Apply Legal and Ethical Parameters to Nursing Practice

  1. The NSQHS standards improve the health care services and delivery method which is important to deliver quality and safe care. The NSQHS standards cover all the different care aspects that need to be considered in the health care setting to improve patient satisfaction and experience (Australian Commission in Safety and Quality in Health Care, 2020).
  2. Nursing and Midwifery Board of Australia (2017) state the professional standards for the nurses which are important to justify the professional role and it include code of conduct, code of ethics and standard of practice.
  3. The process that I will adopt to improve the ethical decision making in the care includes following code of ethics of the Nursing and Midwifery Board and balancing between ethical principle. I will try to follow the Nursing and midwifery professional standard that will help me to critically evaluate the situation to improve ethical decision making. The professional standards will help me to work under the given principle which will improve my ethical working pattern. Another approach that I can use to improve my Ethical decision ability is balancing between the different ethical principles that will help me to analyse the benefit of the patient concerning the ethical aspect of the care. These two processes can help me to improve my clinical practice that includes the right ethical decision-making ability.

Issue

Ethical Principle

Ethical approach

Abortion

· Autonomy

· Beneficence

· I will discuss the whole scenario with the patient and family to maintain the autonomy

· The abortion will be conducted to decrease the physical and psychological harm to the mother.

Tissue transplantation

· Non-maleficence

· Justice 

· I will improve my clinical practice to reduce the harm that occurs due to dysfunction of the organ.

· I will provide all the right care services that will help to reduce the chances of tissue rejection.

Reproductive technology

· Autonomy

· Non-maleficence

· I will discuss the entire process with the consent of the patient and family to improve autonomy.

· I will try to reduce the maximum harm to the patient during the treatment.

Organ donation

· Autonomy

· Maleficence

· I will try to take consent from the patient and the family before the donation.

· I will try to reduce harm during the organ donation process.

Restraint

· Non-Maleficence

· Justice

· I will try to decrease the harm that can occur due to the restraint process.

· I will try to provide all the necessary resources to maintain justice during the restraint.

Stem cell research

· Autonomy

· Non-maleficence

· I will try to explain the full procedure to the client to get consent to improve autonomy.

· I will try to reduce the harm that can occur during the process to decrease the complication of the patient.

Cultural and religious matter

· Justice

· Autonomy

· I will try to maintain equity in the care to improve the equal distribution of resources.

· I will try to include the patient perspective in the process to improve cultural competency.

  1. The people with the life-threatening disorder are expected to frame the advance care directive that helps the health care professional to prefer treatment documentation to the patient preference in case the patient is not responding (Australian Government Department of Health, 2020). Thus there is a requirement to review the advance care directive of Collin’s before initiating the treatment. End of Life Care Policy can help to improve the clinical practices that are important to address the health care requirement of the patient in the palliative care to decrease the suffering and pain (Macaden et al., 2014). I will utilize my therapeutic communication to help Colin’s son to understand the requirement of the advance care directive to start the treatment process. I will also help to understand the suffering of his father that need to be considered with his decision to improve the autonomy of the care.
  2. The legal issue that is related to the clinical trials option for the baby will include violation of human rights as the patient is not provided with the available treatment that can help to improve the health of the patient. The legal issue is not utilizing the available health care resources to improve health status. Parental right state that every action should be the aim of reducing harm to the child by different activities to improve safety. It is also violated in the case study that raises the legal issue. The violation of the guardianship is also observed in the case study that can raise the legal issues due to the adoption of more risky procedure for the patient which is against the guardianship law. The ethical issue that can arise due to the action of the parents includes breach of autonomy as the child is not able to take the decision and he is not able to utilize the different treatment presented by health care professionals. The Breach of justice at society level as the normal health care services is not provided to her and he was selected for the clinical trial that can be harmful to the patient. The last ethical issue raised due to the breach of non-maleficence as the clinical trial can increase the harm for the patient that can increase the risk for the mortality and morbidity.
  3. As a nurse, it is my responsibility to help the patient to understand the whole assessment before starting it so that the patient can be aware of it. Another responsibility is to conduct the patient assessment ethically to improve the quality of the care and justify my professional role. The Western Australia Department of Health (2020) discussed the open disclosure policy which state that there should be an open discussion regarding the events that can negatively impact the patient during the care services. The health care professional is expected to respect the policy and communicate with the patient or the family members reading the clinical incidence which can negatively impact the patient. The health care professional should also provide the right support to the patient promptly. As an enrolled nurse, it is my responsibility to provide information regarding the extra vial to the patient so that she can be aware of the genetic screening procedure.
  4. Kylie has crossed her professional boundaries as she is involved with Shaun on a personal level. Nursing and Midwifery Board of Australia (2017) has proposed code of conduct that state nurses are expected to develop only a professional relationship with the client.
  5. There is a need to improve Kylie behaviour toward Shaun to improve the clinical practice that can be able to justify her professional role. Kylie needs to improve the clinical practice as the urgent practice against the professional guidelines which can lead to negative consequences for her and her profession. She needs to reframe the professional relationship without contacting the patient on the personal bases to provide the right care to the patient as per the nursing standard. She needs to decrease or stop the extra time she spent with Shaun to maintain the ethical practice by maintaining justice.
  6. a. One of the principles of the code of conduct that relates to the case study is Cultural practises and respectful relationship. The 4 aspects of the principle state that nurses should not indulge in any type of bullying or harassment in the workplace. That can affect public safety. Nurses should involve in eliminating such behaviour in the clinical practise if encountered any to improve the quality and safety of the patient as well as staff to improve the organizational working process. The escalation is important in case of any inappropriate response encountered from any of the staff members of the organization.
  7. The social media guide framed by the AHPRA and code of ethics is to improve the health care professional’s ability to accurately understand the right use of social media. The guidelines help the health care professional to understand their professional role during the online sessions that can be under the professional standard of the nursing profession. My duty during the advertisement process is to follow the social media guide to improve my practice that can justify my professional role as a nurse. I will try to utilize the guideline includes in the social media guide to justify my professional responsibility and improve the advertisement process corresponding to the guideline.
  8. The requirement for the national board Professional indemnity insurance registered standard includes individual should be either one of them enrolled nurses, registered nurses, nurse practitioners or midwives and the second requirement is the individual should hold the insurance in their name to sustain evidence for the insurance (Nursing and Midwifery Board, 2017).
  9. Continuing professional development is important to enhance your ability to update yourself not only educational grounds but on practical grounds also to improve clinical practice to be competent for the professional role (Filipe et al., 2020). The 20 hours of continuing professional development is required to maintain the registration as an enrolled nurse to deliver quality care to the patient.
  10. The NSW has introduced the Work Health and Safety legislation framework includes four different aspects that are the NSW Work Health and Safety Act 2011, the NSW Work Health and Safety Regulation 2011, Code of Practise and Guidelines. Three responsibilities of the workers include work as per the guideline to maintain safety, report to senior in case of any safety issue and attend training to improve understanding regarding safe working.
  11. a. The registered nurse will be responsible for the omission done by the student nurse it was also discussed in the one of the article presented by Goudkamp & Plunkett (2017).
  12. There is a set pattern of complaining about any issue that you have faced corresponding to the clinical practice. The step one is lodging a complaint followed by complaint assessment and the third stage is complaint outcome.

