Case Study: Doris

This essay aims to understand the legal and professional framework that underpins professional nursing in Australia focusing on the application of the identified frameworks through a case study. The Australian charter for healthcare right consents along with the maintenance of confidentiality and privacy as a duty of the care provider has been considered as elements while discussing the legal and professional framework from the perspective of professional nursing practised in Australia. The four bioethical principles of Beauchamp and Childress is one of the important sets of principles which has been widely influential in the professional field of medical ethics while considering the understanding of the existing approach towards ethical assessment in the practices of healthcare.

The main 4 principles of healthcare ethics include justice, autonomy, non-maleficence and beneficence as mentioned by Beauchamp and Childress. The principle of healthcare ethics utilised in Australia focuses on the fairness considered in medical decisions revolving around both benefits and burden along with the proper distribution of rare resources as well as new treatments (Birks, Davis, Smithson & Cant, 2016). The principle of autonomy in the healthcare profession indicates that the healthcare professional has the authority to suggest and advise treatment and all other related medicinal aspects however the power to finalize all the actions are retained by the patient.

Following the principles of autonomy is guided by the legal perspective of Australian nursing (Stolt, et al., 2018). The nonmaleficence principle of ethics in nursing ensures that all the decision is for the good of the patient and no harm is intended while finalising a decision for the patient or society. The final principle of beneficence expresses that it is the responsibility of the healthcare provider to ensure that they are considering all the possible approaches to provide benefits to the patient and society under every situation.

The principles combine to motivate the health care provider including medical officers as well as registered nurses who are engaged in providing healthcare services to the patients and society to consider that it is necessary to provide maximum benefit while causing no harm and maintaining the unbiased nature while developing strategies and plans for treatment. The ethical principles are the base on which the professional skills and activities are developed by nurses while understanding the legal binding that forces the nurses to provide maximum benefit to the patients.

The case of Doris describes that the orthopaedic surgeon failed to follow the ethical principle of the nursing profession while receiving signatures in the blank consent form for Doris. It was observed that the doctor did not explain the procedure to Peter and asked him to sign the consent form without informing him about the possible impacts of the surgery in the fractured right hip of Doris. Furthermore, after the nurse understood the medical problem with Peter, he was concerned regarding the ability of Peter to understand the impact of the proposed operating procedure as well as considered him sufficient for receiving legal consent.

She contacted the surgeon regarding her concern who replied that the signature has been received which is sufficient for proceeding with the surgery irrespective of the medical condition of Peter who has been held responsible for assigning the legal consent document. Even though the nurse was able to identify an individual who would have been the suitable individual for finding the legal consent paper, she went off duty and failed to take any further action about the consent form that was concerned regarding the procedure for Doris. It can be identified that both the surgeon and nurse have directly failed to follow the ethical principles that revolve around presenting maximum benefit to the patient as well as following the legal procedure of receiving written consent from a medically stable individual who is related to the patient.

Role and responsibilities of professional nurses include responding to critical incidents and vulnerable populations while providing care to the patient. After analysing the case of Doris, it is evident that the nurses need to understand the responsibility regarding informing the medical team and general practitioner regarding the medical disability within Peter who is responsible for all the legal decisions of both him and his wife. It is the responsibility of the nurse to ensure that the patient can receive care which would be extremely beneficial focusing on the principles of the nursing followed in Australia (Water, et al., 2017).

Nurses need to understand their role after discussing the identify the issue with the nurse unit manager. The nurse looking after Doris has been suggested by the nurse unit manager to document the identified information in the medical chart of Doris to maintain written evidence that would express the understanding of the responsibility of the nurse. The improper assigning of the consent form indicated that the legal role of the professional nurse towards vulnerable populations involves locating an individual who is somehow related to the patient and is in a proper medical stable condition before considering them suitable for signing the consent form (Endacott, et al., 2018).

The legal and ethical issues for healthcare are often observed in the informing regarding the consent to the family member of the patient along with refusing treatment as well as maintaining the proper professional behaviour while avoiding any form of negligence. In the case of Doris several legal and ethical issues have been identified starting from the instance she has been admitted to the orthopaedic ward. The first instance of violation of legal and ethical principles can be observed when the doctor did not consider it important to explain the proposed procedure to Peter before asking him to sign the blank consent form without mentioning any minute details of the proposed procedure.

The next instance of negligence can be observed when the doctor the night to reconsider the signing of the consent form from a medically fit individual after learning about the memory issue in Peter which makes him unfit for signing the concert form and understanding the responsibility. And finally, the extremely unethical and illegal activity considered by the medical professional was delegating the operation to a junior doctor without providing any assistance that resulted in significant injury in the hip and resulted in decreased mobility along with continuous pain suffered by Doris.

The scope of practice in nursing focusing on the professional regulation revolves around the role and responsibilities as well as understanding the functions and activities that can be involved in the nursing practice. The scope of practice is essential before providing care because it helps in identifying the series of activities and processes that are permissible to be practised by a nurse while providing care to the patient (Birks, Smithson, Lindsay & Davis, 2018).

In case of Doris, the nurse was unable to understand the exact scope and her authority regarding receiving consent before proceeding with the proposed plan for surgery in the fractured hip as well as informing the general physician in the healthcare institute regarding the medical abnormality in Peter who is primarily responsible for the wellbeing of Doris post-surgery. The scope of practice along with professional regulation is used to guide the nurses about the practice that can be used for providing care while being confined within the law as well as maintaining the ethical principles of nursing.

The methods of managing information effectively from the perspective of legal factors while maintaining the freedom of information as well as consumer rights as a health professional primary involve informing the patient and family regarding the medical condition as well as expressing the concerned areas (Scanlon, et al., 2016). It is necessary to maintain the language used by the medical professional to inform the patients and ensure that the patient along with their family members can understand the medical scenario and the requirement for the proposed plan.

