Ans: Duty of care is an important aspect of nursing. It is considered important in the nursing profession. The best practices in nursing principles are:
Restorative practice, Supportive practice, and Promotive practices
The legal duties in nursing care are safeguarding clients' possessions and information, malpractice, negligence, mandatory reporting of the case of a client, proper documentation, and discharge of the patient after the care is over (Water et al., 2017 p15). The legal duties are bound to be followed by the nurses to protect the patient's rights and themselves from any kind of defamation that can lead to the cancellation of an occupational license.
Ans: In the Philip Bolton case the duty of care issues was handling the patient with proper fluid food. The patient had a problem in swallowing and as per the case study, he died of brain injury due to airway obstruction by food bolus. He was found to have cake before his death which might have choked his throat resulting in death. The nurses must have taken care of the fact that he must not have accessed such food that would have endangered his life. The cake was solid and it must have got stuck, leading to his sudden death. This duty of care is negligence towards the patient and watching out for the abnormalities in them that can probe danger (Preshaw et al., 2016 p500). Mr Philip had a disability as mentioned in the care plan. The disability issue that he was blind from birth must have been looked at and followed by providing help so that he could have dealt with it properly. In his old age, he must have been provided with a carer who could organize all his day to day life amenities. The medications for epilepsy must have been given
Ans: The course of action that might have helped in following the legal obligation in the Philip Bolton case is providing the proper food chart according to his allergies. The negligence was found to be not providing him with the food that was suitable for him to swallow. There must have been a carer under whom he should have eaten food while sitting upright and with a neck brace. The carer has also helped him with his disability issue under the Disability Act, and it is made mandatory in’ in care’ services. He was only allowed to have milk and yogurt but as found, he had eaten cake which was unsupervised due to the negligence of duty by the nurse. But locking the food in the open kitchen is not acceptable as it is restrictive practice and all have choices of their own (Sustere & Tarpey, 2019).
Ans: The legal obligation relating to negligence is a breach of duty, damages, and causation. These are often denoted as the practice where the nurse forgets to perform her duty in regards to patients who are under their care (Cooper, 2016 p50). For instance, a nurse forgets to feed the person who is unable to have food without help. This comes with negligence. As stated by Raveesh et al., in his journal, the best nursing practice in relation to negligence are changing of the gestures towards the patient, considering regular follow up of the patients’ routine and health, the apologetic gesture if a mistake happens by chance, taking care of potential litigant where the consent has been given by the patient or his family regarding the treatment so that if any complications occur, the nurses would not be blamed and taken legal actions about it (Raveesh et al., 2016).
Ans: The negligence issue that can be related here is the lack of care of the patient where it was seen that the death occurred due to the gulping of solid food. The nurses must have made sure that the patient should have eaten liquid food as he had deformities in the mouth which hindered the food chewing and swallowing. The care plan had stated very well that the food must be cut into small pieces and he must be seated upright while having food. The food that he ate was also u supervised. According to Chadwick and Gallagher, these all factors come in the negligence issues of lack of following the duty concerning the patient, following the care plan and documentation provided in taking care of the patient and supervising the amenities that is used by the patient(Chadwick & Gallagher, 2016).
Ans: The course of action that should have been followed by the nurses could have been following the care plan properly which recommended eating of the soft food. The plan also mentioned that food must be supervised. The supervision of food must have been done and should have been made sure that the patient does not get access to any type of food that causes restrictions in his food pipe. The nurses must make sure and take care that the steps taken in caring for the patient are law confined (Terry et al., 2017 p59). He had epilepsy and a sudden choke might have triggered it. The nurses should have taken care that all his food must have been checked and supervised.
Ans: The purpose and importance of organizational policies in the clinical setting help in addressing the challenges faced by nurses in the professional field. According to Ellenbaker and Edward, it helps in assessing the standards of practising nursing and also maintains the standard of care in hospitals and health care (Ellenbecker & Edward, 2016). The policies also help in implementing norms in which the nurses can work effectively thereby helping them in dealing with the emergency and also work according to the laws so that they do not have to face any legal problems related to the health of the patients. It can reduce the malfunctioning of the duties that have to be followed by the nurses. It also helps the organization in dealing fairly with the patients under the law.
Ans: In the Bolton case, the first thing that can be implemented is taking care of the food section of the patient. There was negligence in taking care of the food selection for the patient. It was observed twice when Mr Philip took the cake in his bag while going to the office. The health care must have taken care of the food section. The care plan suggested that he had a disability. He must have been administered under the Disability Act. He must have been in the custody of a carer who was an expert in taking care of the disabled (Shumba & Moodley, 2018). He died unexpectedly while being in care. This can also come under malpractice as it showed that he ate something which he should not have been and the misguidance or lack of observation is the result of his sudden death. Lack of communication and guidance can also be applied here because Mr Philip ate cake which he was not supposed to. It can be due to the lack of counselling and guidance from the health workers (Fakhr-Movahedi et al., 2016 p270).
