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Ethical and legal issues in nursing practice
Ethical and legal issues in nursing practice
Ethics and nursing law
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By gaining consent Jean's autonomy will be respected and maintained. It is important that all nurses and other health care professions uphold the professional standard when providing direct care to individual, community and groups. Gallagher and Hodge (2012) states reinforce a person's right to exercise choice in relation to personal and bodily integrity and to have that choice respected. Before administrating the medication to Jean the nurse and student nurse made sure that she was given a choice by obtaining consent from Jean first. According to the NMC Code (2015) make sure that you get properly informed consent and document it before carrying out any action. On the other hand, if consent was not implied within the episode of care then …show more content…
Taking this into consideration the nurse began to carry out a risk assessment and care plan to address the issues recognised. According to the National Institute for Health and Care Excellence (NICE) (2015) health and social care staff should identify the specific needs of people with dementia and their carers arising from ill health, physical disability, sensory impairment, communication difficulties, problems with nutrition, poor oral health and learning disabilities. Care plans should record and address these …show more content…
According to the NICE (2015) health and social care professionals should always seek valid consent from people with dementia. This should entail informing the person of options, and checking that he or she understands, that there is no coercion and that he or she continues to consent over time. If the person lacks the capacity to make a decision, the provisions of the Mental Capacity Act 2005 must be followed. The nurse assessed the patient capacity and ensured that the decision made was in the best interest of the patient. The doctor uses specialist knowledge and experience and clinical judgement, and the patient’s views and understanding of their condition, to identify which investigations or treatments are likely to result in overall benefit for the patient (GMC, 2008). They took into consideration how the decision made will benefit Jean. After carrying out a full assessment, it was clear that Jean lack capacity and was therefore place under the mental capacity act
Butler, R. (2008). The Carers of People with Dementia. BMJ: British Medical Journal , 336, 1260-1261.
For the case study one considered the overall working environment of the organisation, with a particular client situation to apply the case study arguments around. This client was experiencing a catastrophic reaction to an event. One applied an integrated person-centred approach which considered meeting their needs by listening to the issue, and working with the person, and their family, as well as care staff, Registered Nurses (RN’s) and the Director of Nursing (DON). In order to find a resolution and meet the client’s needs. As well as, adding to their care plan strategies to assist with future behavioural and psychological symptoms of dementia (BPSD). This particular situation fit perfectly within the two questions of; does the organisation prevent me from providing person-centred care, and do we have formal team meetings to discuss residents’ care.
...tion with the outside world and loss of their life style. Communities need to be educated on dementia so that as to include and create activities they can join in. The residential homes decision makers need to monitor the cares’ behaviour as they and address issues within their working environment to improve and keep everything up to standard. The government need to implement and review their policies to make ensure quality care in residential homes. According to United Kingdom Health and Social Care (UKHCA), (2012) and The National Institute for Health and Care Excellence (NICE), have been working on introducing new guidance which will help dementia patient to get more funding to live in their own homes and avoid living in residential home which is a positive move as people will still enjoy the comfort of their homes and receive excellent care.
Staff should be able to identify the most common signs and symptoms of dementia that can
...the tools meet both CPA and Health of the Nation outcome scales requirement (DOH 2007). The Risk is assessed using the Face Risk Profile. This tool is really easy to use as it has Five sets of Risks indicators, these are then coded as present or absent and a risk status (0-4) is judged (DOH 2007). The problem with this assessment is that the patient would sometimes need to be involved and at present because of Julie’s presenting problems this would not be able to happen but parts of the Risk Profile can be filled in by the Nurse who is in charge of Julie care and wellbeing. The problem with the actuarial approach is that sometimes these tools may not give a conclusive answer to the problem. However many researchers would suggest that the use of both actuarial and clinical risk assessment would be better for a nurse to use to come up with an accurate risk assessment.
In conclusion as shown in the two cases discussed, consent is one of, if not the most important consideration in nursing practice. Patients have an ethical and more importantly, legal right to the choice of the care they receive. As practitioners we have the duty to ensure we are fully aware and work in line with the principles of consent to ensure best practice.