Concern

Ethical issue

Euthanasia and assisted suicide

The ethical issue that rise due to the euthanasia is a violation of human rights as nobody as the right to end the life of the other individual. The violation of the human right is related to the euthanasia due to the unnatural death given to the person with the serious illness.

Artificially Prolonging life

The ethical issue associated with the artificially prolonging life is the maleficence as prolong the life of the patient can increase the suffering of the patient.

Conscientious objection

The ethical issue with the conscientious objection is a breach of the autonomy that can provide the right to the individual to prefer the act as per their choices.

  1. a. Informed consent is the document that is signed by the patient after reading all the different aspects that is mentioned concerning the care process and it helps the health care professional to maintain ethical working practices by informing patient about everything (Kadam, 2017).
  2. The ethical issue in the case study is informed consent is signed by the patient without considering all the different aspect of care that can increase complication in postoperative duration. The doctor needs to be involved in the evaluation process to analyse the patient understanding reading the care to decrease any chances of the legal or ethical issue.
  3. As an enrolled nurse, it is my responsibility to perform two tasks to improve the care perspective and the first action would be informing the doctor about the scenario followed by helping the patient to understand the procedure with future complication using therapeutic communication.
  4. Restrictive practise is the actions that directly decrease the right to freedom of the individual with different means that include seclusion, chemical restraint, mechanical restraint and environmental restraint. The Restrictive practise directly bound the individual under a situation which leads to the restrictive life (NSW Government, 2020).

18.

Term

Definition

Implication

Direct discrimination

It is the process when the individual is not treated equally due to the protected characteristics like age, gender, religion or sex. 

The direct discrimination in the nursing practises leading to the unethical care practice which can negatively impact the patient to staff health status in the care.

Indirect discrimination

It occurs when there are the rules or any policy decrease chances to avail the advantage associated with it to a particular disadvantage group.

The wrong policy or guideline in the nursing practise can increase complication for the whole staff due to irrational behaviour for a particular group of individual in the care.

  1. Equal employment policy help to promote the equality in the prices which help the most suitable candidate to get the job as per the requirement without any discrimination and improve the hiring process (Bishu et al., 2020). Equal employment policy in nursing practise will improve the quality of the health care workers which will improve the safety and quality of the services delivered to the client.
  2. The Recency of practise fact sheet is located in the Professional Code and Guidelines section under the fact sheet column. The Recency of practice helps the health care professional to improve the practice by evaluating the skill with the current requirement of the clinical practice.

21.

