The professional and legal issues in the field of nursing

The main goal of professional and legal issues in the nursing field

The main goal of the professional and legal issues in the nursing field is to strengthen the patient’s rights to high-quality medical treatment. Notably, it is the responsibility of nurses and medical professionals to tell patients of the recommended medical procedures that will improve their course of treatment. Doctors need to increase patient safety and make sure that the standards of medicine they use in their treatment processes are followed. (Forrester & Griffiths, 2010).

Keeping a close connection with patients

Keeping a close connection with patients is essential to ensuring that they follow professional guidelines and legal requirements related to improving healthcare delivery. Particularly, the nurse is the most looked at professional with the intention of enhancing close relationships with the patient and advising the doctor on the progress the patient is making with the prescribed medication and the patient’s preferences in the course of treatment (Forrester & Griffiths, 2010). This paper discusses legal and professional issues based on four case studies.

Case One Study

Regular analgesia has been proven to relieve pain in terminally-ill patients. It substitutes the use of injected opiates as the pain reliever for terminally ill patients. However, the professional issues related to the administration of regular analgesia are the higher likelihood of one pressing the injection button on behalf of the patients leading to higher doses further harming the patients. Medical researchers established there is a need to conduct careful patient analysis and match them with the best treatment option that would lead to the treatment of the condition they are going through (Forrester & Griffiths, 2010). Pain relief is also a professional issue that practitioners in the medical fraternity have an obligation to handle while attending to the medical needs of various patients.

The ethical issue of patient preference

The patient detests being turned every time and has offered an advisory to the family members taking care of him not to provide additional medication. Under the ethical codes of medicine, a patient has a right to make decisions on the treatment option that he/she may undergo during the treatment process. Additionally, doctors have an obligation to ensure a patient is at ease and does not face any form of pain that can be managed (Forrester & Griffiths, 2010). It leads to an ethical dilemma being faced by the doctors and the family members.

Legal considerations

Notably, the medical officers in the case study have no evidence of being in communication with the patient to discuss the treatment options that could then lead to relief of the pain the patient is facing. According to the Australian and Victorian law, patients have the right to make a choice whether they are going to use a given medication or not (Elder, Evans & Nizette, 2009). Additionally, doctors have the obligation, against the will of the patient, to issue medication, where the patient is regarded to be causing harm to other people or him/herself. Though the argument by the medical officers to enforce the use of the extra medication is ethical, it does not follow legal channels that would affirm the appropriate measures have been undertaken to stabilize the medication of the patient. First, nurses and doctors can only compel the patient with a given drug, where it has been affirmed the treatment would facilitate quick recovery of the patient. Second, there has to be proof of all options needed for the voluntary treatment being exhausted before the effective medication to the patient. Third, where family members of the patient and close associates of the victim have been involved in the treatment process with no success, the doctors may make a rational decision to issue medication with the intent of protecting the patient’s interests and health. Another legality is there being proof the benefits of the treatment option outweigh the risks that may result if the treatment has not been granted. As relieving the pain is more beneficial to the patient, the staffs only need to have an active engagement with patient and affirm the importance of turns and continued use of opioids.

The consequences of pulling away from medication

The negative consequence of pulling away from the medication is the increase in distress and pain. The benefit is the condition being stabilized and feeling less pain. Therefore, the medical specialists do not act in a professional manner by alluding that the patient is confused due to the heavy medication. Instead, the specialist has a moral and legal duty to consult with the patient on the most appropriate medication procedures and treatment options (Elder et al., 2009).

Case Two Study

The ethical issue relating to the case is the lack of observation of due diligence within the emergency department. There is a need to better plan how the RNs are to take care of the patient, including counter checking the medications they are to offer to the patients before their issuance. According to the details in the case study, there are only two RNs in shifts, meaning the staffs are overstretched. Overworked staff members may not follow due diligence needed in the medicine, thus exposing the patients to avoidable and possible risks (Freckelton & Petersen, 2006). Therefore, the professional case related to the context lies with the management of the hospital on their inability to meet the staffing needs.