It is necessary to have a communication with the patients regarding the terms mentioned in the consent form as well as explaining the family members about the implications of signing the consent form before initiating a proposed procedure for providing care to the admitted patient (Ingham-Broomfield, 2017). It is the responsibility of the nurses to maintain a medical chart of the patients and mention all the important evidence identified while examining the patient that might be concerned and considered while devising the treatment plan.

The application of the professional framework for the nurses along with individuals, groups, communities and population have a positive outcome on the service and care provided to the patients. The appropriate application of a professional framework from the perspective of a nurse ensures that all the legal terms, as well as ethical principles, are incorporated in the activities performed by the nurses (Riedel, 2016). The outcome of the professional framework can be identified while analysing the case of Doris.

The proper utilisation of professional framework would have motivated the doors to document the concern regarding Peter who had signed the consent form for Doris and ensure that Bert, who was neighbour of the couple for 25 years, was considered as the most suitable individual for signing the consent form before proceeding with Doris's surgery. The appropriate utilisation of professional framework would have stopped the doctor from appointing a junior doctor without any kind of assistance and avoided the injury of the right hip along with ensuring that Doris can have a steady recovery instead of continuous pain.

The legal issues revolve around the standards specified by the Australian government focusing on the written law that put a barrier on improper practices in healthcare which are considered as illegal by the Australian legislation. The ethical issues mainly focus on human rights that are common for the patient. It is necessary to understand that activity might be legal while being unethical. the principle of law and ethics that mainly influence the nursing practice revolves around providing healthcare to the patient while ensuring that they can access their common human rights as well as the legal rights provided to them by the Australian government (Davis, Morgans, Birks & Browning, 2016). In the case study of Doris, both legally and ethically inappropriate activities have been practised by the surgeon as well as nurses to fail to inform Doris and Peter regarding the proposed procedure as well as ensuring that she is receiving the maximum benefit from the proposed plan.

The common law of health professional practice revolves around the decision finalized by judges in a similar case previously submitted to the court. The statute law is the law that has been made by the parliament that is referred to as statutes and under no condition can be modified and neglected (Westrick & Jacob, 2016). The ethical principles are generally involved in the common law that has been identified after a few cases regarding the lack of concern from the medical professionals and the concern regarding the common rights of the patients have been identified (Lamont, Stewart & Chiarella, 2019). The common law motivated the nurse to discuss the concern regarding Peter with her nurse unit manager. The statute law can be considered for legally accusing the surgeon of the extreme discomfort and continual pain suffered by Doris.

The knowledge regarding the requirement of professional regulation and nursing registration involves learning about the legal aspects as well as the ethical principles that need to be followed while practising nursing and providing care to a patient. It is necessary to have a clear knowledge about the responsibility and authority provided to us to ensure that the patient is receiving at most care as well as a benefit after being admitted for a particular medical requirement.

In conclusion, the main 4 principles of healthcare ethics include justice, autonomy, non-maleficence and beneficence as mentioned by Beauchamp and Childress. The principle of healthcare ethics utilised in Australia focuses on the fairness considered in medical decisions revolving around both benefits and burden along with the proper distribution of rare resources as well as new treatments. The legal and ethical issues for healthcare are often observed in the informing regarding the consent to the family member of the patient along with refusing treatment as well as maintaining the proper professional behaviour while avoiding any form of negligence. Roles and responsibilities of professional nurses include responding to critical incidents and vulnerable populations while providing care to the patient.

Reference

Birks, M., Davis, J., Smithson, J., & Cant, R. (2016). Registered nurse scope of practice in Australia: an integrative review of the literature. Contemporary Nurse, 52(5), 522-543.

Birks, M., Smithson, J., Lindsay, D., & Davis, J. (2018). How registered nurses determine their scope of practice: a cross-sectional study. Contemporary Nurse, 54(6), 578-591.

Davis, J., Morgans, A., Birks, M., & Browning, C. (2016). The rhetoric and reality of nursing in aged care: views from the inside. Contemporary Nurse, 52(2-3), 191-203.

Endacott, R., O'Connor, M., Williams, A., Wood, P., McKenna, L., Griffiths, D., ... & Cross, W. (2018). Roles and functions of enrolled nurses in Australia: Perspectives of enrolled nurses and registered nurses. Journal of Clinical Nursing, 27(5-6), e913-e920.

Ingham-Broomfield, R. (2017). A nurses' guide to ethical considerations and the process for ethical approval of nursing research. Australian Journal of Advanced Nursing, 35(1), 40-47.

Lamont, S., Stewart, C., & Chiarella, M. (2019). Capacity and consent: knowledge and practice of legal and healthcare standards. Nursing Ethics, 26(1), 71-83.

Riedel, A. (2016, March). Sustainability as an Ethical Principle: Ensuring Its Systematic Place in Professional Nursing Practice. In Healthcare (Vol. 4, No. 1, p. 2). Multidisciplinary Digital Publishing Institute.

Scanlon, A., Cashin, A., Bryce, J., Kelly, J. G., & Buckely, T. (2016). The complexities of defining nurse practitioner scope of practice in the Australian context. Collegian, 23(1), 129-142.

Stolt, M., Leino-Kilpi, H., Ruokonen, M., Repo, H., & Suhonen, R. (2018). Ethics interventions for healthcare professionals and students: A systematic review. Nursing ethics, 25(2), 133-152.

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.

Westrick, S. J., & Jacob, N. (2016). Disclosure of errors and apology: Law and ethics. The Journal for Nurse Practitioners, 12(2), 120-126.

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