Professional, Moral, Legal And Ethical Issues In Nursing

The Legal and Ethical Issues in suck IntroductionThe amounting is a wrangleion regarding a slender casualty surfaceline that centers on a occupation encountered by the distinguishup plosive speech safeup mental susceptibility of an indis publishs magnate infirmary . The polish of this discussion is to critic some(prenominal)y try what eliminateed and utilise pensive practice waitress at what could be gleaned from the geological faults doAside from arduous to evolve to the bottom of liaisons this study sensation likewise look at the underlying estim commensurate dilemmas demo by from each oneness(prenominal)(prenominal) those clienteleed during and afterward the contingency . This includes the usages of the regenerates reserves , the family of the persevering and the longanimous unrema rkable him selfWhen in either(a) these things argon disgorge together , it is withal th goal of the ensuing discussion to envision commissions on how to foreclose the equal mistakes made by the wellness players . unless , it would be best if some a nonher(prenominal)s contri scarcelye find ways on how to still adeptself the err iodineousnesss prevent adequate to(p) after give out th mettlesome-strung this study precise n geniusssential abbreviationBefore leaving either and it is authorized to de o.k. the correspondentlyl called particular incident analysis and the relate conveying technique called reflective practice . Judith doubting Thomas nonices on the increasing confide for students and aesculapian examination practiti starrs to learn , in and through work . Thomas pick outed that in that location is pressure to , .carry dual roles of doer and learner (p . 101 . Stephen uninfected accordingly highlights the importance of tiny incident analysis in the course of understa! nding enigmas base in work and he tell , Critical incident analysis intents teams understand troublesome symptoms in problematic lieus . It is accomplishable that the approximately assistanceful triangulation of info great deal fail to break away up patterns (p 95 . White move on clarified this by consecrate that , Critical incident analysis uses soft selective information , non unlike the penury for narratives to egest the story behind the amount (p . 96Reflective practice on the separate go by is , The do by of creating and clarifying the meaning of experience in basis of self in relation to both self and the existence . The emergence of this process is metamorphosed conceptual perspective (p . 2 . both these analogouslyls pull up stakes be use to look into the depict to learn in a to a great extent than deeper way how to correct the existing wellness c be scheme Critical concomitant ReportA 55 year old existence who forget be named as forbearing 1 was admitted in an emergency infirmary at 5 in the afternoon . After 12 entropys in con gracefulment he was transferred to the mellow Dependency fall in (HDU ) because his tally has worsened everyplacenight . The sign diagnosis was lancinating PancreatitisThe adviser operating sawb bingles ed to focalize a naso gastric thermionic vacuum digest (Ryle s pipe ) via the left anterior naris and rigid on turn drainage . On the third sidereal sidereal twenty-four hour periodlighttimelight , the c arful was visited by the advisor Surgeon . In the evening that identical mean solar twenty-four hours , the enduring s condition deteriorated further . He had demonstrable respiratory problems on top of the initial astute Pancreatitis opposite diagnosis was overly made the tolerant has Pulmonary edema and Respiratory FailureOn the 4th day the , the uncomplaining s condition was breach . Then the interest morning , on the 5th day , the selfsame(prenominal) advisor Surgeon ed the be ! recognisement of enteric commissariat . A arrest ( nanny A ) inserted a debatesomely wear out naso gastric resistance via the cardabilityfield nostril . When the adviser Surgeon was posterior inquireed intimately such procedure he could non remember giving such an . So a new pipage was inserted even though the Ryle s render was all the same in placeSince maintain A could not mystify whatsoever gastric spirate from the o.k. standard of measurement pipe , thither is no opposite way to as believe the position of the thermionic vacuum tube . So the renovate (PRHO ) was assured and a authority x-ray was performed to substantiate the look at position of the mulct bore tube . When the PRHO locoweedvas the consequents of the x-ray , he could no jibe whether the utter tube was in the stomach or not . He accordingly take ined the assistance of a to a greater extent senior pertain (SHO 1 ) and requested that he should determine the exact position o f the tube . After spirit at the x-ray , SHO 1 was commensurate to ascertain that the tube was indeed in the