The choice of intravenous potassium chloride

The second professional issue referring to the case is the choice of intravenous potassium chloride amongst the patients in the high-risk medical condition. Notably, the Australian Council for Safety and Quality in Health has issued an advisory on the use of KCI amongst patients in the high-risk medical state. According to their recommendation, direct injection of KCI into a patient could lead to hyperkalaemia. Additionally, the use of intravenous potassium chloride in the treatment of ED patients, when issued in higher dosage, may lead to cardiac arrest. Therefore, the case presents professional negligence that would offer grounds for the RNs to be sued for being responsible for the murder of the patient.

Legal actions against RN Z

Legally, RN Z needs to be sued for professional negligence leading to the death of the patient. The patient, who has suffered cardiac arrest, is the breadwinner to her two children, and the loss of her life owing to negligence recorded from the two nurses is a leading cause of alarm calling for compensation to the family. Statistically, about 18,000 patients die annually in Australia owing to the negligence of the doctors and wrongful use of medication without double checking the prescription being issued is relevant to the medical condition being treated (Freckelton & Petersen, 2006). As presented in the case study, the RN Z offered the injection mistakenly meaning there was no second verification of the medication before the injection. Though the management of the hospital may be enjoined in the case, the RN Z has to take up the personal responsibility of the wrongful action that has led to the death of the patient.

The importance of reporting medical errors

Therefore, the professional issue related to this case is the need to report the occurrence of the medical error instead of a medical cover-up. Medical cover-ups often lead to severe disciplinary issues when they are finally unearthed. Additionally, the family of the patient has the right to sue the nurse and the hospital for medical negligence for the loss of their breadwinner (Staunton & Chiarella, 2007). Since the death of the breadwinner, not being natural, is caused by the incompetence of the nurses, the level of compensation needs to be commensurate with the costs of taking care of the relevant requirements of the children until they are in a position to take care of themselves. Therefore, it is professional for RN Z to report the medical issue to their immediate supervisor and have it documented in the records of the medical facility. Legally, the Nursing and Midwifery Board of Australia may take up the role of an investigation (Staunton & Chiarella, 2007). The board can make decisions on the compensation the nurse and hospital need to pay, the additional safety measures to be installed in the hospital, and, in the worst case, revoke the operating license of the nurse entangled in the case.

Case Three Study

The professional issue related is the need to report or not to report Nurse M for the loss of controlled medications in the hospital. Professionally, reporting the nurse to the administration is the most justified act since such action undermines the medical needs of the patients, who ought to have access to medication (Johnstone, 2009). Since the colleague involved in the stealing of the controlled medication is a single mother, she needs to recognize that stealing medication could lead to employment termination, i.e. financial strain in taking care of her children. Therefore, the professional conduct affirms that evidence must be presented to the hospital management for consideration (Johnstone, 2009).

Reporting for the health and safety of patients

Professionally, the need for reporting the issue to the hospital’s administration is in support of the health and safety of the patients who could be affected by the nurse’s conduct. First, the patients could have been wrongfully billed and would qualify for a refund. Second, it would be professional for the medical facility to profile the patients with the intent of re-examining them to ensure they are indeed safe. Reporting the case would enable the hospital to take responsibility for any treatment or medication that would result from the lack of use of the controlled drug in the treatment process if such had been billed to the patient (Then & McDonald, 2014). The hospital management may need to issue a refund to the insurance companies for using the controlled medication.

Legal actions against the nurse

Legally, it is appropriate for the hospital to dismiss the staff member owing to a lack of professionalism. Since the nurse is a registered health practitioner under Australian and Victorian laws, there is a need to report the nurse to the Australian Health Practitioner Regulation Agency to suggest the disciplinary measures to be undertaken against the nurse based on the evidence and testimonials supporting the claims. As such, it is wise for the case to be reported to the police with the intent of facilitating criminal proceedings against the patient found criminally responsible. It would also enhance the safety of persons receiving supplies of such medication. Under the fourth and eighth schedules of the Controlled Substances Act 1984, the provision of a controlled medicine or any prescribed medication by an individual or entity not permitted by the legislation to supply or issue such prescription is illegal (Then & McDonald, 2014). Notably, a nurse is not licensed to engage in the provision or prescription of controlled medicine, affirming the legal threshold of instituting a case. According to the case’s details, the public interest and the need to maintain the public health safety standards are higher than the need to consider the well-being of the nurse’s child. As such, the case has to be reported to the authorities for the appropriate decision to be taken up by the patient.

