has an online CQU APA Referencing Style Guide.


• We recommend you access your discipline-specific library guide: the Nursing and Midwifery Guide and Social Work and Community Services Guide.


• For information on academic communication, please go to the Academic Learning Centre Moodle site. The Academic Communication section has many helpful resources, including information for students with English as a second language.

Learning Outcomes:

1. Demonstrate an informed understanding of the basic concepts and principles that underpin Australian healthcare law.


2. Analyse and reflect on healthcare problems and identify relevant ethical and legal issues.


3. Develop a broad and coherent body of knowledge of how legislation, policies, frameworks, codes, and guidelines are applied to nursing practice in Australia.

Module 4 - Professional Negligence & Duty of Care

Activity 1: Define medical negligence and explain how its four elements duty of care, breach of duty, damages and foreseeability contribute to establishing liability in a medical malpractice case.

(5 marks, 125 words)

References:

Activity 2: Application Activity.

Comro Coast hospital is a small twenty-two-bed hospital located in Yelloon, Queensland. It serves a growing population of 7,037 who predominately reside along the coastal regions. On a Friday night, the hospitals Emergency Department (ED) is short-staffed due to a surge in patient admissions following a motor vehicle accident. Two registered nurses (RNs) allocated to ED have not shown up for shift due to influenza. Registered nurse Douglas, who has been at the hospital for nine yearsbut typically works in the mental health department, is temporarily assigned to theED triage area. The shift coordinator informed RN Douglas that they could not get replacement staff and that the ED nurses must manage the additional patient load.

By 2137 hours, the waiting room is overcrowded, and RN Douglas feels overwhelmed, given his lack of recent experience in triage. At 2149 hours, Mrs Patt arrives with her 71-year-old father Mr Palmer, who has been complaining of chest pain. Using the Emergency Departments Australasian Triage Scale, RN Douglas assesses Mr Palmers vital signs: blood pressure 161/92 mmHg, heart rate 115 bpm, respiratory rate 24 breaths per minute, oxygen saturation 96% at room air, and temperature37.3 degrees Celsius. Despite noting that the patient appears fatigued and diaphoretic, RN Douglas triages Mr Palmer as a Category 3 (potentially life-threatening, assessment and treatment start within 30 minutes) and directs him to the waiting area.

At 2202 hours, RN Chase, a recent graduate nurse with no prior experience in ED, is called in from the maternity ward to assist RN Douglas. Registered nurse Chase takes over triage duties after a short handover with RN Douglas. At around 2209 hours, Mr Palmer approaches RN Chase, seeing the ED full of more visibly distressed patients, she reassures Mr Palmer that a doctor will see them soon and advises him to continue waiting. At 2209 hours, Mrs Patt rushes to the triage desk in distress, as her father has collapsed in his chair. A Code Blue is initiated, and Mr Palmer is transferred to the resuscitation area, where the medical team diagnoses him with an acute myocardial infarction. Unfortunately, despite thebest efforts of the treating medical team, Mr Palmer passed away. Following the event, Mrs Pratt filed a complaint with the hospital management, alleging that the RNs failed to act promptly and appropriately, which led to the death of her father.

Discuss the issues in the above scenario with reference to the four elements of the tort of negligence. Also, did any nursing staff breach their duty of care towards Mr Palmer? Why/why not?

(10 marks, 250 words)

Module 5 - The Nursing Profession: Care, Interventions & Consent

Activity 1: In Queensland, a minor is anyone under the age of 18 years. Can a minor consent to medical treatment? Why/why not?

(3 mark, 75 words)

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Activity 2: Application Activity.

Mr Sczeski is a 55-year-old man diagnosed with early-stage colon cancer. He is married, works as an accountant and has two adult children. Mr Sczeski attends the Caltone Base Hospital for a consultation with his oncologist, Doctor Moss, who explains the treatment options, including surgical removal of part of his colon followed by chemotherapy to reduce the risk of cancer spreading. Doctor Moss provides Mr Sczeski with detailed information about the surgery, including the risks, benefits, possible complications, and the expected recovery process.