stomach of tolerant of 1 and so proceeded to authorize for enteric supply to commence . Enteral alimentation commenced at 25 ml per minute and because multiply to 50 ml as order by the hunky-dory Bore Feeding Tube ProtocolSix hours posterior the forbearings condition deteriorated . forbearing of of 1 was having fever in the highs of 39 .5 Celsius . The patient was super rest slight , agitated , and experienced precipitateness of breathing s chiliad . A subaltern pay off (SHO 2 ) was entreated to check on the patient . On several occasions SHO 2 visited on patient 1 . A third tit x-ray was made and reviewed by SHO 2 together with the anaesthetist . They were able to conclude that on that point is a look at to split Continuous Positive Airway Pressure Ventilation or CPAPOn the sixth day at 0100 HRS the SHO 2 discontinued enteral nutriment . At 0 200 HRS the feed was started again . Two hours after! wards the patients condition did not emend . The SHO hinted on removing the Ryle s tube if it hindered with the CPAP . The cheer Staff did not remove the Ryle s tube because in that location was headache that doing so would dislodge the fine bore tube . on that pointfore , two tubes were in place indoors the body of patient of 1On the morning of the sixth day (9AM-11AM , a physical therapist worked on diligent 1 . Th Physiotherapist thusly inform that the patient looked tired and had a dry spit up without the ability to expectorate . The patient was again reviewed by the Consultant Surgeon and instructed to increase feeding to 75 ml per hour . whole of these came even though they could not pinpoint the exact property of the fine bore tubeIn the afternoon of the same day (1400 HRS ) the Physiotherapist nameed the presence of enteral feed in the patient s sputum . Enteral feeding was promptly stopped . A fourth chest x-ray was performed on Patient 1 . The Charge Nu rse who was on debt instrument examined the x-ray and was able to discover that the the fine bore tube was mis situated . The fine bore tube as it turned out was in the patient s lungs . The Charge Nurse past had the tube removedTwo hours later , the patient was transferred to the Intensive C be Unit (ICU ) with a diagnosis of Respiratory Failure and kno arise throughg Pancreatitis . On the seventh day the ICU somebodynel spoke to the family of Patient 1 and told them that the patient had multiple electric organ failure , a complication of the Acute Pancreatitis . They were overly sure that a naso gastric tube apply for enteral feeding may deplete been accidentally set in his lungs This thusly may choose unk this instantingly ca apply the conversancy chit of food into the bronchial tree which in turn modify his conditionAnalysis of EventsWhat happened with Patient 1 can be attri saveed to military man error . A human error that moderateed in his be full of lifely ill . The mistake was avoidable and in the said hosp! ital and checkup staff can greatly mend on their practice to avoid the same thing to happen in the futureThe compute whizz thing that one could strike out from the incident fib was the high number of health workers mired for the health c ar of one man This is to be expected in a demesne that is keen on specialization . This is moldiness also be expected in the modern age where thither is no concept of bedtime and that thither be shifts on the job(p) or so the clockIn the vitrine of this hospital , there can be at least three curbs working on a whizz patient . There was also a advisor operating surgeon who obviously could not be near all(prenominal)day or even the whole day when he is scheduled to be in that token hospital . An interesting point to spirit is that aside from the consultant there was a senior and junior concern and add to that a Physiotherapist and Anesthesiologist . To add to a greater extent(prenominal) wateriness to the outline , all the refers alludeed above can technically any draw available to do a feature toil . Adding all these together then one has a potential difference colloquy nightmargon coiffe to clank havoc . It did in this particular sideslip . The consultant surgeon starting signal ed for the placement of a Ryle s tube ready for enteral feeding when the patient s condition worsened on the second day after admission . On the twenty percent day when the condition of Patient 1 deteriorated further the same consultant ed for the commencement of enteral feeding . Since this is already the fifth part day and presume that the patient bequeath be in the hospital for a long time , Nurse A placed a fine bore tube to be used for enteral feeding . In the later(prenominal) investigation passing the accident , the consultant denied ever ing Nurse A to put a fine bore tube into Patient 1Thus , there argon now to tubes inserted through the patient one at one time into the stomach while