Act/legislation

Definition

Carers recognition legislation (NSW)

It states that carer’s recognition act is to enact a carers charter to identify the responsibility and contribution related to the carers in the community setting. This act improves the recognition and support toward the carers to improve their presence in society

Criminal Code Act 1995 (Cwlth)

The act frames the general principle that is related to the responsibilities related to the criminal covering the Commonwealth laws. The general aspects that are covered include offence, irrelevant behaviour and negative action. 

Disability discrimination act 1992 (Cwlth)

It states that it is not right and unlawful to discriminate any individual because of the disability and decrease chances of equality in employment, education, different services, housing or place.

Children and young people legislation enacted in each State/Territory

Different activities are enforced to improve the protection of children and young people. These acts help the society to uplift the right of the children and young people for equal opportunity of different services and survival.

Working with children legislation as enforced in each State/Territory

This allows the different support worker to collaborate with the legislation framing team so that children need from the society can be addressed by new enforced act or law to improve the state in the society.

Health Practitioner Regulation National Law Act enacted in the State/Territory

It set the guideline for the health care professionals practice and it is passed by each state and territory that includes rule reading the registration process of the health care professionals.

National Safety and Quality Health Service (NSQHS) Standards 

These standard state different aspects that are important to address the different section of the health care services and all the standards in collaboration aim to improve the quality and safety of the health care services.

Health Legislation

It helps in the protection of health at the community level by improving the services that aim to enhance the health status of the community. The health legislation helps the government to frame the different laws that are enforced to uplift the health of the population by reducing the health-related issue.

Mental Health Legislation

The Mental Health Legislation helps to frame the law and act in the favour of the population dealing with any mental illness. The major aim of the mental health legislation to improve the care and treatment process of the patient-facing any mental issue.

Privacy Act of 1998

This act state that all the information related to any individual should remain confidential and privacy of the document should be maintained to decrease any chances of future complication

Health Record Act 2012 (Cwlth)

The act states that health care professionals are expected to participate in the My Health Record process to improve the care pattern. The Act improves the care process by adding the My Health Record for the patient.

Aged Care Act 1997

The activities aim to improve the funding, regulation and services provided to the aged care to improve the quality of care delivered to the senior citizens. The Act aims to improve the facilities in the aged care which will improve the health care experience of the resident of aged care.

22.

a) Ethics

b) Nursing ethics

c) Bioethics

References for Equal Employment Opportunity

Australian Commission in Safety and Quality in Health care. 2020. National Safety and Quality Health Service (NSQHS) Standards. Available at: https://www.safetyandquality.gov.au/standards/nsqhs-standards

Australian Government Department of Health. 2020. Advance care directive. Available at: https://www.health.gov.au/health-topics/palliative-care/planning-your-palliative-care/advance-care-directive

Bishu, S. G. and Headley, A. M. 2020. Equal employment opportunity: Women bureaucrats in male-dominated professions. Public Administration Review, pp. 1-12. https://doi.org/10.1111/puar.13178 

Filipe, H. P., Silva, E. D., Stulting, A. A. and Golnik, K. C. 2014. Continuing professional development: Best practices. Middle East African Journal of Ophthalmology, vol. 21, no. 2, pp. 134–141. https://doi.org/10.4103/0974-9233.129760

Goudkamp, J. and Plunkett, J. 2017. Vicarious liability in Australia: On the move? Oxford University Commonwealth Law Journal, vol. 17, no. 1, pp. 162–170. https://doi.org/10.1080/14729342.2017.1321817 

Kadam R. A. 2017. Informed consent process: A step further towards making it meaningful!. Perspectives in Clinical Research, vol. 8, no. 3, pp. 107–112. https://doi.org/10.4103/picr.PICR_147_16

Macaden, S., Salins, N., Muckaden, M., Kulkarni, P., Joad, A., Nirabhawane, V. and Simha, S. 2014. End of life care policy for the dying: consensus position statement of Indian association of palliative care. Indian Journal of Palliative Care, vol. 20, pp. 171-81. https://doi.org/ 10.4103/0973-1075.138384.

NSW Government. 2020. Restrictive practice. Available at: https://www.health.nsw.gov.au/mentalhealth/psychosocial/principles/Pages/restrictive.aspx#:~:text=At%20a%20glance&text=Under%20the%20NDIS%20Rules%2C%20certain,the%20use%20of%20restrictive%20practices.

Nursing and Midwifery board. 2017. Professional indemnity insurance (PII) arrangements. Available at: https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/faq/fact-sheet-pii.aspx

Nursing and Midwifery Board. 2017. Professional Standard. Available at: https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx

Western Australia Department of Health. 2020. Open Disclosure. Available at: https://ww2.health.wa.gov.au/Articles/U_Z/WA-Open-Disclosure-Policy#:~:text=Open%20disclosure%20is%20the%20%E2%80%9Copen,%2C%20their%20family%20and%20carers.%E2%80%9D&text=ensure%20that%20communication%20with%2C%20and,a%20supportive%20and%20timely%20manner.

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