Posted: July 22nd, 2021

SNPG923 | Legal and Professional Issues

Introduction:

The occupation of nursing is the holistic method to the society and the nurses are accountable in the direction of their sufferers, employers and their society. Each nurse ought to have distinct moral emotions on their thoughts to offer the sufferers with competent care. Their loyalty to ethics can be liable for their contribution to the society and the occupation. It is rather vital that the nurses have an understanding over numerous moral, authorized points, which they might usually face whereas working in a healthcare facility (Morton et al. 2017). The Hong code of ethics for the nurses has divided the code into 4 fundamental elements.  They're respectively Nurses and other people (the accountability of a nurse in the direction of the sufferers), Nurses and follow (the accountability of a nurse to offer the sufferers with protected and competent care), Nurses and Career (a nurse’s accountability in the direction of the holistic occupation of nursing) and Nurses and society (accountability of a nurse to the society). A nurse practising in Hong Kong would additionally need to be accountable with the legal guidelines related to the occupation (Nchk.org.hk 2017).

Key occasions:

  • When Mr. Symes, the affected person who underwent laparoscopic cholecystectomy on 21stCould morning, reported that he's experiencing extreme stomach ache, his surgeon did not assess him. Nonetheless, a Medical Officer (MO) was current there who assessed him and contacted the surgeon. Each of them made a be part of determination of prescribing 10 mg morphine to the affected person subcutaneously.
  • The Prolonged Day Solely Unit (EDOU) was at full capability that day and solely two Registered Nurses (RN) had been the one nurses who was rostered to the attend the evening shift that day. The nurse-patient ratio was improper at that day.
  • The nurses didn't correctly doc the observations after assessing Mr. Symes. Just one commentary was documented, that too with none reference to the standing of the stomach ache of the affected person.
  • The nurse didn't file any of the analgesia administration on Mr. Symes. The day RN didn't discovered any information of the drug administration when she commenced her work.
  • Two of the opposite male sufferers had been in distressed situation through the shift of Nurse Prior other than Mr. Symes. The nurse couldn't acknowledge the important acuity of the sufferers.
  • An upset feminine affected person was distressed about her mattress association. She was offended and was repeatedly wailing over the issue. This was upsetting the full surroundings of the hospital ward.
  • The feminine affected person and her husband have reported the problem to the hospital administration. Nonetheless, the administration has not taken any measures to resolve the state of affairs.
  • The case examine doesn't present any details about the nurse-in-charge. Nonetheless, it's endorsed that ne nurse-in-charge should be current in each ward of a hospital each time (Haber and Singh 2014).

Absence of the surgeon: 

Authorized:  

All physicians have a authorized obligation over the sufferers to offer them with sure requirements of care. When a doctor agrees to offer a affected person with correct remedy, the authorized obligation of the physician over the affected person is created. The surgeon who carried out the laparoscopic cholecystectomy on the affected person Mr. Symes is legally certain to see the affected person if the affected person wants him in misery. When the MO referred to as him, he attended the decision however he didn't discover it essential to entry the situation of the affected person at the moment.

Moral: 

It is usually the moral obligation of a physician to see a affected person in misery (Guinane et al. 2013). Any medical follow will be implicated as a holistic method in the direction of the society and it's mentioned that it's the obligation of a physician to see a affected person in misery (Kangasniemi et al. 2014). When the affected person reported that he's affected by extreme stomach ache, the surgeon being his physician and his main remedy supplier refused to return to see the affected person, which is in opposition to the moral obligation of a physician.

Improper nurse – affected person Ratio: 

Authorized:  

The Australian Nursing and Midwifery federation has strongly really helpful that one nurse ought to be current for each 4 sufferers to offer each affected person with satisfactory care (Shekelle 2013). It is usually mentioned that if the ward consists of many excessive acuity sufferers, then one nurse should be allotted to offer look after the smaller variety of sufferers (Zhu et al. 2012) (Butts, and Wealthy 2012). It is usually really helpful that there ought to be one nurse-in-charge per ward to direct the entire system of caregiving. In line with the code of ethics conduct for nurses in Hong Kong commonplace 5.2, it's the moral obligation of the nurses is that, they're liable for their very own requirements of follow (Nchk.org.hk 2017). Because of the scarcity of the nurses within the ward, the current nurses couldn't preserve their very own commonplace of follow.