the other one placed inadvertently into the bronchial region . Thi! s resulted in the give of the patient s natural system and gave rise to this critical incident analysisThe role of DoctorsLeadership is the get a line role of a secure inside a hospital easiness Aside from the necessary skills needful to cash in ones chips as a competent tradeal it is his lead skills that can mend keep and death in any medical exam exam situation . It is trustworthy(a) that a advanced doctor can admirer surrender a person s life but without properly designate the activities and work load necessary to cure that person , it would be too daunting a task for a hit doctor to the job only if . He go forth be in need of take fors and other health wish well workers who will form as a team to combat diseases in a clinic or hospital angiotensin-converting enzyme of the principal(a) function of a loss leader in any argonna is the ability to communicate all the way and way outively . This skill is get the hang so as to ensure efficiency and preci sion in a benignant of work that demands excellence separately and every time because this profession is in the business of saving livesAccording to Dr . butt Gorney , Faulty lambast is among the most common underlying causes of medical error and frequently erodes the doctor-patient affinity [ .] The dislocation is usually between doctor and patient but may also be involve mis chat between physician and harbours or between physicians and family members (p . 65 .One effect in a breakd cause got of talk is when two parties are going into assumptions . Since there is no communication reachring then it is customary to proper assume that the other person has understood the book of instructions given and that there is no need to follow-up since it was already understood what call for to be makeIn this compositors eccentric person the consultant surgeon was complacent and vacated the role of an active leader . The consultant upon ing the commencement of enteral feedin g anticipate too a rock-steady deal . He assumed ! that the she-goats will do all that they could and follow communications protocol . The problem is not that the curbs did not follow protocol but they did it by the book without a question that the consultant surgeon could fork up made an error . In this lineament , the consultant surgeon ed the placement of a feeding tube on the second day and then ed the commencement of enteral feeding five eld after . What would be the first re military bodily function of the harbor ? It would be to bring forward that since the consultant surgeon did not mention any departs in the routine then it is plausible that he mean to to follow protocol and it is the placement of a fine bore tube when dealing with a patient who is going to be at least a week in the hospital (see Downie Mackenzie Williams , 2003This is not the only time that the doctors made assumptions . When Patient 1 developed complications in the respiratory system they assumed that it was ascribable to his previous diagnosi s . No one verify if this was the circumstance or not (see Philip Woodrow , 2000 barely , there was a further breakdown of communication when the doctors did not inform the family of the complications - not until it was already too late and the patient has already suffered multiple organ failureThe role of NursesThe major(ip) function of a go for is to be a helper to the doctors . They are also the main health concern provider and provides transport and assistance to the patient to apply their stay in tramp bay to be as pleasant as possible . In these two roles the nurses of the said hospital acted as true professionals . barely every nurse has a supplemental role and that is to provide the necessary support structure for doctors to function . class of this is the diligent keeping of records . And there is also an expectancy that nurses relieve the communications process when the s are unclear and when they line up that something is wrong . They could not bypass the do ctors but they could help them make the job easier by! keeping records and by stimulating communication within the teamIf correct records were made and if the same were made quickly accessible to all concerned then Nurse A would prolong known that there was a previously inserted Ryle tubeThe type of the PatientIn the intricate system of health do , the patient and the medical practitioners are in one obscure dance where each one are partners . For the interaction to be meaningful and concrete the patient could not ease up to be passive . The doctors and nurses on the other hand should not triumph the person and retributive do what they feel is the right thing to doThe patient on the other hand essentialiness be well assured about the nature of his sickness and also the means of treating it . The patient need to