Ans: The nurses can ensure the rights of the person by advocating practices with ethics and justifiable in nature by creating an environment that accepts a standard of professional practice. The practices must be made in such a way that it positively affects the environment and influences the patient in a moral way. Nurses can make stress on human rights protection by refusing the practices that can cause negative effects on the patient. They must always stress on human rights values and should have values and ethics while carrying out their profession. Nurses must not follow any norm that discriminates based on humans and all must be treated equally in the healthcare profession. Human rights describe the ethical nursing profession concerning the concept of human rights of the patients and both must be simultaneously followed (Haddad & Geiger, 2019).
Ans: In the Philip Bolton case, the negligence could have been avoided by using better practices such as going through the care plan and documents related to the health history of the patient. The nurses must go through the documents properly and minutely so that smaller details can be kept in mind. It helps in providing better care to the patients. In case of providing medicines or care, the equipment and status must be checked twice to ensure the credibility of the measures used. In this case study, it could have been done on proper supervision of the food that the patient ate. The ‘in care’ death caused the police investigation and it puts danger on the practising nurses as well who are appointed to look after them. The following of the policy can help in getting away clean from these situations and can save the license of nurse practice. The health care workers must keep in mind that in no way a patient's life can be put in danger. It constitutes both moral and professional obligations (Moradi & Shademanfar, 2016 p174).
Chadwick, R., & Gallagher, A. (2016). Ethics and Nursing Practice. In Google Books. Retrieved from: https://books.google.co.in/books?hl=en&lr=&id=vG6CDAAAQBAJ&oi=fnd&pg=PR3&dq=avoid+negligence+in+nursing+practice+recent+journal&ots=_K95qTFYlc&sig=EEu-38fuAI1g7ijZEKOPi52wssA
Cooper, P. J. (2016). Nursing Leadership and Liability: An Analysis of a Nursing Malpractice Case. Nurse Leader, 14(1), 47–51. Retrieved from: https://doi.org/10.1016/j.mnl.2015.11.006
Fakhr-Movahedi, A., Rahnavard, Z., Salsali, M., & Negarandeh, R. (2016). Exploring Nurse’s Communicative Role in Nurse-Patient Relations: A Qualitative Study. Journal of Caring Sciences, 5(4), 267–276. Retrieved from https://doi.org/10.15171/jcs.2016.028
Haddad, L. M., & Geiger, R. A. (2019, January 19). Nursing Ethical Considerations. Retrieved from Nih.gov website: https://www.ncbi.nlm.nih.gov/books/NBK526054/
Moradi, F., & Shademanfar, M. R. (2016). The Legal Responsibility of Nurses in Administration of Prescriptions. Journal of Politics and Law, 9, 174. Retrieved from https://heinonline.org/HOL/LandingPage?handle=hein.journals/jpola9&div=88&id=&page=
Preshaw, D. H., Brazil, K., McLaughlin, D., & Frolic, A. (2016). Ethical issues experienced by healthcare workers in nursing homes. Nursing Ethics, 23(5), 490–506. https://doi.org/10.1177/0969733015576357
Raveesh, B., Nayak, R., & Kumbar, S. (2016). Preventing medico-legal issues in clinical practice. Annals of Indian Academy of Neurology, 19(5), 15. Retrieved from: https://doi.org/10.4103/0972-2327.192886
Shumba, T. W., & Moodley, I. (2018). Implementation of a disability policy framework in Namibia: A qualitative study. South African Journal of Physiotherapy, 74(1). Retrieved from: https://doi.org/10.4102/sajp.v74i1.400
Sustere, E., & Tarpey, E. (2019). Least restrictive practice: its role in patient independence and recovery. The Journal of Forensic Psychiatry & Psychology, 30(4), 614–629. Retrieved from: https://doi.org/10.1080/14789949.2019.1566489
Terry, L., Carr, G., & Halpin, Y. (2017). Understanding and meeting your legal responsibilities as a nurse. Nursing Standard, 32(12), 52–63. Retrieved from: https://doi.org/10.7748/ns.2017.e11015
Water, T., Rasmussen, S., Neufeld, M., Gerrard, D., & Ford, K. (2017). Nursing’s duty of care: From legal obligation to moral commitment. Nursing Praxis in New Zealand, 33(3), 7–20. Retrieved from: https://doi.org/10.36951/ngpxnz.2017.010
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