Ethical Challenges in Nursing Practice: A Comprehensive Analysis of Professional Conduct, Consent, Duty of Care, and Legal Implications

This assignment navigates through various ethical dimensions within nursing practice, shedding light on the significance of professional conduct, obtaining valid consent, upholding the duty of care, and legal implications associated with patient care scenarios. Emphasizing the importance of adherence to regulatory guidelines, the paper underscores the role of nurses in maintaining the national standards of conduct and the consequent impact on community expectations.

Examining the requirement of informed consent for medical procedures, the assignment explores the necessity of patients like Elijah providing consent that considers individual perspectives on risks, costs, and pain. The concept of duty of care is dissected, highlighting the obligation of healthcare providers to deliver competent and diligent care while upholding ethical standards.

The assignment delves into the complex issue of obtaining consent when a patient, like Elijah, is unable to provide it, necessitating involvement from relatives. It discusses the nurse’s advocacy role, detailing the process of securing consent and ensuring informed decision-making. Legal requirements for restraint are explored, emphasizing the need for comprehensive hospital policies, proper assessment of reasons, and constant evaluation.

A critical analysis of nursing negligence unfolds as Elijah falls due to inadequate supervision, emphasizing the nurse’s responsibility for optimum patient care. The role of the Australian Nursing and Midwifery Federation in ensuring appropriate compensation for injured nurses is also discussed.

Ethical dilemmas, including end-of-life decisions and patient autonomy, are examined, emphasizing the need for nurses to act ethically in decision-making processes. Strategies for addressing ethical issues, such as supporting professional codes and ongoing education, are presented.

The paper discusses the importance of responding promptly to patient and family complaints, outlining steps to assess and rectify concerns while maintaining high cleanliness standards. The ethical responsibility of student enrolled nurses is highlighted, emphasizing the importance of seeking guidance from senior practitioners to avoid potential complications.

Exploring the principles of open disclosure, the assignment suggests its importance in acknowledging adverse events, communicating openly and timely, and offering apologies when necessary. The potential challenges for enrolled nurses in adhering to open disclosure principles are discussed.

The assignment concludes with insights into the role of a coroner’s case in investigating sudden or suspicious deaths, underlining its importance in determining the cause of death before issuing a death certificate.

EN assignment

A1: Professional conduct is important in nursing practice since it is the manner in which a person

behaves and should act in a professional manner. It is important that nurses perform their duties

and conduct their activities in a professional manner. As in the case of Elijah, it is vital that

nurses, under whom he has been put, follow regulatory guidelines. The guidelines provide a set

of minimum national standards of conduct members of the nursing profession that they are

expected to upheld. Also, these inform the community of standards of professional conduct

expected from nurses (Chiarella&McInnes, 2008). Lastly, it helps the consumers, regulatory and

professional bodies to evaluate the professional conduct of nurses.

A2: The surgery requires consent. A valid consent includes informing the patient about the risks,

costs and pain involved in the medical treatment. The consent must be taken since for some

people, the risks and cost of the medical treatment might be worth it while for another, these may

not be. Therefore, Elijah is required to provide consent to the nurses to perform procedure on

him (Russell, 2012).

A3: Duty of care is defined as the extent to which a healthcare provider must make sure that

there is no harm to the patient under the provider’s care. In the case of Elijah, duty of care

indicates that he is given proper care with competence and diligence. The nurses should provide

equal amount of care and they are also expected to hold a set of healthcare ethics, which are

standards of conduct (Russell, 2012). It is vital that the healthcare provider establishes that they

will use high degree of care and skill for their patient.

A4: In Elijah’s case, he is not healthy enough to provide consent for his surgery so his relatives

can provide the consent. However, the nurses are required to play the role of advocate. Nurse has

to ensure that the consent form is signed by the guardian of the patient under a durable attorney

for health care. Nurse has to play the role of the witness to the guardian who would put his

signature on the consent form. The nurse has to put her signature as the witness and the date as

well (Russell, 2012). Also, it is the primary duty of the nurse to provide proper information to the

guardian if he is confused and instruct him not to sign the form until his doubts are cleared.

A5: There are several legal requirements to restrain in case of Elijah. The nurses should be well-

informed about the restraint policy of the hospital. The policy must cover every type of physical

and chemical restraint. Also, it is vital to specify how to apply the policy and the procedures to

follow (Zahedi et al 2013). Secondly, it is needed that nurses assess the reasons for Elijah’s

restlessness and agitation. It might be due to the pain of Elijah that he tries to remove his IV

treatment. Nurses need to make sure that they do not delegate the duty to see the patient when

offering restraining without proper approval from doctors. At last, it is vital that the need of the

restrain is constantly evaluated.

A6: It is the negligence of the nurses that they left Elijah supervised due to which he fell down

and hit his head. A nurse is expected to promote, advocates for and take steps to protect the

health of the patient. Therefore, they are responsible for the optimum care of the patient. In

health care, the nurses are held to reasonable nursing standards of care. They are judged against

what the nurses in the similar situation might have done.