After the discussion, Mr Sczeski expressed concerns about undergoing surgery due to the risks involved, especially the potential for postoperative complications, including infection and changes in bowel habits. He states, Ive heard of people not making it through the surgery. Id rather not take the chance. Cant we try just taking meds or something? Doctor Moss reassures Mr Sczeski that the surgery is the best option for treating his condition and explains that delaying or refusing surgery could result in the cancer spreading, making future treatment more difficult. Despite these explanations, Mr Sczeski becomes increasingly anxious and insists on taking time to think about it further.

The next day, Mr Sczeskis wife calls the hospital and speaks to a registered nurse, expressing concern for her husbands health. Mrs Sczeski states that her husband is often stubborn when it comes to medical decisions and that she wants the hospital to schedule the surgery as soon as possible, even if her husband is still hesitant. Mrs Sczeski states, I know him, andhell come around eventually, but I want to make sure this surgery happens so we dont lose any more time. Based on Mrs Sczeskis call, the hospital scheduled the surgery.

When Mr Sczeski arrives at the hospital for pre-operative preparations, he expresses confusion about the surgery being scheduled so soon, as he has not yet given his formal consent. He tells the registered nurse, I needed more time to think about it. My wife may want me to have surgery, but its my decision. Mr Sczeski is uncomfortable with the situation and reiterates that he still has not decided about the surgery or treatment options.

Question:

How would you apply the three elements of valid consent to this scenario? Was consent obtained?

(7 marks, 175 words)

Module 6 - Risk Management: Workplace Health & Safety, Indemnity & Insurance

Activity 1: In Queensland, if a person renders first aid in good faith during an emergency, are they liable for any harm the casualty sustains from their act? Why/why not?

(3 mark, 75 words)

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Activity 2: Application Activity.

Katie, a first-year nurse graduate, is walking through a crowded shopping centre on the weekend when she notices a commotion ahead. A middle-aged man has collapsed near the entrance of a clothing store, and a small crowd has gathered around him. As Katie approaches, she hears people calling out for help and sees that the man is unresponsive and lying on his back. Some bystanders try to assist, but no one knows what to do. Katie quickly assessed the situation and noticed that the man appeared pale, sweaty, and had trouble breathing. She checks his pulse and finds that it is weak and irregular. One of the bystanders calls out, Does anyone know CPR? We need to help him! Feeling uncertain, Katie introduced herself as a registered nurse.

Before taking any further action, Katie asked one of the bystanders to call 000 while she began to assess the mans airway and breathing. After confirming the man is showing no signs of life, she instructs a nearby shop assistant to retrieve the malls automated external defibrillator (AED) while she begins chest compressions. Katie continues CPR with the help of the AED once it arrives, and a few minutes later, paramedics arrive on the scene. They take over, stabilise the patient, and rush him to the nearest hospital. After the event, Katie reflects on her role. She feels proud that she was able to help but is also anxious about whether she made the right decisions and wonders if she will be held legally responsible for any rib fractures that may have occurred.

What common law, legislation or guidelines are relevant to this scenario? State and discuss.

(8 marks, 200 words)

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Module 7 - Legal and Ethical Implications of Skill Mix, Scope of Practice & Staffing Practices

Activity 1: Application Activity:

Mortel Aged Care Facility (MACF) isa 62-bed Queensland state-owned facility with a resident population split between general (40 beds) and the dementia care unit (22 beds). An evening shift team includes experienced and novice nurses to create a supporting learning environment for nursing students. Todays evening team is led by two senior registered nurses (RNs): Deb, a generalist nurse who has over twenty-two years of experience and serves as the shift coordinator, overseeing all clinical operations and is rostered in the secure dementia ward, and Craig, an experienced RN with post-graduate studies Master of Ageing and Health. Craig is also rostered with Deb in the acute dementia unit.They are joined by two enrolled nurses (ENs), Janette and David, who have three and five years of experience and will primarily care for residents in the general care unit. Micheal, a recent nurse graduate (less than 12 months experience), has also commenced employment at MACF and will work with the ENs in the general care unit.

Additionally, there is a single third-year nursing student, Olivia, who is completing her clinical placement. Olivia is taking on a small, supervised patient load of three residents, allowing her to assist with basic care, assessments, and documentation under thedirect supervision of Craig. Three aged care assistants are also on the shift (two in the dementia ward and one in the general ward), attending to the residents non-clinical needs, such as feeding, mobility, and personal hygiene, which helps freethe RNs to focus on clinical tasks. Supervision is reinforced with an on-call clinical nurse consultant (CNC) who provides additional support when required but generally works the day shift.