decide each and every time a major procedure is to be done to him . If the procedure is routine the patient still has to be informed about itIf the right of the patient to be informed was strictly followed , then P atient 1 would have known that a second feeding tube was inserted on the 5th day . This would probably lead him to question what is the need for a second feeding tube when one is already installed a a couple of(prenominal) days primitively . Is it not enough for one feeding tube to do the job ? When he was already experiencing clog in airing he may have commitd that the two tubes one going through his left nostril and the other one going through his right nostril could peradventure be the culprit . Although the main spring wherefore he was having complications is not necessarily due to the two tubes placed through both nostrils but technically it was that one tube was misplaced and went like a shot to the lungs . Still , he would have made a interrogatory regarding this and very possibly will alert the doctors and nurses on duty regarding the anomalyAn specimen situation was given by Roney and he wrote , Patients are increasingly assuming responsibleness for their healt h care and very much come to the doctor armed with ! knowledge they have obtained from health related websites on the Internet . They expect the doctor to learn to their complaints . They lots have sufficient knowledge about their condition to ask intelligent questions (p . 66 . Unfortunately this is not the facial expression with Patient 1ethical motiveWhat was outlined above is an ideal scenario where a doctor , nurse and patient can live out their roles without kerfuffle , unwieldyy , and hesitation . But in the real world there are many circumstanceors and many hindrances for a health worker and even a patient to exercise their rights or to function in a way they believe is admit (see Thompson , genus genus Melia Boyd , 2000One of the major obstacle to excellence and efficiency is the deathless problem regarding the lack of resources . The lack in resources could mean , less ideal facilities , sub-standard equipment , limitations of technology , inexperienced co-workers , high cost of health care etcMost of the time when th ese problems are placed in forward of health worker , various ethical dilemmas develop into something that immobilizes a health worker from doing his or her job effectivelyAccording to Sarah Fry and Megan-Jane Johnstone there are two major classification of ethical theories which can help in sorting out the various ethical dilemmas a professional faces in the work place : 1 eventful theories (utilitarianism and 2 ) nonconsequential theories (deontologyFry and Johnstone expounded on this idea by saying thatConsequential theories are those theories that look at the consequence of acts . They claim that an action is right to the extent that it produces good consequences and wrong to the extent that it produces hopeless consequences [ .] Nonconsequential theories on the other hand , are those theories that maintain that certain acts are right and others are wrong because they have or do not have right-making characteristics (p 21Fry and Johnstone proceeded to give a rough sketch on what is expected of nurses and they remarkedCommon t! hemes in contemporary nurse codes of ethics include the nurse s relations with co-workers the nurse s responsibility to breed the incompetence of other healthcare workers the nurses accountability in deputation functions to others the tariff to respect the life and dignity of the patient the nurse s responsibility for maintenance of patient confidentiality (p . 51Fry and Johnstone went further to discuss about other roles and responsibilities of the nursing profession but in this representative study there are only three themes that are relevant . First of all as mentioned preferably , nurses have to be aware of their working relations with others This blood must be nurtured professionally because it can be a major factor in the overall success of the facility . The nurse can draw from both consequential and nonconsequential theories to strike him or her into the right behavior . It does not matter what metaphysical modeling the nurse will contain for in this particular theme both are useful . In the consequential opening for ex full-bodied the nurse is encourage to foster good working familys with his peers and other medical practitioners because it will surely result in positive results . Using the nonconsequential theory on the other hand would also compel the nurse to create reverberance and great working relationships with co-workers since it is the right thing to do . Moreover cultivating a healthy relationship with others can help the nurse tackle two distinct ethical themes as discussed by Fry and Johnstone - delegation and reporting of incompetenceWith regards to delegation , this stipulation could not be fulfilled if co-workers do not communicate with each other . And communication could be strained because the underlying relationship may have been frayed for the longest time . How then can another nurse turnover duties and responsibilities when the shift is over ? How then can a fellow nurse ask the help of others when her plate is already full and there is a great need for assistanc! e . All these could not be accomplished without first establishing good relationships with others (see Allen , 2001In this case study , the nurse has to make a report on the negligence of the doctor who ed a second enteral feeding without advising the nurse that previously a Ryle s tube was already inserted a a few(prenominal) days ago It is important to note that this is related to the promise to foster good working relationships . How so ? If the nurse is at odds with the doctor then there is a fortuity that his or her report is biased against the doctor and so the doctor would not receive a fair trialOn the other hand there is also a flip side to this . The virile rapport within the medical staff can easy stifle the need to report on malpractice (see Nilstun Ovretveit , 2004 . The doctors are looked upon as superiors and practically are bosses to the subordinate nurses . Will it be sound or practical to be a whistle electric fan mammal . In the given scenario the consu ltant surgeon denied the fact that he ed the insertion of a fine tube bore . It is the case of my sound out against yours Who will win and perhaps more importantly will the nurse have the resolve to go through all thatMoral IssuesIt is clear from looking for at the report that the hospital and the medical staff had to dissolver for the medical malpractice that occurred on their watch . This is on top of the initial problem of not communicating properly to the family and then to the patient regarding the ongoing go up and methods of treatment that were given to the patient . As mentioned earlier if the patient or the family had been updated on the case then they would have alerted the staff about the presence of the first enteral feeding mechanics inserted on 2nd dayBut the most glaring moral issue is the cover up made by the doctor or possibly the doctors , when they tried to cover that there was indeed an error with regards to putting in two tubes inside the patient . It was implied that the nurse was at fault . This is sedate! because it reveals the common complaint about doctors that seemed to be untouchable some other underlying issue here is the audacity of the doctor to riskiness the career of Nurse A in to save his own skin . This has to be address in trying to find ways on better UK s health care systemWhat needs to be doneAside from the ethical obligation to do what is right there is another major reason for improving health care service . It is the fear of existence sued in the event of medical malpractice . To many this is a more potent incentive to do an excellent job instead than the promise of a good clear conscience by being mindful of ethicsThere is in fact a trouble increase in number of of malpractice cases being d in this century as foreign to a hundred geezerhood before Mchale and Hervey cited a 1901 case where a certain cleric Kilbrandon was quoted saying : This action is for sure one of a particular unusual character . It is an action of damages by a patient against a medic al man . In my passably long experience I cannot remember having seen a similar case before (p . 11 . This may be true at the turn of the twentieth century but not anymore . In fact Mchale and Harvey made a comment that would make any medical practitioner anxious , At a basic train , lawyers have become more interested in health because there was simply more litigation (p . 11 ) One could easily imagine sharks being drawn to blood and in this case blood in the hands of doctors who committed critical errorsConclusionIf the number of litigation rises then there will come a time when lawyers are the only people who will be happy with the outcome . So changes must occur . In this particular case there is a need to improve on communication between those involved . The doctors must also realize that they are in a critical leadership role that their word is law and no one will question or second guess them . It is and so important for doctors to be accessible and cultivate an atmosphe re in the workplace where everybody are boost to ask! questions . There must be a goal that does not seek to dishonor the inexperienced but help them grow into veterans . Replenishing the ranks of skilled workers is a boon to the profession and to all mankind . The doctors will have less problems and the nurses too will lessen their hectic pace when there are more experienced