Introduction
The legal and ethical issues of nursing are an essential part of healthcare, which involves a myriad of topics. While some might assume that the simple objective of any nurse is to simply follow the guidelines, it indeed should be clarified that at times, nurses have to make quick judgment calls, which might not be the most suitable ones. As a result, it is vital to give an analysis of the nurse’s malpractice and what standards they must follow to ensure the provision of quality care along with compliance with the law. Moreover, it is vital to assess to what extent the delegation of tasks in healthcare might lead to mistakes and what might minimize the risks. Thus, the given paper will mainly aim at illuminating the areas of nurse malpractice, standards of care, and delegation.
Discussion
If there is enough proof, the state board of nursing may arrange a proper hearing where witnesses are summoned and both parties might be accompanied by attorneys. According to the law, the case should show each aspect against the accused further than a possible suspicion in order to prove that an individual committed wrongdoing (Guido, 2019). From the given case, it is obvious that the case lacks evidence beyond a reasonable doubt. The only evidence the management has is the discrepancies between the records and the explanations that were not perceived as credible (Guido, 2019). Furthermore, the testimonies of the nurses showed that the practices used by the accused were not out of the ordinary. In the given situation, due to the lack of solid proof, it was insufficient for suspension and further investigation was required.
When it comes to the influence of testimonies on the final verdict, they can play a key role. At the trial, the circumstances are established by the jury, the legal principles are then implemented to the established facts, and a legal decision is made (Guido, 2019). Typically, evidence is provided through the responses of multiple witnesses to particular queries (Guido, 2019).
When assessing the facts surrounding the case, the jury focuses on the evidence and reliability of the witnesses (Guido, 2019). As a result, if the witnessing nurses are telling the truth and their testimonies are credible, they can contribute to the perspective of the accused. Considering the fact that the witnesses prove that they quite often have similar approaches to the defendant, their testimonies can lead to exoneration.
As for the questions that the institution must address before the court rules the case, the first one pertains to malpractice. The case states that the nurse has a working experience of twenty-five years. In this situation, the management will have to assess her experience and investigate, whether there were cases of malpractice, disciplinary issues, or professional violations of the Nurse Practice Act. By doing so, it will be more evident whether the nurse was prone to “diverting narcotics for her own use” (Guido, 2019, p.258). Moreover, an additional question the institution needs to address is whether the narcotics that were allegedly stolen were compatible with the patient’s medical condition and requirements. It will be necessary to interview the patients in certain cases to evaluate the situation.
I believe that the system in the given system lacked cohesion, proper leadership, guidelines, and management. In this case, it was mentioned that the facility “was slowly moving to an all-electronic charting system” (Guido, 2019, p.258). The nurses had to report via both a conventional handwritten version and an electronic version, which was confusing. Possibly a lack of proper training and regulations led the nurses to improper use of the reporting.
The witnesses claimed that it was not rare to report the use of medications beforehand or after the process. The defendant in this case was accused of appropriating the narcotics for personal use. However, in the 25-year experience, the employee was told to have “respect for her competence and dedication” (Guido, 2019, p.258). There is no solid evidence beyond a reasonable doubt, and, thus, I rule that the defendant is not guilty.
The expert witness for the defense must offer testimony based on informed consent and the position of a nurse. Before beginning to provide care or provide treatment to a specific client, the nurse ensures that they have valid informed consent from the patient. Moreover, during the hospital stay, the NP ensured that the patient was aware of their position as a nurse and that they were not a doctor. Therefore, the patient consented to the treatment that was based on both the physician’s recommendations and the nurse’s follow-ups. Thus, the patient was offered the most optimal care for the symptoms and complaints at the moment.
For the convenience of client families, medical personnel, and the prospective practices of medicine, an autopsy serves two purposes: first, to carefully assess the prevalence and severity of human disease among patients, and second, to assess the efficacy of treatment methods. Without doing an autopsy, forensic experts and coroners frequently identify the cause of death (Singh, 2020). Certain death certificates created in this way might not accurately reflect the nature and cause of mortality. In circumstances where an autopsy is not performed, skilled forensics experts may cause inaccurate death records (Singh, 2020). As a result, not having a full autopsy will impact the outcome of the case either against the NP and the clinic. They failed to perform a standard procedure, which could result in incorrect estimates.
