Legal and Ethical Requirements in Nursing and Midwifery Practice

scenario: Louise, a 46 year old female, attended the rural accident and emergency department with her partner and complaining of upper abdominal pain. Louise was initially triaged by the registered nurse (RN), having her vital signs and a pain score completed. Her vital signs were recorded within normal parameters and her pain score was six out of ten. Louise also complained of nausea and abdominal bloating and told the nurse that she had been taking Mylanta for indigestion. Additionally, she had a urine sample tested and this had no abnormalities. Due to a motorcycle road traffic accident, it was a busy evening in the rural emergency department. The driver of the motorcycle had obtained significant leg and chest injuries; hence Louise was kept waiting. She was aware of the accident and did not want to bother anyone as they appeared to be short of staff and very busy. Despite the department being busy, the RN did manage to intermittently assess Louise, however, she was increasingly nauseated and vomited dark ‘coffee ground’ fluid approximately two hours after her admission. When the RN checked her observations, her heart rate (HR) was rising and her blood pressure (BP) was falling, therefore, she notified the medical officer (MO). Intravenous fluids were commenced, a full blood count performed as was a group and hold (blood matched a​‌‍‍‍‌‍‍‌‍‌‌‍‍‍‌‍‌‌‌‍​nd prepared in case it is required for transfusion). Louise was prescribed and received Pethidine 100mg for her pain and Maxolon 10mg for her nausea. Drowsy from the pain relief, Louise vomited again and her vital signs continued to be monitored. She was prepared for theatre following consent for an emergency endoscopy. During the procedure, the anaesthetist encountered difficulty maintaining her oxygen saturation levels and she was transferred post endoscopy to the high dependency unit. The anaesthetist perceived that Louise had aspirated whilst vomiting in the ward, prior to the procedure. The overall aim of this presentation is to demonstrate your knowledge and understanding of the unit content listed: • Possible ethical dilemmas associated with the clinical scenario • Utilitarianism and Deontology • Beneficence, Non Maleficence, Autonomy, Justice (distributive justice) • Capacity/ legal capacity and competence • Consent/ the elements of informed consent • Veracity (truth telling) • Fidelity • The Tort of Negligence/ Components of Negligence/Acts and Omissions • Duty of Care/ Scope of Practice Create a synthesis using the relevant unit content (the legal and ethical concepts specified above), linking it to the relevant and specific areas of the clinical scenario and the relevant nursing legislation e.g. The Registered Nurses’ professional co​‌‍‍‍‌‍‍‌‍‌‌‍‍‍‌‍‌‌‌‍​des and standards).”

Sample Solution

Ethical dilemma

This Discussion is regarding the situation ethical dilemma shown in the video. When you finish viewing the video, use the 7 steps to process the ethical dilemma and then discuss what you would do. Describe how you progressed through the ethical dilemma to determine your course of action. Be sure you review the Discussion RubricPreview the document when you complete this assignment I have included the video to be watched..

Process an Ethical Dilemma
step 1 Ask if this is an ethical dilemma
step 2 Gather all relevant information
step 3 Clarify Values
step 4 Verbalize the problems
step 5 Identify possible courses of action
step 6 Negotiate the outcome
step 7 Evaluate the action

Limit fancy words and no restating previous sentences.

Sample Solution

Ethical Principles

  1. Conduct some library or internet research to identify an article describing an unethical, health related research practice that violates the principles described in the Belmont report.
  2. Discuss the principles that were violated and how.
  3. Identify how the human subjects could have been protected.

Sample Solution

Virtue Ethics

Based upon your reading of Dr. Christina Sommers’ article on Virtue Ethics & the video lecture by Tamar Gendler on the same, write a 2 to 3 page essay (double-spaced) on what virtue ethics is and how each of these philosophers explains it. You will need to answer the following questions: According to Sommers, what is the main problem today and what is her basic answer both in terms of content and scope? And then, from the lecture by Dr. Gendler, explain how we can turn normative commitments into descriptive laws and what does it mean to do that, according to her explanation of Aristotle’s virtue ethics (video link)? Do you think it is fair to say that virtue ethics, as Tamar Gendler explains this moral theory, is a type of human programming and, if so, does this view challenge or undercut the idea of good human behavior as a matter of choice rather than response without thought? Explain. Do you think this approach of Professor Gendler to how virtue ethics becomes part of us goes along with Professor Sommers’ thesis on what is needed in schools today or not? Explain. Finally, what part of Christina Sommers’ analysis and proposal you find convincing, if any, and what part of it, if any, do you find questionable?

Sample Solution

The Ethics Behind Assessment

A 27-year-old man with Crohn’s disease has been admitted to the emergency room with an extreme flare-up of his condition. He explains that he has not been able to afford his medications for the last few months and is concerned about the costs he may incur for treatment.

