There are different situations where the ethical and legal decision-making framework is necessary to use. The main issue described in this scenario is regarding a woman who tends to live alone even she has a poor health concern. The woman is in the hospital and is facing the chest problem and cannot live alone, but still, she forces to live alone. In different cases, nurses are with different ethical dilemmas in clinical practice and research. However, during these ethical dilemmas, the nurses are not allowed to refuse the treatment, disagree with the caregivers, and have to treat the patients with the impaired decision-making process.
Nurses are considered to be the most ethical and honest professionals in Australia; therefore, it is their duty to make the right decision in every kind of situation (japara, 2019). However, the main objective here is to use the ethical and legal decision-making framework to the given scenario in which a nurse is confused about sending the woman with poor health condition home or keeping her for the treatment.
According to articles 1 and 2, it is the responsibility of the nurse to the patient to care for her and make the ethical and right decisions for them (anmj, 2019). For example, in this case, Cathy has a right to stay at a hospital or move out to the home, but it is the responsibility of RN Stephen to provide her with the quality care and make an appropriate decision on behalf of her, as she needs the proper treatment for her infection.
According to article 4, the nurses are considered to be the third party who is involved in the valuation of a person who is not in the care, such as for insurance or other tenacities. In this case, it is the responsibility of the nurses to explain the person their specialized area of practice and the degree of the valuation and antedate any kind of misunderstanding. For example, in the case of Cathy, RN Stephen needs to explain the condition of thoroughly to stabilize the whole situation and make a suitable decision for her.
Ethical and Legal Principles
According to article 1.1 of the code of conduct of the nurses, all the nurses must be knowing their responsibilities under the National law (nursingmidwiferyboard, 2019). According to the general rules of the code of conduct for nurses, it is the responsibility of the nurses to deliver their patients with high-quality care. They are challenged with different kinds of professional challenges during their training, so they should be acquainted with the ethical codes of conduct and the basics of ethical decision making.
The code of ethics has been designed for many different professions, but nursing is considered to be the most trusted profession; therefore, it is given much importance in this profession. The two main national codes that are necessary to consider here were designed by the ANA and CAN. These two national codes illustrate how the nurses behave ethically during their professional practice and how they should make decisions when they face different kinds of barriers in their profession.
According to article 2.1 of the codes of conduct for nursing, nurses are allowed to apply the person-centered decision making and are responsible for ensuring the distribution of safe and quality care (nursingmidwiferyboard, 2019). The main elements of the relevant code of conduct include practicing nursing according to the build standards of the profession, which include standards for aged care etc. Another element of this code of conduct includes providing guidance to confirm the distribution of safety and quality care. It is the responsibility of the nurses to protect the patients in any way. In this case, the nursing leaders are required to check up on their employees, whether they are complying with their obligations or not (Australian Commission on Safety and Quality in Healthcare, 2019). The final element of this code of conduct includes reporting or documenting the concerns of the nurses who believe that the practice environment is causing any kind of problem to the patients in receiving care.
However, this code of conduct can be applied in this situation or scenario too. For example, RN Stephen has to provide quality care to Cathy, even if she is refusing and is forcing to go home. It is the duty of his to make a decision for her that is better for her health and quality care. However, before making the decision directly, he needs to inform his senior colleagues, but before his duty to his colleagues, he needs to take of the patient and provide her every kind of comfort. According to the first standard for aged care, the consumer can act independently and make their own choice, but when the health condition of the individual is poor, the caregiver has a choice to decide on behalf of the patient. So, in this case, RN Stephan can decide according to the health condition of Cathy to put her in the hospital and given the best treatment.
Furthermore, according to article 2.2 of the code of conduct for nursing, making decisions regarding healthcare is the communal accountability of the person, such as nominated partners, nurses, and other health professionals (nursingmidwiferyboard, 2019). The nurses have to create positive conditions that can promote shared decision-making practice. The main elements of this code of conduct include taking a person-centered approach to managing the relevant person’s care and providing support to his or her values. Another element indicates advocating on behalf of the person when it is necessary while making a decision, supporting the rights of the people, recognizing that the care is provided by the similar person or by diverse nurses, and recognizes the scope of the practice.