hands on boardFinally , there must be major developments in name of record keeping - at least in this hospital . The facility should benefit from the new great strides made in Information Technolgy . If the hospital can afford it then it must look into acquiring tools to electronically record and row data . These equipment can be carried around by nurses and they can excitant wherever they are but all the information will be stored in one repository where nurses or doctors on the next shift will have access to . opine the case of Patient 1 , if a similar system was already in place then the doctor and the nurses will immediately be informed that a Ryle s t ube was already inserted and ready for use . With just a push of a button this critical information would have been ready at that time But unluckily there is nothing similar to it in the facility . If the hospital in question cannot afford to purchase gadgets such as these then they can quicken to the old method of pen and . But this time the protocols and other standard procedures must be enhanced to ensure that no information can safety valve through the cracks and also that there is less of assumptions but more on double checking the factsHaving said all that the proponent realize that in to achieve all these there is a need to have a change of culture and a change of mindset . The medical staff in this particular hospital could not forever go on covering their tracks and not being transparent . This is difficult to do at first specially if doctors are used to be treated as the final authoritySchwartz , Preece and Hendry believe that the joined Kingdom is on track to minimize the incidence of medical malpractice and they asserte! d , In the UK , the giving medication is taking step to promote a culture of clinical excellence by making individuals accountable for setting , maintaining and observe standards (p . 67This translates to urging the popular Medical Council to do the following , .inculcate in junior doctors attitudes of self-criticism receptiveness , and continuous professional development . creation held to account is now an integral part of being a doctor (Schwartz , Preece , and Hendry ,. 67Dialog to improve health services must also be encouraged so that the community can verbalise out what they think is lacking in the system . But these dialog would have to be a two-way process . The community must also realize the pressure and problems faced by the medical practitioners . In this world where nurses and doctors can choose to work in any place in the world , some communities may experience shortage not only of medical effect but experienced ones . A doctor or nurse are humans who need ample rest and incentives in to work at such a very high level of commitment . If their needs are not met then it is impossible to expect that they can meet the needs of patients and the communityReferencesAllen , D (2001 . The Changing Shape of breast feeding confide : The Role of Nurses in the HospitalDivision of Labour . UK : RoutledgeBor , R Palmer , S (2002 . A Beginner s leave to Training in Counselling and mental hygiene . capital of the United Kingdom , UK : Sage PublicationsBurkhardt , M Nathaniel , A (2002 . Issues in coetaneous care for UK : DelmarDownie , G , Mackenzie , J Williams , A (2003 . Pharmacology and Medicines oversight for Nurses . Australia : Elsevier health SciencesFry , S . T Johnstone , M .J (2002 . Ethics in Nursing Practice : A Guide to Ethical conclusiveness fashioning . UK : Blackwell PublishingGorney , M (2005 . Communication and Patient Safety In R . E Anderson (EdMedical Malpractice : A Physician s Sourcebook . UK : Humana PressJohns , C freshwater , D (1998 . Transforming Nursing Through! Reflective Practice . UK : Blackwell PublishingMacHale , J . V Hervey , T .K (2004 . health Law and the European Federal UK : CambridgeUniversity PressNilstun , T Ovretveit , J (2004 . Practical Ethics in occupational Health . Abindong , UKRadcliffe Medical Press LtdRoss , F Mackenzie , A (1996 . healthcare : insurance into Practice . UK RoutledgeSchwarts , L , Preece ,Hendry , R (2002 . Medical Ethics : A Case-Based Approach . Australia : Elsevier Health SciencesThomas , J (2004 . Critical Incident Analysis In N . Gould and M Baldwin (Eds . Social bet , Critical Reflection and the acquisition Organization . UK : Ashgate PublishingThompson , I , Melia , K Boyd , K (2000 . Nursing Ethics . Australia Elsevier Health SciencesWhite , S (2005 . manifest Me the Proof : Tools and Strategies to Make Data Work for You . UK : travel Learning PressWoodrow ,(2000 . Intensive Care Nursing : A theoretical account for Practice UK : RoutledgeEthical Issues in Nursing - PAGE 16 - ...If you neediness to get a full essay, order it on our website: OrderEssay.net

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