This structure allows the RNs to provide real-time support, ensuring that residents in the acute dementia ward receive safe, attentive care. To further enhance the staff skills and support ongoing professional development, the CNC wants to introduce monthly training workshops focused on geriatric and dementia care. A structured skills checklist for the nursing studentwill alsobe developed to meet their ANSAT objectives whilst on placement at the facility.

Question:

Comment on the skill mix, staffing ratios, and supervision capacity at Mortel Aged Care Facility

In terms of improvement to the staffing, what would you recommend and why?

(10 marks, 250 words)

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Module 8 - Back to Basics: Documentation, Confidentiality, and Mandatory Reporting

Activity 1: As a registered nurse (RN) working in the Emergency Department (ED), you are assessing Sarah, a 9-year-old girl who has been brought in with severe abdominal pain and vomiting. During your examination, you notice multiple bruises on her abdomen and back, as well as some old scars on her arms. The child appears withdrawn and hesitant to speak. Her caregiver states she has been having stomach issues and falls frequently. The childs medical history shows previous visits for unexplained injuries.

Question:

In this scenario, what actions should the RN take, and should a mandatory report be made? Explain.

(3 mark, 75 words)

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Activity 2: Application Activity

Emma, a five-year-old girl, is brought to the Emergency Department (ED) at 1644 hours by her aunt, who states Emma fell down the stairs while they were at home. Emma is quiet and seems nervous, holding onto her aunt without speaking. After examination, it is determined that she has a minor ankle sprain, and she is admitted overnight for observation. You are a student nurse (SN) on a three-week placement in the paediatric ward. The next morning, you have been assigned to help Emma with her care, including assisting her in goingto the bathroom and attending to her activities of daily living (ADL).

While helping her change into a clean gown, you notice faint bruises on her upper arms and back, which do not seem consistent with an ankle sprain. Emma seems usually quiet and flinches when you move your hands to adjust her gown. When you ask Emma if she is okay, she whispers, Im scared to go home. As you proceed with her care, you also notice that Emmas hair is tangled and has lice, and her clothes have a strong odour, suggesting they have not been washed in a while.

Question:

What actions should you take as a nursing student based on your observations, and what justifies these actions in Emmas case?

(4 marks, 100 words)

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Module 9 - When Things Go Wrong: Coronial Inquiries

Activity 1: Application Activity

Michelle, a newly graduated registered nurse in a major hospitals Intensive Care Unit (ICU) in Queensland was in her third week of a graduate rotation. During a busy shift, in her haste, due to a misunderstanding about the lines in place, she mistakenly injected the morphine into the patients arterial line rather than the central venous line. Shortly after the administration, the patient exhibited signs of acute distress, including a severe drop in blood pressure and cardiac arrhythmias. Despite immediate intervention by the ICU team, the patient went into cardiac arrest and could not be resuscitated.

Questions:

Based on the definition of a reportable death, would this incident qualify as a reportable death? Explain why or why not, considering the cause of death and relevant criteria.

(3 marks, 75 words)

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Module 10 - Applying Ethical behaviours in different Contexts

Activity 1: Application Activity

You are a nursing student on placement in a palliative care unit in Queensland. One of your patients, Miss Chasse, is a 43-year-old woman who has been diagnosed with terminal pancreatic cancer. Despite ongoing treatments, her condition has worsened, and her medical team has estimated that she has less than 12 months to live. Miss Chasse is an Australian resident and has lived in Queensland for 6 years. She has spoken with you about her desire to avoid prolonged suffering and is interested in learning more about voluntary assisted dying (VAD). Miss Chasse asks if she might qualify for VAD under Queensland law and expresses that she feels ready to begin the process. You know that eligibility requirements include age, residency, citizenship and prognosis.

Question:

Based on Queenslands VAD legislation, does Miss Chasse meet the eligibility? Identify any requirements she fulfils and any additional information that must be confirmed to determine her eligibility.

(4 marks, 100 words)

You have now completed the workbook. Submit by Wednesday, 28 May 2025, at 1600 hours via Moodle.

Markers only: