The main principle of patient safety applicable in this scenario is ‘appropriate responsibility or accountability at all levels. Under this principle, all the teams and individuals must share the responsibility or accountability for the delivery of safe health care at Microsystems level. In addition, the administrative organ in the organization must be involved (Springhouse Corporation, 2010). In this case, it was necessary for the nurses involved to ensure that the highest level of responsibility in managing My Abraham’s condition was achieved.
From a legal perspective, the nurses at the hospital care owed Mr Abraham a duty of care under the tort law. In fact, under the American tort law, registered nurses have a professional as well as a legal duty of care (O’Keefe, 2009). Therefore, it was necessary for the nurses to take some steps to protect themselves from malpractice claims under the tort law. For instance, they would have reported Abraham’s behaviour and intention of running away from the hospital. In addition, a special attending nurse should have been assigned the duty of monitoring Abraham’s behaviour and progress.
From an ethical perspective, the principles of beneficence and nonmaleficence apply in the case of Abraham. The principle of beneficence applies to the acts and willingness “to do and promote good”. It is an ethical role of all nurses to promote the best interests of their patients. In addition, they must strive to achieve the best outcomes. The principle of nonmaleficence means “to avoid harm”. Nurses must always maintain a competent level of practice in order to ensure that the patient does not receive any form of injury or suffering (Guido, 2011). It also includes the process of reporting suspected abuse to avoid victimization and provide patient protection. The nurses did their best to “do good” and “no harm” as shown by their willingness to use any means possible to protect the patient from running away from the facility.
In addition to the principles of nonmaleficence and beneficence, the principle of autonomy applies to the ethical perspective of nursing. This principle applies to clients, giving them the right to be self-determined and make decisions on what happens to them (Helm, 2008). Nurses must respect the patient’s decision to refuse or accept care. However, in the case of Abraham, it was evident that his mental ability had been affected by excessive consumption of alcohol. Therefore, the principle of autonomy should not be used as a legal ground to sue the nurses involved.
In this case, the nurses involved and the hospital management are the respective defendants. In particular, the nurses taking care of Mr Abraham bear the highest responsibility as the defendants because the incident happened at the time Mr Abraham was under their care. They owed the patient a duty of care, which could have been breached due to negligence.
After looking at the facts and claims presented in court, the judges might argue that the hospital’s negligence combined with the patient’s contributory negligence were responsible for the injury and death of Abraham. For instance, it was evident that the nursing practice allowed the nurses to monitor Mr Abraham’s conditions on an hourly basis. Secondly, it is clear that records were being kept after each visit. Moreover, the principles of beneficence and nonmaleficence applied. This is clearly indicated by the effort to bring the patient closer to the nursing station.
In giving the ruling, it is necessary for the judges to refer to the ruling in case law Busta v. Columbus Hospital Corporation. In this case, the Montana Supreme Court ruled that the injuries on a patient were caused by the hospital’s negligence as well as the patient’s contributory negligence. In addition, the judges would also refer to case law Pellerin v Humedicenters in determining whether documentation was done in the right manner and time.
References
Guido, G. W. (2011). Legal and ethical issues in nursing. Upper Saddle River, NJ: Prentice Hall.
Helm, A. (2008). Nursing malpractice: sidestepping legal minefields. Philadelphia: Lippincott, Williams & Wilkins.
O’Keefe, M. E. (2009). Nursing practice and the law: avoiding malpractice and other legal risks. Philadelphia: F.A. Davis Co.
Springhouse Corporation. (2010). Nurse’s legal handbook. Springhouse, PA: Springhouse.