In this scenario, nurse RN Stephen also has to make the decision based on the shard conditions and responsibility. He needs to recognize why Cathy does not want to stay at the hospital and whether she needs another nurse for the care or not. RN Stephen also needs to support Cathy along with her values and preferences. However, he can make a decision or advocate on behalf of Cathy but cannot force her to stay at the hospital as it will be acting against the values and preferences of the patient.
Several legal cases should be considered in this case, such as related to negligence. For example, in the case of Busta v. Columbus Hospital Corporation, the patient died because of the insufficient car provided by the hospital and nurses (Pellerin v. Humedicenters, 1997). The mind-altering effects of the patient were ignored by the nurses, which causes the patient’s injuries and death. In this case, the negligence in the care of patient Cathy can also lead to some dangerous circumstances. RN Stephen also needs to document such type of behavior to the higher authorities in order to make the best decision. In the case of Pellerin v. Hummedicenters, a nurse failed to document the nursing procedures, which also involve informing the higher authorities and making a decision on her (Busta v. Columbus Hospital Corporation, 1996). In this case, the patient got a nerve injury due to giving the wrong injection to the patient and failed to report it to the higher authorities.
According to article 4.3, nurses are considered as a third party in order to deliver a valuation to the person who is not in care for legal, administrative, or insurance tenacities (nursingmidwiferyboard, 2018). The main elements of this article include explaining the individual about their specialized area of practice, inform the person about the criticalness of their health, and anticipate to correct any kind of misunderstanding. This code of conduct is based on the legal amendments of the patients and the complete information on the other administration assessments. It is a matter of duty of care to inform the person about their referring health or serious problem in order to keep them at the hospital. This can be applied in the current scenario. RN Stephen needs to tell Cathy about her condition and how serious it is to keep her at the hospital for further tests and treatments. He can also do this by explaining to her kids and neighbor about his specialized area of training and the degree of the treatment that is needed in this case.
There are different principles and actions which can be implemented to the given scenario of Cathy and RN Stephen. In this case, RN Stephen can make a better and appropriate decision for her patient Cathy who needs better treatment for a chest infection. It is a serious problem that needs treatment, so he should decide for Cathy to remain in the hospital for tests and treatments. Furthermore, he also needs to inform the senior authorities about the condition of the patient so that an appropriate decision could be made. There are also needs to think about the preferences and values of the patients and need to think whether the patient wants to go home, and she is right. If there is no threat to her health to going home, then the decision should be made in her side.
The nurse should evaluate the decision and seek any kind of support from his senior staff by explaining the medical condition of Cathy. If the nurse thinks that the tests and treatment for the chest infection of Cathy are not so necessary, then he could send her home; otherwise, he could keep her to the hospital for quality care as this could be the best option. He also needs to inform her family members, including the husband, about the present condition and decision made by the nurse for her.
1. Health Practitioner Regulation National Law
2. NMBA Standards
3. Australian Commission on Safety and Quality in Health Care
1. Pellerin v. Humedicenters (1997)
2. Busta v. Columbus Hospital Corporation (1996)
1. The ICN Code of Ethics for Nurses in Australia
2. Nursing and Midwifery Board of Australia Code of Conduct for Nurses in Australia
anmj. (2019). International codes of ethics have come into effect for Australian nurses and midwives. Retrieved from anmj: https://anmj.org.au/new-codes-of-ethics-for-nurses-and-midwives/
Australian Commission on Safety and Quality in Healthcare. (2019). The NSQHS Standards. Retrieved from safetyandquality: https://www.safetyandquality.gov.au/standards/nsqhs-standards
Busta v. Columbus Hospital Corporation, 916 (Supreme Court of Montana January 17, 1996).
japara. (2019). Survey Reveals Nurses Australia’s Most Trusted Profession. Retrieved from japara: https://japara.com.au/news/survey-reveals-nurses-are-australias-most-trusted-profession/
nursingmidwiferyboard. (2018, March 1). New codes of ethics in effect for nurses and midwives. Retrieved from nursingmidwiferyboard: https://www.nursingmidwiferyboard.gov.au/News/2018-03-01-new-codes-of-ethics-in-effect.aspx
nursingmidwiferyboard. (2019). National Law. Retrieved from nursingmidwiferyboard: https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/faq/the-use-of-health-practitioner-protected-titles.aspx
nursingmidwiferyboard. (2019). Professional standards. Retrieved from nursingmidwiferyboard: https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx
Pellerin v. Humedicenters, 696 (Court of Appeal of Louisiana July 31, 1997).
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