The Lab Assignment
• Write a detailed one-page narrative (not a formal paper) explaining the health assessment information required for a diagnosis of your selected patient (include the scenario number).
• Explain how you would respond to the scenario as an advanced practice nurse using evidence-based practice guidelines and applying ethical considerations.
• Justify your response using at least three different references from current evidence-based literature.

Sample Solution

Ethical and Legal Implications

You are a family nurse practitioner working in an outpatient primary care office of a large hospital system. The practice has been operating for over 15 years, and many of the administrative and clinical staff were hired when the practice opened. You have been in the practice for less than 3 months. In that short amount of time, you have witnessed several of the clinical staff engaging in heated arguments with each other, sometimes in patient areas. You overhear an argument occurring today between two staff. You pick up a patient’s chart and notice a very low blood pressure that the medical assistant failed to notify you about. When you confront the MA, she states that she was going to report the vital signs to you when she became engaged in the heated argument you overheard and forgot to notify you.

Unfortunately, this pattern of behavior is not unusual in this practice. Working with staff who cannot cooperate effectively can negatively influence your ability to spend time with patients, can impede the flow of patients through the office, and could impact patient safety.

Case Study Responses:
Analyze the case study for potential issues for members of the healthcare team from office conflict. Contrast the potential effects for each member of the healthcare team based upon the required readings from the week. Discuss the potential ethical and legal implications for each of the following practice members:
Medical assistant
Nurse Practitioner
Medical Director
Practice
What strategies would you implement to prevent further episodes of potentially dangerous patient outcomes?
What leadership qualities would you apply to effect positive change in the practice? Focus on the culture of the practice.

Sample Solution

Addiction as a moral failure.

View the following TedMed Talk and answer the following questions.

  1. Discuss the concept Volkow notes of addiction as a moral failure.

sources are to be scholarly sources no more than 5 years old, please include paragraph number if using a journal

  1. Relate this concept to the patient, nurse, therapist, family.

Sample Solution

Ethical Responsibilities

Why might an organization’s legal rules sometimes be insufficient to fulfilling one’s ethical responsibilities? Can
you think of cases in which a businessperson had done something legally right, but ethically wrong? What
about the opposite—are there situations in which a businessperson might have acted in a way that was legally
wrong but ethically right?

Sample Solution

Organizational Change and Ethical-Legal Influences

You are a family nurse practitioner employed in a busy primary care office. The providers in the group include one physician and three nurse practitioners. The back office staff includes eight medical assistants who assist with patient care as well as filing, answering calls from patients, processing laboratory results and taking prescription renewal requests from patients and pharmacies. Stephanie, a medical assistant, has worked in the practice for 10 years and is very proficient at her job. She knows almost every patient in the practice, and has an excellent rapport with all of the providers.

Mrs. Smith was seen today in the office for an annual physical. Her last appointment was a year ago for the same reason. During this visit, Mrs. Smith brought an empty bottle of amoxicillin with her and asked if she could have a refill. You noted the patient’s name on the label, and the date on the bottle was 1 week ago. You also noted your name printed on the label as the prescriber. The patient admitted that she called last week concerned about her cough and spoke to Stephanie. You do not recall having discussed this patient with Stephanie nor do the other providers in the practice.

Case Study Questions:
What are the potential ethical and legal implications for each of the following practice members?
Medical assistant
Nurse Practitioner
Medical Director
Practice
What strategies would you implement to prevent further episodes of potentially illegal behavior?
What leadership qualities would you apply to effect a positive change in the practice?  Be thinking about the culture of the practice.

Sample Solution

Virtue Ethics

Based upon your reading of Dr. Christina Sommers’ article on Virtue Ethics & the video lecture by Tamar Gendler on the same, write a 2 to 3 page essay (double-spaced) on what virtue ethics is and how each of these philosophers explains it. You will need to answer the following questions: According to Sommers, what is the main problem today and what is her basic answer both in terms of content and scope? And then, from the lecture by Dr. Gendler, explain how we can turn normative commitments into descriptive laws and what does it mean to do that, according to her explanation of Aristotle’s virtue ethics (video link)? Do you think it is fair to say that virtue ethics, as Tamar Gendler explains this moral theory, is a type of human programming and, if so, does this view challenge or undercut the idea of good human behavior as a matter of choice rather than response without thought? Explain. Do you think this approach of Professor Gendler to how virtue ethics becomes part of us goes along with Professor Sommers’ thesis on what is needed in schools today or not? Explain. Finally, what part of Christina Sommers’ analysis and proposal you find convincing, if any, and what part of it, if any, do you find questionable?

Sample Solution