NURS2004 Inquiry for Legal and Ethical Nursing Practice Assessment
- Subject Code :
NURS2004
- Country :
Australia
CASE STUDY
Bessie Watkins is a 70-year-old, retired school teacher who was admitted to the hospice care unit of a small community hospital. She was diagnosed as having metastatic cancer that had spread from her left breast to her spinal column and ribs. She had decided not to have chemotherapy. She was a single woman and had been living in her own home with her only sister. She was admitted to the hospital because she had become too weak to walk and could barely feed herself. Her admission orders noted that she was in the terminal stages of cancer and that she was to be kept comfortable with medication (narcotic) per continuous IV infusion.
As she became sicker, her bony prominences became more pronounced. A special mattress was ordered to help prevent the breakdown of her skin, but the staff still needed to turn her off several times a day to prevent bedsores and to change the bed linens. When they did, Miss Watkins cried out from the pain and begged the staff not to move her, so much that the staff wondered if they were really helping this patient by their nursing interventions.
Finally, the staff met to decide what they should do.
Nurse Joan, the head nurse for 4 years, insisted that Miss Watkins be turned at least every 2 to 3 hours for linen changes and for observation of her skin. After all, she pointed out, that was routine and minimal nursing care for all bed-ridden patients, and this was the standard of the unit. Any skin breakdown and its necessary treatment would be a very serious problem for Miss Watkins in her already severely compromised condition.
Bernadette, a nurse's aide on the unit for almost 15 years, said that she could not stand to see this patient cry every time she was turned. She said that she would prefer that Miss Watkins's sedation be increased to reduce her pain and facilitate linen changes.
Nurse Duncan, a recent graduate, voiced her opinion that the patient should have some say regarding her care. After all, she had terminal cancer, and not turning her would hardly make a difference in the overall outcome of her illness.
Nurse Lesley, the evening nurse, thought that the doctor ought to be the one to decide how often Miss Watkins should be turned. Then the nurses would not have to make a decision and could just follow their orders. The rest of the nurses strongly objected to this suggestion. Turning a patient, changing linen, and observing for skin breakdown are nursing measures, they argued, and they should decide together the appropriate nursing interventions for this patient.
FRAMEWORK
- INTRODUCTION-
- clearly describe the purpose of the paper-
- introduce structure of essay-
- DO NOT summarise the case study
- CONSENT BATTERY
Use this section to
- define the legal issues of consent and civil battery-
- describe and apply the legal issue of consent.
- describe and apply the legal issue of civil battery.
- ensure any relevant legislation, case law, or WA Health Policy is included.
- ETHICAL THEORIES
- Choose TWO nurses and relate an ethical theory to each nurse's opinion.
- Provide a description of each ethical theory including the history, background, concepts of the ethical theories and limitations.
- Demonstrate how each ethical theory fits with each nurse's opinion and how the theories complement or conflict with each other.
- PROFESSIONAL PRACTICE-
- Define professional misconduct in nursing, including specific elements from the legislation and apply it to this case.
- Identify, describe and apply 2 different elements from the professional framework that may contribute to a claim of professional misconduct in this case
- Professional framework includes the Code of Conduct for Nurses, ICN Code of Ethics, RN Standards for Practice, NSQHS Standards
- CONCLUSION-
- what is the best course of action to resolve this situation?
- clearly state what action the nurses should take
- justify the proposed course of action using law and ethics.