Moral: 

There's a scarcity within the variety of nurses within the healthcare sector all around the world. That is the rationale finishing up the moral obligation correctly is tough for the nurses. The primary moral obligation any of the nurses face is their obligation to guard the sufferers from any potential hurt. Because of the scarcity of the nursing employees, it will get tough for the remaining nurses, as they've to offer look after a number of sufferers directly. The nurse – affected person ratio is rarely maintained because of this. The hospital ward talked about within the case examine solely had two nurses on the evening obligation (with 12 sufferers and three important sufferers) whereas the required nurse – affected person ratio is one nurse per 4 sufferers.

Improper recording within the paperwork: 

Authorized:  

Incomplete and improper documentation really demonstrates that the nurse supplied the affected person with insufficient care (Alspach  2013). If one thing dangerous occurs to the sufferers, the unfinished documentation is used as a authorized doc to offer proof that the nurse haven't correctly handled the affected person. This might convey authorized complication to the profession of a nurse. If a nurse produce any incomplete documentation of medical information, the nurse can lose the license to follow (Joel 2013). Within the case examine, the nurses haven't produced any correct documentation of the affected person’s situation.

Moral: 

 In line with the code of ethics conduct for nurses in Hong Kong (four.2), the nurses have to make sure the person security and should follow protected and applicable care to the sufferers (Nchk.org.hk 2017). On this case examine, the nurses haven't correctly documented the stories of Mr Symes. This breaches their moral obligation to offer protected look after the affected person. If a nurse correctly doc the situation of the affected person over their obligation, the docs and the opposite nurses finds it useful to deal with the affected person from such level.

Unsure standing of remedy administration: 

Authorized:  

If a nurse doesn't register the standing of remedy administration, it might probably simply fall beneath among the Hong Kong Regulation ordinances just like the Hong Kong Invoice of rights ordinance (383), medical well being ordinance, Hospital Authority Ordinance (113) and Nurses Registration Ordinance (164) (Nchk.org.hk 2017). If a nurse is accused of not offering the drugs to the sufferers correctly, she or he can lose his or her registration to work as a nurse.  

Moral: 

Because the occupation of nursing falls beneath a license of privilege, there are some further skilled duties of a nurse together with drug security and medicine administration. Because the nurse is the first caregiver of the affected person, she or he holds skilled accountability of his or her personal motion. Each state of each nation gives the nurse with codes of ethics to keep away from the implications. The Hong Kong Code of ethics commonplace 5.2 clearly states each nurse has to offer the sufferers with greatest commonplace of care as potential (Nchk.org.hk 2017). Handing over a affected person with not sure standing of drug administration to different nurses isn't a correct instance of greatest commonplace of care. Ethically it is usually fallacious handy over the logbook of a affected person, which doesn't point out if the affected person acquired his or her remedy.

Incapability of the nurses to acknowledge the affected person acuity: 

Authorized:  

The nurses at all times have to supply accountable nursing judgments and produce motion in accordance with that judgment. In that case, Nurse Prior has failed to acknowledge the severity of the situation of the sufferers, which places all of the sufferers in harmful situation. If any of the sufferers is harmed because of, the nurse’s incapacity of judging the severity of situation, the hospital and the federal government holds the authorized proper to terminate the registration of the actual nurse (Urden, Stacy, and Lough  2015).

Moral:

Because the ward has solely two nurses and there have been many sufferers in that ward for the nurses, it's comprehensible that the nurses had a busy work to maintain up with all of the sufferers. Other than Mr. Symes and the lady affected person, two different male sufferers had been additionally distressed throughout that point. It's the moral obligation of the nurses to offer the absolute best commonplace of care to the sufferers regardless of the circumstances is (commonplace four.5) (Nchk.org.hk 2017). The Hong Kong code of ethics additionally directs the nurses to make sure that the usual of follow is in synchronization with the usual of occupation (Customary 5.2) (Nchk.org.hk 2017). The nurses couldn't preserve the moral codes through the time of their obligation. As 4 of the sufferers had been in distressed situation, the surroundings of the entire ward can be chaotic and should be uncomfortable for the opposite sufferers as nicely. The moral obligation of the nurse to keep up the surroundings of the state of affairs was additionally breached as nicely.

