Nurses and midwives are very important parts of healthcare but they face manyethico-legal issues. According to McDermott-Levy et al. (2018), the ethical consideration is – roles of all parties included, the quantity of all information provided, and patient autonomy. The main legal considerations include – supervision, the standard of care, and consent. The nurses and midwives are bound to work in a professional manner under the ethical and legal boundaries as per the code of ethics. In nursing, there are 4 main ethical principles which are as follows: beneficence, autonomy, non-maleficence, and justice. This essay will discuss the ethical and legal requirements in Nursing and Midwifery Practice in nursing in the case study.
According to the Nursing and Midwifery Board of Australia (2018), the principle 2.1 states that it is the duty of the nurse to respect and support the decision of the patient regarding the acceptance for the treatment start or refusal for the same.One of the ethics in nursing is autonomy and it says that there should be no interference in the decisions of the patient. Beneficence is another ethical principle – the nurse mustpromote good towards patients,reduce maltreatment,and minimize harm (Hartin, Birks & Lindsay, 2018). In this case study, it was found that the patient refused to receive morphine but the nurses did not listen and respected the patient’s decision and administered him with it. During this administration the needle broke and which might lead to needle-stick injuries. This might harm the patient or the nurse and it can lead to legal issues as well, as the patient can take legal actions against the procedure that did not maintain the autonomy, consent, and ethics while practicing. According to the 2.3 principles of the code of conduct, there should be informed consent with the patient. This shows that autonomy and beneficence were required to be maintained. Furthermore, the nurse and midwives should inform and educate the patient about his health issues and treatments so that he does not take decisions that can negatively impact his health.
According to Australian Nursing & Midwifery Federation (2020), with the help of the National Decision Making Framework the following points are always met: ensuring consistent care to the patient and effective patient-centered care in which the decisionsare guided in an effective manner. If Tim's refusal was respected then he might not receive effective care services and this care will be not patient-centered, as the senior doctors have recommended morphine for his benefit only. Therefore, he should be educated about his and his health issues so that he takes a decision that helps him to get a patient-centered care and consistent care services. In this ways, the ethical principle of justice which states that the patient has a right to be treated equally by health care providers and fairly was maintained as well and non-maleficence – this involves that the nurse should provide care to the patient in such a way that he does not get harmed, is maintained (Australian Nursing & Midwifery Federation, 2020).
According to principle 6.2 of the code of ethics, the nurse should prevent the situation that can potentially harm the patient or hospital’s workplace healthcare services (Birks, Smithson & Lindsay et al., 2018). In this case study, due to the busy hospital, the patient was a bit delayed to be brought to the hospital for surgery which makes him impatient and uncooperative as well. So, there was a need to maintain are beneficence, justice, and non-maleficence. It is the right of the patient to get patient-centered care and a safe environment as well. If such ethics are not maintained the patient has the right to take legal actions. According to Ingham-Broomfield (2016), a nurse should always maintain the professionalism and code of conduct while working in the workplace. This is so because it is a duty of the nurse to provide a safe and secure environment and comprehensive services to the patient.
The 3.2 principle of safe care was also not maintained because the delay leads to the development of poor trust of the patient on health providers that made him aggressive. The nurses should calm the patient down and make him understand the importance of his cooperation and his treatment procedures so that he understands the value of his medications and take decisions accordingly (Steven et al., 2019). Therefore, with the help of the National Decision-Making Framework will help in eliminating the complexities in nursing practice. Moreover, in this case, study, there were issues with trust. Without trust, it becomes difficult to ensure a continued strong relationship bonding that involves a safe environment, effective communication, and shared decision-making. Moreover, it might also lead to a conflict in the workplace due to the unexpected actions of the nurses and poor maintenance of the expectations. This conflict can harm the safe environment of the patient Tim, and such an unhealthy and unsafe environment can lead to serious health complications and stress issues in Tim. There should be no shouting among the health professionals and by the patient as well, as it might create a feeling of doubt regarding safety in the hospital and lead to harm to the respect or dignity of co-workers in the field (Parizad et al., 2018). The patient should also maintain the respect of the care providers. If a patient shouts or shows anger then the nurse should always work as per the boundaries of professionalism in their nursing practice and this will lead to the least ethical and legal issues. The ethics like fidelity, beneficence, justice, principles of totality and integrity,nonmaleficence, and autonomy - are of high significance in nursing (Yıldız, 2018). If these are not met then various major issues can arise leading to legal complications/problemsin the future. According to principle 8.2 of the code of conduct in Australia for nurses, the nurses are required to maintain a professional environment for fast and effective recovery of the patient (Schmidt et al., 2017).
It is concluded that sometimes the midwives and nurses face many complex situations in nursing. With the help of ethics, professionalism, and code of conduct many complexities can be resolved very easily. There is a need for the development of ethics among nurses and midwives like maintenance of autonomy, respecting the decision of the patients, providing fair and safe care services to the patients, and many others.It is the right of the patient to get patient-centered care and a safe environment as well. If such ethics are not maintained the patient has the right to take legal actions. If the rights of the patient and nursing practice standards are not maintained then it can lead to legal considerations as well. Therefore, there is a need to establish the code of ethics and professionalism in nursing.
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Hartin, P., Birks, M. & Lindsay, D. (2018). Bullying and the nursing profession in Australia: An integrative review of the literature. Collegian, 25(6), 613-619.
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Parizad, N., Hassankhani, H., Rahmani, A., Mohammadi, E., Lopez, V. & Cleary, M. (2018).nurses’ experiences of unprofessional behaviors in the emergency department: A qualitative study. Nursing & Health Sciences, 20(1), 54-59.
Schmidt, B.J., MacWilliams, B.R. & Neal-Boylan, L.(2017).Becoming inclusive: A code of conduct for inclusion and diversity. Journal of Professional Nursing, 33(2), 102-107.
Steven, A., Wilson, G., Turunen, H., Vizcaya-Moreno, M.F., Azimirad, M., Kakurel, J., Porras, J., Tella, S., Pérez-Cañaveras, R., Sasso, L. &Aleo, G.(2020). Critical incident techniques and reflection in nursing and health professions education: Systematic narrative review. Nurse Educator.
Yıldız, E.(2019). Ethics in nursing: A systematic review of the framework of evidence perspective. Nursing Ethics, 26(4), 1128-1148.
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