Law and Ethics in Health

Scenario You are a nursin" rel="nofollow">ing student workin" rel="nofollow">ing on a busy surgical ward and it is 10.00am. One of your patients, Gerald, is a 68 year old retired barrister who has undergone a laparotomy for acute bowel obstruction. He is first day post-op and his recovery so far has been uneventful; his vital signs have all been within" rel="nofollow">in normal limits. This mornin" rel="nofollow">ing, however, his vital signs have altered somewhat; his heart rate has in" rel="nofollow">increased to 92bpm, his blood pressure has decreased to 105/70; his temperature is 37.9ºC, although he looks a little pale; also he has not passed urin" rel="nofollow">ine sin" rel="nofollow">ince midnight although he has an IV in" rel="nofollow">infusion in" rel="nofollow">in situ and is receivin" rel="nofollow">ing adequate hydration. When you are carryin" rel="nofollow">ing out his vital sign monitorin" rel="nofollow">ing, he seems rather confused and disorientated and this is quite marked because you helped Gerald wash himself less than an hour ago and he seemed fin" rel="nofollow">ine then. He also becomes a little aggressive towards you and tells you to ‘go away’. You go to tell your preceptor of your fin" rel="nofollow">indin" rel="nofollow">ings because you feel a little unhappy with his condition and she asks you to return to Gerald and repeat his observations. En route to Gerald, you are held up by a patient who desperately needs a bedpan, so you organise this and as soon as you have removed the bedpan, the man in" rel="nofollow">in the next bed, asks for a urin" rel="nofollow">ine bottle, so you comply. Then you are called help to turn a patient with another nurse and are then asked to undertake another couple of urgent tasks. Once you have completed these actions, you return to Gerald; about 25 min" rel="nofollow">inutes have passed sin" rel="nofollow">ince you first approached your preceptor to express your concerns. As you approach Gerald, you see that he has thrown off the bed covers and is naked. He has also soiled the bed, removed the dressin" rel="nofollow">ing from his wound and is smearin" rel="nofollow">ing faeces across his abdomen and onto his surgical wound. Additionally, he has pulled out his IV cannula and is bleedin" rel="nofollow">ing from the in" rel="nofollow">insertion site. You immediately pull the curtain" rel="nofollow">ins around him to give him some privacy and return to your preceptor to ask for assistance. She tells you to go and clean him up, while she calls the doctor to come to resite the IV cannula. You return with the items you need to attend to Gerald’s hygiene needs and in" rel="nofollow">inform him that you need to give him a wash. However, he aggressively tells you that he does not want a wash and is verbally abusive towards you. How are you goin" rel="nofollow">ing to handle this situation? What are the issues you need to consider? How are you goin" rel="nofollow">ing to address them? What resources are you goin" rel="nofollow">ing to use consider the legal and ethical concerns arisin" rel="nofollow">ing in" rel="nofollow">in this situation. You also need to consider the possible actions that could be taken and the implications of those actions.