NCS3203: Law And Ethics In Health - Nursing - Case Study Analysis - Assessment Answer

Nursing Assignment

Assignment Task

The case study:

Tim, a 32 year old man, was admitted via the emergency department following a fight at a

weekend football match he attended as a spectator. Examination has revealed a dislocated

shoulder, deep scalp lacerations and extensive bruising to his face and upper body. The

emergency department was very busy, with multiple ambulances arriving and many

patients being admitted. It took some time for Tim to be admitted for surgery, during this

time an alcohol and drug screen was undertaken and these tests were clear. Tim did not

like waiting; he stated he felt unwell and drowsy, he became increasingly noisy and

uncooperative - this was a change from when he arrived; at that time, he was lucid and

polite. Tim fasted, went to the operating theatre and returned to a room on the ward. On

waking, Tim’s observations were stable, although the nursing staff had difficulty doing his

postoperative observations as he was drowsy and noncompliant. Two hours after surgery

Tim stated, “I’m going back to the football match because my team need me to play”. The

Registered Nurse (RN) and doctor on duty tried to persuade Tim not to leave, he continued

arguing and shouted, “Leave me alone, don’t touch me, I want to get out of this bed”. The

doctor thought perhaps the behavior may be attributed to pain, and ordered intramuscular

morphine. Tim stated, “I’m not in pain, I don’t want morphine”. The RN went ahead as per

the orders and administered the injection to Tim, whilst another RN and a nursing assistant

held Tim to prevent him from struggling, causing the needle to break off, and necessitatingfurther surgery, which resulted in an additional four weeks in hospital.

Assignment brief:

The assignment brief is structured under the same headings as the marking rubric, please

consider both documents carefully as you construct your essay.

Content

You need to consider:

• The legal and ethical concerns that the situation in the case study raises.
• Apply all the relevant unit content throughout the essay.
• The possible actions (or inactions/omissions) that could be taken and the implications ofthose actions (or omissions).
• You do not need to provide the ‘right’ answers, what you will be assessed on is yourability to determine the implications of different actions or inactions from a legal and ethical perspective.
• Think of the possible courses of action, and inaction that could be taken, and then consider, do any ethical theories support (or not) the actions that you discuss?
• Which ethical principles, doctrines or concepts apply to the actions/inactions put forwardand if so, how?
• Do any of the ethical principles conflict with each other or with the law?
• Which torts or other legal concerns apply to your suggested actions/inactions?

Description

There is a difference between the law and ethical behaviour. The law gives instruction son what should be done by an individual. Going against the law will result in some consequences. For example, it is against the law to steal items from another person. If one steals, they will be arrested and taken to jail. As residents of any country, people have the obligation of observing all the legal requirements of the country. From a legal perspective, there is no choice other than adhering to the law. On the other hand, people have a choice of acting in an ethical manner. Ethics is purely based on the moral values that people were taught growing up. It can be tied to the behaviour that one possesses. Ethics is also tied to the manner in which people relate to one another (Van der Elst, De Casterlé & Gastmans, 2012). When one is treated in an ethical manner, chances of treating another person with the same ethical behaviour will increase. Promoting ethical behaviour will be good for the society. However, one will not be arrested for failing to act ethically in certain situations. This means that ethical behaviour is at the discretion of the individual. By the way, Tim was behaving while in a hospital, one could easily be disappointed in him. However, this aggression does not warrant the use of excessive force on him. We should always display good morals while interacting with other people around us.

Ethics

Every profession has its set of ethics that must be followed. There is a code of ethics for the nursing profession. This refers to the values by which the nurses must operate. These elements of ethics will be visible in their behaviour and interaction with patients. These professional occupations are governed by rules established by the governing bodies. It requires everybody who practices within the profession to conform to them. The code of ethics was established as a guide for carrying out responsibilities within the nursing profession. The responsibilities must be carried out in a manner that is consistent with the quality of nursing services offered to the community. The code of ethics also dictates the obligations within the nursing profession. Nurses should also do what is best for the patient, despite their arrogance on the matter. The nurse attending to Tim’s needs performed actions that were in his best interests.

While in the hospital, Tim started behaving in an arrogant manner. This prompted the nurse to make a decision of injecting Tim with morphine to ease his pain. The decision resulted from the fact that the nurse was for the idea that Tim was acting in this manner because he was in pain. Tim demanded to leave the hospital without receiving his treatment (Sojourner, Grabowski, Chen & Town, 2010). At the time, the emergency department was overwhelmed by a large number of patients it was receiving. This forced the department to prioritize the patients in accordance with the extent of their injuries. It is the responsibility of the nurse practitioners to make the decision based on what is best for the patient. Due to Tim's arrogance, the nurse decided to inject morphine into his muscle tissue to help relieve the pain he was feeling. However, Tim kept stating that he did not feel any pain. The nurse acted in an ethical manner based on the decision that was made.