Improper judgment of the nurses: 

Authorized:  

The improper judgment of a nurse put any affected person in danger (Fowler, and Davis 2013). The affected person Mr. Symes was in ache after his surgical procedure and when the nurse assessed him, she didn't doc the severity of the affected person’s stomach ache. Any incomplete documentation can put the nurse in authorized bounds because the affected person’s household and the hospital can accuse the nurse of displaying irresponsibility (Huston 2013).

Moral: 

In line with the Hong Kong Nursing commonplace four.three and four.four, the nurses are accountable and maintain the accountability of manufacturing skilled nursing judgment. The nurses failed to guage the situation of Mr. Symes as he was complaining of extreme stomach ache. The nurses was ethically irresponsible for the situation of Mr. Symes as they didn't correctly documented the remedy administration of the affected person, so, it may be potential that she didn't inject the morphine to the affected person. It's in opposition to the ethics of a nurse to place a affected person in such a situation (Kim, Kang, and Ahn 2013).

Misery of the feminine affected person: 

Authorized:  

The nurses didn't take any step to unravel the issue of the feminine affected person. The entire incident can drag each the hospital authority and the nurses in authorized hassle. The affected person and the household have the authorized proper to go to the court docket and accuse the hospital authority and the nurses for incompetent service.

Moral:

The feminine affected person was distressed as a result of she was in a room with many male sufferers. The affected person was in misery due to her non secular views. In accordance the Hong Kong code of ethics 1.1, the nurse is ethically certain to serve all sufferers regardless of their gender, faith, forged, ethnicity, political background and socio-economic standing (Nchk.org.hk 2017). The Hong Kong code of ethics 1.four additionally states that, a nurse need to respect the view, beliefs and customs of each particular person (Nchk.org.hk 2017). By not reporting the incident, the nurses have additionally disrespected the non secular perception of the affected person. The throughout surroundings of the hospital was additionally hampering due to the state of affairs and the nurses are ethically certain maintain the ward surroundings therapeutic for all of the sufferers.

Absence of administration from the hospital authority: 

Authorized:  

Because the hospital, administration has ignored the affected person’s plight to vary the room due to her non secular views. The affected person and her household may also file a lawsuit in opposition to the hospital administration.  

Moral:

The important thing obligation of the hospital directors is to carry the principle duties of a healthcare facility to maintain all of the duties functioning effectively (Chan et al. 2012). The work of the hospital administration is to strategize, lead and handle the medical service (Grohar-Murray, DiCroce and Langan 2016). When the feminine affected person and her household reached to the hospital administration themselves, they did promise them to unravel the issue as quickly as potential. Nonetheless, they didn't change the affected person’s seat as promised. It is usually the accountability of the hospital to respect the view and perception of a affected person. However, the hospital authority forgot their moral obligation and ignored the sufferers. Additionally they forgot their work ethics of conserving the hospital performing at its greatest as they did ignore them, which brought about monumental misery within the ward.  

Absence of the Nurse-in-charge: 

Authorized:  

Each ward of a hospital ought to have a Nurse-in-charge, who usually directs the entire state of affairs in a correct means (Chan 2013). The absence of a nurse-in-charge can put the lifetime of the sufferers in danger if the opposite inexperienced nurses of the ward couldn't preserve the fully critically distressed situation of the ward (Cohen et al. 2014). On this case situation, it isn't talked about that if a nurse-in-charge was current in that state of affairs and the nurse affected person ratio was 1:6 which was additionally distressing for the nurses (Sullivan 2012) (Parahoo 2014). If any of the sufferers information a lawsuit over the loss, they've encountered due to the distressed situation of the ward; it might probably put the hospital authority in authorized hassle.

Moral:

Not having a nurse-in-charge within the ward shadowed the judgment of the opposite nurses current within the facility. The distressed situation of the ward jeopardized the security of all of the sufferers. The Hong Kong code of moral commonplace four.6 states, the nurses can not take any actions, which can put the sufferers in danger or jeopardize the state of affairs. Absence of the nurse-in-charge left each the RNs with enormous accountability over their obligation. Furthermore, the absence of the opposite nurses at this situation has additionally made the nurses to supplied compromised care to the sufferers. The Hong Kong code of ethics four.7 states nurse can increase objection over the follow, which lowers the allover commonplace of the care-giving course of. Nonetheless, the nurses didn't object about it to the hospital authority. That is additionally a breach of the moral accountability of a nurse in accordance with the Hong Kong code of ethics for the nurses commonplace four.7(Nchk.org.hk 2017).