Consent is an issue of concern for all healthcare professional when coming in contact with patients either in a care environment or at their home. Consent must be given voluntary or freely, informed and the individual has the capacity to give or make decisions without fear or fraud (Mental Capacity Act, 2005 cited in NHS choice, 2010). The Mental Capacity Act perceives every adult competent unless proven otherwise as in the case of Freeman V Home Office, a prisoner who was injected by a doctor without consent because of behavioural disorder (Dimond, 2011). Consent serves as an agreement between the nurse and the patient, and allows any examination or treatment to be administered. Nevertheless, consent must be obtained in every occurrence of care as in the case of Mohr V William 1905 (Griffith and Tengrah, 2011), where a surgeon obtain consent to perform a procedure on a patient right ear. The surgeon found defect in the left ear of the patient and repaired it assuming he had obtained consent for both ear. The patient sued him and the court found the surgeon guilty of trespassing. Although there is no legal requirement that states how consent should be given, however, there are various ways a person in care of a nurse may give consent. This could be formal (written) form of consent or implied (oral or gesture) consent. An implied consent may be sufficient for taking observation or examination of patient, while written is more suitable for invasive procedure such as surgical operation (Dimond, 2011).
The patient is lethargic, but has trouble sleeping which can impose serious psychological issues. Before having a heart attack and being put on dialysis, he spoke of “ending it all”. All of these factors prove that George’s competency should be questioned. In order to give informed consent the patient must be competent, a standard for concurrence. Therefore, he cannot approve of treatment if he is lacking decision-making capacity.
Due to an ageing population , The Francis Report recommends the introduction of a new status of nurse, the “registered older persons nurse”. One of the illnesses linked in with this is dementia, and multiple factors relating to dementia are having an impact on how nurses are trained and their deliverance of services. In 2013, the Royal College of Nursing (RCN) began a new development program to transform dementia care for hospitals. There aim is to develop skills and knowledge related to dementia, the roles of all those who are involved, understanding the development of action plans that identify key changes.
Dementia patients must have the right to participate in all decisions concerning their care. Every person in this world has the same equal rights, no matter the situation. Doctors, caregivers, nurses, and even family members brush off the request of the person suffering from dementia each and every day. Most people call this carelessness while others call it freedom and in all reality, it is far from freedom. Luckily, there are many people who fight for the freedom everyone deserves. The majority of "Health professionals are usually keen to keep people with dementia at the center of decisions. Independent advocacy can support this by giving the extra time and skills needed to help people have a voice without the tensions of any other role"
Drug administration forms a major part of the clinical nurse’s role. Medicines are prescribed by the doctor and dispensed by the pharmacist but responsibility for correct administration rests with the registered nurse (O'Shea 1999). So as a student nurse this has become my duty and something that I need to practice and become competent in carrying it out. Each registered nurse is accountable for his/her practice. This practice includes preparing, checking and administering medications, updating knowledge of medications, monitoring the effectiveness of treatment, reporting adverse drug reactions and teaching patients about the drugs that they receive (NMC 2008). Accountability also goes for students, if at any point I felt I was not competent enough to dispensing a certain drug it would be my responsibility in speaking up and let the registered nurses know, so that I could shadow them and have the opportunity to learn help me in future practice and administration.
... event arises and it was due to lack of assessment of genuine comprehension. I think the best system of obtain consent would incorporate a regulated system that accommodated each institution and their requirements, but also equally weighed the importance of true understanding of facts and realization of the patient’s capacity to make decisions. But even if this was established as standard practice, there would still be the issue of how the assessment is made and how accurate it is due to other influences i.e. current injury status or medications needed for full psychological and or conceptual functioning. There could also be an issue of how to regulate such a subjective issue; each physician is going to have different ethical views and this will inevitably influence how he/she assess the patient and their ability to make the best decisions concerning their health.
I introduced myself to the patient stating that I was a student nurse and gained verbal consent to carry on with the assessment, as a student nurse you must respect patients wishes at all times, if t...
In every nurse's career, he or she will face with legal and ethical dilemmas. One of the professional competencies for nursing states that nurses should "integrate knowledge of ethical and legal aspects of health care and professional values into nursing practice". It is important to know what types of dilemmas nurses may face
In EOL decisions for aged, nurses who have previously developed a trusting relationship with the family gain a unique perspective that allows them to become aware of a clinical deterioration and this places nurses in a position to facilitate EOL decision-making (Adams, Bailey & Anderson,2011). Thou the individual competence, employer policies standards and conditions may vary the registered nurse’s scope of practice allows her to commence an EOL decision when a plan is already in place but restricts her to make a decision for the patient in the first place, she give the information and directions so that family or patient itself reaches the right decision (Leditshke, Crispin & Bestic, 2015; Tiffen, Corbridge & Slimmer,