Tim tried to resist the morphine injection by being stubborn. This prompted the nurse to seek assistance from other medical experts around the hospital to help holding Tim in position. However, they moved resulted in the needle breaking off in Tim’s body. This will be rectified by further surgical procedures. For this reason, Tim will have to spend an additional 4 weeks in hospital. According to Tim, he endured additional time at the hospital. He was not supposed to have this additional time, but the actions of the nurses caused him to require further surgery. This is ethical behaviour because the actions undertaken by the nurse will not result in her arrest or facing trial in court. Tim was only 32 years of age. This age was not enough to cause him to behave in an arrogant manner. However, the nurses tried their best in persuading Tim to remain in the hospital and not go out.

Ethical behaviour requires one to observe the rights of other people. Tim has the right to receive appropriate treatment when attending the hospital. Tim has begun shouting and demanding to be removed from hospital so that he can go back and continue playing his match. This may seem to be the best thing to do according to Tim. However, the nurses prevented him from heading out. This was the most ethical thing to do at the moment (Tronto, 2011). The nurses forced Time to take the injection full of morphine. After this move, the needle broke in Tim’s body. Activists may state this scenario in various different ways. It may be seen as ethical while in other cases, it may be seen as unethical. However, the move comes off as ethical in most cases. This is evident by the fact that the nurse working in the best interests of the patient.

Legal

The law has a different point of view from that of ethics. The legal standing dictates the actions that must be undertaken by the nurse practitioner despite the conditions presented. Legally, the nurse is expected to administer medical services to the patients without discrimination. When a nurse fails to offer these services while in the line of duty, they will be acting against the law. In such a scenario, Tim will have the full right to sue the hospital and the nurse in a court of law. The nurse acted in accordance with the law when they prevented Tim from leaving the hospital. However, they caused further injury to him. This will force Tim to spend an additional four weeks at the hospital where he will undergo further surgical procedures to remove the broken piece of needle.

The law dictates that every individual should respect the actions of other people. However, the law does not specifically apply to nurses. Rather, it affects everybody living within the borders of a country. Nurses are also citizens of the country and so they ensure that they abide by the rules and regulations presented by the legal arm of the government. Tim was treated as a patient without any form of discrimination. The government develops laws and legislation that will help in controlling all the actions of the citizens living in the country. It forces the people living in the country to observe these regulations that had been brought forward (Lee, Singh, Bartsch, Wong, Kim, Avery & Huang, 2013). There are several reasons as to why laws are developed. However, the most common purpose is to maintain law and order. In some cases, nurses are encouraged to against the wishes of the patient if it is in their best interests. Therefore, the nurse was well within their rights to prevent Tim from leaving the hospital.

Despite the fact that prevention Tim from leaving the hospital, the result was that Tim needed further surgical procedures. This prolonged the period to stay in the hospital for an additional four weeks. Tim had the right to argue the nurse's actions disrupted his life because he was forced to remain in the hospital for a longer period than he was supposed to. Legally, the nurse did nothing wrong. The actions of the nurse were done in the best interests of Tim who was the patient. Events in the medical field are often examined to determine whether they are done with the best interests of the patient (Palumbo, Mclaughlin, Mcintosh & Rambur, 2011). In some cases, patients die while in the hospital. Investigations are conducted to determine the circumstances of which the patient died. In all countries, killing a person is against the law. This does not matter whether it happens within the hospital or outside the hospital. If the actions of a nurse lead to the death of a patient, the nurse will be held accountable. However, it is the duty of the nurse to justify the actions they undertook that lead to the death of a patient.

The actions of the nurse did not lead to the Tim’s death, but it added him another four weeks at the hospital and an additional surgical procedure that he would not have gone through. The justification of these actions show that the nurse was acting in the best interests of the patient. Tim has begun behaving in an arrogant manner where he shouted and demanded to be released from hospital. Tim wanted to go back to the match that resulted in his injuries. He also claimed that the other team members wanted him to go back and play because they needed him. However, Tim was not part of the team that was playing in the game. Instead, he was a spectator. Therefore, his requests did not seem reasonable and realistic at the time (Gimenez, 2012). This was a high indication that he have been suffering from a brain injury because he was not acting in a normal manner. Legally, the nurse was making the right decision in preventing him from leaving the hospital.