Every medical session a client has with a doctor must include a physical examination, which is crucial to the patient’s diagnosis. A medical assessment of the abdomen can provide diagnostic indications for the majority of gastrointestinal and genitourinary disorders as well as signals for disturbances in other body functions (Mealie et al., 2022). A thorough abdominal examination plays a crucial part in the management of patients by reducing the necessity for in-depth radiographic examinations. Therefore, the care of this patient would have been positively impacted by a more thorough examination of the patient’s gastrointestinal problems. This could minimize the risks of the potential issues and save the life of a man if he was treated in a timely manner.
In the given case the court should decide on the issue of negligence relying on the main features of malpractice. The plaintiff, which is the family of the deceased, claims that “the NP should have ordered a complete metabolic panel, sent a stool sample for analysis, scheduled a follow-up visit within 48 hours, and taken into consideration that Flagyl can enhance diarrhea” (Guido, 2019, p.234). Therefore, upon reviewing the details of the case, the court will find that there was, indeed, a lack of duty owed to the patient (Guido, 2019).
The NP failed to monitor the patient and do a follow-up call after the patient was discharged. Moreover, the complementary analysis of the tests was not performed, with a focus on only the patient’s symptoms and complaints. Finally, there was emotional damage, with the NP failing to educate the patient on the medication and additional instructions upon discharge (Guido, 2019). Therefore, the court will mostly rule that the NP is liable for the negligence case.
The nurse manager is not a party that has a direct responsibility to provide care for the patient. Rather, individuals in this position perform the duties of overseeing the team and efficient work in the department. However, it is the responsibility of the nurse manager to oversee the work of another nurse, such as the one from rotation (Guido, 2019). In this situation, the manager must ensure that the new member fully understands the assignment and risks (Jones et al., 2019). They must supervise the situations that involve dosages and administration of drugs and assist rotating nurses if they require any help.
The delegation process is an intricate procedure that involves specific guidelines and, if not followed, will lead to issues and even a violation of the law. In the given situation, the LPN was not provided with a proper delegation of the case by the charge nurse. The latter only gave the shallow details, what to measure and what to do. However, what the charge nurse should have followed is the encouragement of asking questions and provision of different plans in case there was an emergency (Guido, 2019). In the first situation, the LPN would have been given an opportunity to ask for additional information that the charge nurse might have omitted. In turn, emergency plans would give the LPN a set of instructions on what to do in case the patient’s condition deteriorates.
Although the charge nurse delegated their case to another individual, they still hold responsibility for the outcome. The reason for this is that, firstly, the LPN followed their command and the plan the charge nurse prepared. The second reason why the charge nurse would have to be held responsible is that they failed to provide the LPN with additional information. The rotating nurse did not have sufficient details on what to do in emergency situations. Moreover, the charge nurse did not perform their obligation to do a follow-up on the patient, as well as the work of the LNP, offering assistance.
In the given situation, the LPN should not be held responsible since they acted according to the plan given to them by the charge nurse. In this case, a licensed practical nurse did not violate any recommendations or advised care plan, providing the patient with the required medications and measuring the temperature. The LPN was not, however, given any plans of action in case of emergencies. The charge nurse failed to do a follow-up on the patient or make an inquiry regarding the practical nurse’s work. As a result, in this situation, the responsible party is the charge nurse and the LPN should be justified.
Conclusion
Hence, the primary goals of the provided paper are to shed light on nursing misconduct, care standards, and delegation. Regarding the first case, it is possible that the nurses’ incorrect use of the reporting was caused by a lack of proper training and guidelines. The defendant was charged with taking the drugs for his or her own use. I concluded that the defendant is innocent because there is no strong proof that would disprove it. In the second instance, the defense’s expert witness is required to provide testimony based on informed consent and a nurse’s perspective. The obligation owed and emotional harm were the standards of care that were breached in the given case, and the court should rule on the issue of negligence based on the signs of malpractice. Finally, the delegation process is a complex method that requires detailed rules that, if not followed, can result in problems and even legal violations. The task delegator must constantly encourage the person to whom the task is assigned to inquire. Moreover, the person to whom the task is assigned must be given the essential instructions.
References
Guido, G. W. (2019). Legal and ethical issues in nursing. Pearson.
Jones, G. E., DeMarco, J. P., & Daly, B. J. (2019). Ethical and legal issues in nursing. Broadview Press.
Mealie, C. A., Ali, R., & Manthey, D. E. (2022). Abdominal exam. StatPearls Publishing.
Singh, V. P. (2020). Legal issues in medical practice. Jaypee Brothers Medical Publishers.