Diploma Of Nursing: Case Study
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Diploma Of Nursing: Case Study
In your owns words, briefly describe the following legal and ethical concepts:
(That is: research, paraphrase and correctly reference your understanding of the following terms 🙂
- Nursing ethics
- Civil Law
- Common Law
- Stature Law
- Vicarious Liability
- Open Disclosure
- False Imprisonment
- Right to Refuse
Part 2: Case Study
Susan is a 76 year old lady who was swooped by a magpie when out walking. The bird hit Susan’s left eye at speed and caused severe injury. The ambulance is called and Susan is taken to City South Hospital.
Susan is triaged in the emergency department where she was given pain relief and reviewed by the Ophthalmic surgeon. The surgeon tells Susan that although it is not urgent, she will need to have surgery on her eye.
The surgeon has a cancellation on his theatre list that afternoon. So he asks Susan to consent to having the surgery that afternoon. Hazy from the pain medication, Susan signs the consent form.
As a result of the extent of injury to the eye, Susan looses permanent sight in her left eye. Whilst recovering in the ward, Susan’s friend (a doctor) comes to visit her. EN Stuart who is looking after Susan, tells Susan’s friend that Susan is blind in one eye after surgery and gives Susan’s chart to the friend to read when he requested. EN Stuart gave the friend the chart because she believed that it was alright to do so because he was a doctor.
It is City South Hospital’s policy that bed rails are used for all post operative patients. EN Stuart did not put the rails up and Susan fell out of bed and hit her head. EN Stuart does not want to get into trouble so she does not tell anyone or document the event. EN Stuart helps Susan back to bed. Susan then develops a delirium secondary to a hematoma on her brain. Susan’s behaviour is quite erratic and the RN uses a sheet to tie her to the bed.
The afternoon shift arrives and the nurse assigned to Susan notices that she is retained to the bed via the sheet and is non-responsive. The nurse calls for assistance and medical team arrive however they are unable to revive Susan.
- Please explain if legal, informed consent was obtained from Susan.
In the answer discuss:
a) What is Informed Consent? Include in your definition the legal age of consent.
b) Was the consent obtained from Susan Informed Consent? Explain your answer by applying one (1) example of legislation, regulation, guideline or policy that guide nursing practice in regard to informed consent.
c) Discuss the four (4) elements to the process of open disclosure in the health care environment, in your discussion, include your role as an EN and the roles of other health care workers, use examples from the case study to show your understanding of the principles of open disclosure.
2. Please explain whether EN Stuart should have given Susan’s chart to her friend to read?
In the answer:
a) Define privacy and define confidentiality.
b) Then, provide two (2) examples of legislation, regulation, guidelines or policies that guide nursing practice and apply these to EN Stuart’s actions in regard to privacy and confidentiality of documentation.
3. Please discuss whether EN Stuart was negligent and whether he breached his duty of care to Susan. In the answer discuss:
a) The tort of negligence including
1) duty of care,
2) breach of duty of care,
3) standard of care,
5) omission and
6) reasonable standard
b) Using one (1) example of legislation or regulation that guides nursing practice in regard to duty of care, and apply it to your discussion of negligence above.
4. EN Stuart did not document the use of physical restraint.
a) What are the legal requirements for documentation in your role as an EN?
b) Document a nursing progress note for the use of physical restraint on a patient
c) What is the protocol for using restraint in a healthcare facility? (list the steps).
5. Susan’s death is a coroner’s case.
a) Discuss the functions of the State Coroner
b) What is the legislation and/or regulation that guides nursing practice in regard to reportable deaths, including the nurses’s responsibilities?
6. An inquest is held into Susan’s death.
a) Define what is meant by the term “Expert Witness”.
b) Discuss what evidence might be required by the coroner’s court, and include the evidence that EN Stuart could be asked to provide.
7. Explain if EN Stuart was in breach of the Codes and Standards that govern EN practice? Using the Codes and Standards that govern EN practice, identify and discuss how EN Stuart was in breach of one (1) from each of the following documents:
a) Nursing Code of Conduct
b) Nursing Code of Ethics and
c) Enrolled Nursing Competency Standards
8. Choose an ethical dilema from Susan’s situation, and in your own words, define the steps of the Moral Decision Making Model, using your chosen ethical dilemma as an example to discuss each step of the Model.
9. A relative complained about Susan’s care while she was in hospital.
a) As an EN state how you would sensitively receive the family members complaint as per hospital policy.
b) How would you encourage the family member to advocate and support Susan’s right to care?
c) How would you respect and support Susan and her family’s decision to lodge a complaint?
10. Susan is a fit and healthy 76 year old person normally, however hypothesise that you were caring for a 76 year old person who was admitted to your ward who appeared to be malnourished with multiple cuts and bruises. Using one (1) example of legislation that guides your nursing practice, discuss the mandatory reporting responsibilities of the enrolled nurse in regards to elder abuse.
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