Case Four Study

Patients have a right to choose the medication they have to undergo while hospitalized. According to the case, the patient has objected to the treatment process suggested by the medical practitioner, thus calling for the termination of the treatment process already instituted. Therefore, the professional question that one may ask is - should the nurse and the doctors compel the patient to go through the treatment process starting with the annulation process? First is the determination of the health risks that could result if the patient does not go through the treatment process. The chest pains are signs of the infarction the patient is going through that if not managed could lead to the death of the patient. Since the patient does not have an understanding of the medical condition he is going through, the doctors must resort to the content of the hypocritical oath that binds them to the protection of lives.

Medical intervention for patient’s well-being

The medical case of the patient is fatal despite the patient not having an understanding of the resultant effect of the decision that he prefers of not going through the treatment process. Studies have affirmed that infarction results from thrombosis of the coronary artery and could lead to ventricular fibrillation and dysrhythmia. Either of the two conditions could result in the death of the patient within the first one hour of symptom detection. As such, the doctors cannot bow down to pressure from the patient to go home without going through the recommended treatment process. Therefore, the professional practice that needs to be sought out by the doctors is defibrillation to avoid any likelihood of cardiac arrest by the patient (Casanelia & Stelfox, 2010). Such would stabilize the medical state of the patient, further creating room for explaining to the patient the treatment alternatives that are existent and related to his/her medical condition. The patient has a higher potential of dying within 24 hours if no appropriate medical intervention has been instituted to take care of the needs of the patient. As a result, the nurse has to continue with the recommendation of the doctor to prepare the patient for the recommended treatment.

Legal considerations for treatment decisions

Legally, the medical staff may go against the wishes of the patient where it has been ascertained that the patient cannot process the information related to his/her medical state. Additionally, the assessment of the condition of the patient affirms that the patient is not competent enough to make the decisions related to his health care – thus, the need to involve the family and close associate in advising the needs of the patient (Casanelia & Stelfox, 2010). Such is affirmed in the proposal by the son to seek medical intervention with the patient dismissing the child despite the glaring fact of the patient going through severe illness. Therefore, the suggested treatment has to align with the best interest of the patients, that is, being relieved from pain and stabilizing the mental condition or situation of the patient.

Conclusion

The professional codes of practice in the nursing profession have the intent to enhance the safety of the patients. Additionally, the legal issues that are related to the nursing profession offer the basis for reprimanding the nurses who do not abide by the professional nursing codes. Notably, the professional codes and the legalities of the approved code of conduct for nurses have the mission of creating a patient-centered care system in Australia (Townsend & Luck, 2013). However, the need for a patient to grant consent before the commencement of treatment serves to undermine the role that the doctors have to play in enhancing the treatment process. Therefore, there is a need to establish legislation that would protect the best interests of the healthcare profession, such as going ahead with emergency treatment without the consent of the patient. The case at hand is where a patient has an infarction and is oblivious to how fatal the condition may be – that is, it may lead to the death of the patient. Where a nurse fails to adhere to the professional codes of practice, such as stealing controlled medicine, the nurse needs to be sacked, with the certificate or license of practice suspended.

References

Casanelia, L., & Stelfox, D. (2010). Foundations of massage. Sydney, NSW: Churchill Livingstone.

Elder, R., Evans, K., & Nizette, D. (2009). Psychiatric and mental health nursing. Sydney: Mosby Elsevier.

Forrester, K., & Griffiths, D. (2010). Essentials of law for health professionals. Chatswood, N.S.W: Mosby/Elsevier.

Freckelton, I. R., & Petersen, K. A. (2006). Disputes and dilemmas in health law. Annandale, N.S.W: Federation Press.

Johnstone, M.-J. (2009). Bioethics: A nursing perspective. Sydney, N.S.W: Churchill Livingstone/Elsevier.

Staunton, P., & Chiarella, M. (2007). Law for Nurses and Midwives. London: Elsevier Health Sciences APAC.

Then, S.-N., & McDonald, F. J. (2014). Ethics, law, and health care: A guide for nurses and midwives.

Townsend, R., & Luck, M. (2013). Applied paramedic law and ethics Australia and New Zealand. Chatswood, N.S.W: Elsevier Australia