Conclusion:

If anybody seems to be on the healthcare trade, one can understand that authorized and moral points are prevalent within the occupation of nursing. Many nurses don't even have formal schooling within the authorized and moral points, which might come up in a hospital state of affairs. This could hurt the general situation of the healthcare facility as they'll unknowingly be breaching many authorized and moral codes associated to the occupation of nursing. Because the nurses works with the sufferers from completely different strata of the society in an surroundings, which is extraordinarily dynamic, authorized and moral points can come up. The nurses can keep away from the state of affairs by rising consciousness about all potential authorized and moral points.

References:

Alspach, J.G., 2013. Core Curriculum for Crucial Care Nursing-E-Guide. Elsevier Well being Sciences.

Butts, J.B. and Wealthy, Ok.L., 2012. Nursing ethics. Jones & Bartlett Publishers.

Chan, E.A., Jones, A., Fung, S. and Wu, S.C., 2012. Nurses’ notion of time availability in affected person communication in Hong Kong. Journal of medical nursing, 21(7?eight), pp.1168-1177.

Chan, Z.C., 2013. A scientific assessment of important pondering in nursing schooling. Nurse Schooling In the present day, 33(three), pp.236-240.

Cohen, I.G., Amarasingham, R., Shah, A., Xie, B. and Lo, B., 2014. The authorized and moral issues that come up from utilizing advanced predictive analytics in well being care. Well being affairs, 33(7), pp.1139-1147.

Fowler, M.D. and Davis, A.J., 2013. Moral points occurring inside nursing schooling. Nursing ethics, 20(2), pp.126-141.

Grohar-Murray, M.E., DiCroce, H.R. and Langan, J.C., 2016. Management and administration in nursing. Pearson.

Guinane, J.L., Bucknall, T.Ok., Currey, J. and Jones, D.A., 2013. Missed medical emergency crew activations: monitoring choices and outcomes in follow. Crucial Care and Resuscitation, 15(four), p.266.

Haber, J. and Singh, M.D., 2014. Authorized and moral points. Nursing Analysis in Canada-E-Guide: Strategies, Crucial Appraisal, and Utilization, p.112.

Huston, C.J., 2013. Skilled points in nursing: Challenges and alternatives. Lippincott Williams & Wilkins.

Joel, L.A., 2013. Superior follow nursing: Necessities of position growth. FA Davis.

Kangasniemi, M., Vaismoradi, M., Jasper, M. and Turunen, H., 2013. Moral points in affected person security: Implications for nursing administration. Nursing ethics, 20(eight), pp.904-916.

Kim, Y.S., Kang, S.W. and Ahn, J.A., 2013. Ethical sensitivity referring to the applying of the code of ethics. Nursing ethics, 20(four), pp.470-478.

Morton, P.G., Fontaine, D., Hudak, C.M. and Gallo, B.M., 2017. Crucial care nursing: a holistic method. Lippincott Williams & Wilkins.

Nchk.org.hk (2017). The Nursing Council of Hong Kong - Code of Ethics and Skilled Conduct for Nurses in Hong Kong. [online] Nchk.org.hk. Out there at: https://www.nchk.org.hk/en/code_of_conduct_and_practice/code_of_professional_conduct_and_code_of_ethics_for_nurses_in_hong_kong/index.html [Accessed 28 Oct. 2017].

Parahoo, Ok., 2014. Nursing analysis: rules, course of and points. Palgrave Macmillan.

Shekelle, P.G., 2013. Nurse–Affected person Ratios as a Affected person Security StrategyA Systematic Assessment. Annals of Inside Medication, 158(5_Part_2), pp.404-409.

Sullivan, E.A., 2012. Crucial pondering in medical nurse schooling: Software of Paul’s mannequin of important pondering. Nurse schooling in follow, 12(6), pp.322-327.

Urden, L.D., Stacy, Ok.M. and Lough, M.E., 2015. Priorities in important care nursing. Elsevier Well being Sciences.

Zhu, X.W., You, L.M., Zheng, J., Liu, Ok., Fang, J.B., Hou, S.X., Lu, M.M., Lv, A.L., Ma, W.G., Wang, H.H. and Wu, Z.J., 2012. Nurse staffing ranges make a distinction on affected person outcomes: a multisite examine in Chinese language hospitals. Journal of Nursing Scholarship, 44(three), pp.266-273.

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