From a legal perspective, the nurse has a duty to improve the lives of the patients they attend to. Their actions must be justified as the best course of action for the patient. If Tim would have been released from hospital, maybe he would have hurt himself more seriously. This is based on the fact that he was not thinking clearly or behaving in a normal manner. However, the nurse made an assumption that Tim was feeling pain from the injuries that were inflicted on him during the scuffle. Pain could have been the cause of the behavior, but the nurse should have carried out more tests to determine whether Tim was suffering from a brain injury. This would have prompted the nurse to take a course of action rather than injecting him with morphine. Maybe this would have prevented Tim from staying in the hospital for additional time due to a broken needle. From a legal perspective, the nurse acted swiftly as they had no time for further deliberations. Also, the hospital was overwhelmed by the large number of patients that were coming in at once.

Actions

These are steps that would have been undertaken to ensure that the patients are well taken care of. The hospital was overwhelmed by the large traffic in patients. This was due to a scuffle that took place at a football match where Tim was spectating. In such an event, the hospital could have requested for more back-up from other nearby hospitals in the area. This would have helped in easing the congestion at the hospital. Also, the hospital would have performed first-aid actions for the critical patients then transfer them to other nearby hospitals (Huang, 2011). This would have helped ease the congestion at the hospital while at the same time maintain their ethical standards. Also, they would have been well within the law. The actions that are undertaken by the nurses should adhere to the legal structure of the country they practice. Nurses are governed by a code of ethics, which dictates their every move in the medical field. However, there are instances where people often go against these regulations. It may be because of some temptations to achieve certain goals and objectives.

Seeking for further assistance from outside sources will work in the best interests of the patients and the hospital. A hospital only has limited recourses. The hospital that Tim was admitted in, was small and could hardly accommodate the large number of people that were streaming in as patients who were injured in the football match. The actions undertaken by the nurses in the hospital should be in the best interests of the patients. This will amount to an ethical practice. Nursing is characterized by having specialized knowledge and skills with independent decision-making procedures. However, varieties in the decision-making process is affected by the type of client that attends the hospital (Davison, Kahwa, Atkinson, Hepburn-Brown, Aiken, Dawkins & MacFarlane, 2013). The type of diseases and attention required by the patient, will affect the decisions made by a nurse. In this scenario, Tim was behaving in an arrogant manner where he kept shouting and demanding to be released from hospital. The nurse then decided to administer morphine to ease the pain. However, Tim kept stating that he was not in pain and did not need the morphine. The decision to give Tim the morphine was made based on the current situation and the actions performed by Tim.

Over 100 years ago, laws were enacted to ensure that every individual is exposed to safe nursing practices. During the course of their education and training in the nursing profession, nurses gain knowledge about the law and what is expected of them. This ensures that they engage in safe nursing practices at all times. Therefore, they will be in a position to act well within the law and offer the best nursing practices to their patients. This will put into practice all what they have been studying up to that point in their careers. However, the legal requirements are constantly changing and updated. It is the responsibility of the nursing professionals to update their knowledge on the current legal requirements within their profession. There are bodies that coordinate and monitor the actions of the nursing professionals (Kjellström, Ross & Fridlund, 2010). Nurses are expected to subscribe to these bodies. In the event that a law or an ethical code has been breached, the nursing representative body is helped accountable for the actions of their nurses.

Nurses are taught on how to provide specialized care to their patients. During their training sessions, nurses are encouraged to put the needs of their patients first. This teaches them to promote their ethical behaviour in their line of duty. Lack of embracing ethics in their character, nurses will be acting in an unprofessional manner. This will go against their responsibilities in the nursing profession. In a bid to maintain their ethical nature and abide by the law, nurses employ a nurse legal expert in the team. These professionals will advise the nurses when they go off course. Also, nurses will seek the advice of these people when they encountered by dilemmas while executing their duties. For example, at the hospital where Tim was admitted, the nurses would have sought advice from the legal professionals in the medical field. This would have made the decision making process a smooth and easy one.

Conclusion

Nurses are governed by both ethical and legal practices in the field of medicine. The nurses attending to Tim acted in an ethical nature because they are looking after the best interests of their patient. From a legal perspective, the nurses did not break any law by going against the patient’s wishes. It was in the best interests of the patient not to leave the hospital. Tim was in need of some surgical treatment because of the scuffle that took place at the football match. The nurses did their best to make sure that he was contained within the hospital environment to receive full treatment for his injuries. However, the actions of the nurses resulted in another surgical requirement for Tim to remove the broken needle in his body.