A7: Australian Nursing and Midwifery Federation ensures that the nurses or midwives who

suffer any type of injury or illness are given appropriate compensation. It is due to the policy of

ANMF that the registered nurse, in case of Elijah, gets the work cover.

A8: In case when patient’s guardian abuses him physically, it is mandatory for the nurse on duty

to report the incident to the seniors and administration. The administration can take necessary

action and inform Elijah’s family about the same.

A9: The report should include the reasons and observation of the incident. Also, the report

should include the conclusions drawn from the incident.

A10. The knowledge and skills of a nurse are significant aspects that can contribute to the

ability to influence the care of a patient in an ethical manner. Ethics in nursing arms the nurse

with the power and ability to act as a key player in the decision-making process concerning a

care is given to a patient. In this case, for the request by Elijah’s family to withhold his treatment

to be acknowledged, the nurse has to act ethically and find out if there are any legal documented

noted that allows the family to make such decisions in end-of-life situations (Hester, 2010).

A11. While interacting with clients, a nurse or a practitioner is expected to make the patient

primary concern while administering the care in a manner that preserves and protect the dignity

of the client. The practitioner has to demonstrate honesty and integrity while interacting with the

relatives of the customer acknowledging that they have to know the conditions of their loved

ones. Ethics in nursing also demands that a practitioner treats their colleagues and other health

workers with respect.

A12. Nurses are faced with an ethical issue concerning the freedom of a patient and the control

of a nurse. Patients may refuse to follow the advice of a practitioner who is ethically required to

ensure that the patients show the best outcomes in the treatment.

There are honesty issues versus information where families choose to hide truthful information

from their sick relatives while in nursing, the patient has the right to true information about their

condition.

There is a battle of beliefs where clients might refuse treatment based on some religious and

cultural beliefs. In the case, nurses face a dilemma as their primary role is to give care to the

patient who is, in this case, refusing treatment.

A13. Ethical issues are becoming part of the everyday nursing career, and it is high time they

get reduced if not eliminated. Some strategies to fight ethical issues include;

In a role as a nurse, it is highly recommended that one supports the ANA codes of ethics as being

familiar with the systems enhances ethical practices in the nursing career.

There should also be an ongoing education as ethics is usually learned just like discipline. The

training programs should be incorporated in the healthcare institutions with ethics contents and

examples on how to apply the principles to complex issues (McCaffrey, 2012).

A14. Complaints from patients or their families have to be responded to at the earliest

convenient time. In the case of the claim by Elijah’s family, the immediate action is to assess the

room and confirm the level of cleanliness and find the responsible department and have them do

the needful. The responsible body should them make sure that there are no similar complaints in

the facility. After having the responsible team take care of the cleanliness, there has to be an

apology to the patient and his families and assure them to maintain high levels of cleanliness at

all times.

A15. The actions of the student enrolled nurse could lead to further complications to the patient.

The patient can develop allergic reactions to the wrong injection or; there can be body reactions

with the medicine causing other complicated issues. The nurse should have asked the practicing

nurse or a senior practitioner for advice before administering the medication. In such a case, it is

recommended that the SEN should seek help from the seniors before applying any medication to

a patient. As such, the nurse will be able to avoid any wrong injections or drugs that can cause

harmful effects to the patient.

A16. Open disclosure refers to the art of discussing openly the issues and incidences that can

cause harm to a patient while receiving care. It is an open discussion with the patient, their

relatives, families and other parties that support them during the time of their treatment. Among

the principles of open disclosure includes;

An open and timely communication where in case certain things are not right, the patient and

their friends and families are issued with the information about the situation earlier and in an

open and honest manner.

Acknowledgment is another principle where all the adverse events have to be acknowledged to

the patient, their family, and caregivers at the soonest convenient time. The health center has to

recognize the time of the occurrence of the adverse event and initiate an open disclosure.

Apology or an expression of regret is also another principle. The patient, his family, friends and

relatives have to be given an apology or an expression of regret earliest in the case of any harm

that comes as a result of the adverse event.

In the case of Elijah, the hospital should have initiated an open disclosure as soon as they

learned of the mistake by the nurse to avoid complicated issues from the families and friends.

A17. Enrolled nurses have to adhere to the ethical responsibility of ensuring that their patients’

health is a primary concern in their operations. Open disclosure is. However, a barrier to the

same as it at times deny a nurse the chance to give their immediate patient response at times

when there has been a wrong prescription given to a patient. When a nurse is supposed to

implement the emergency response to a case where a patient has been misdiagnosed, or when the

patient's conditions have gotten worse, the nurse instead is expected to initiate an open disclosure

that prevents them from doing what they are ethically supposed to do (Stewart, Kerridge&

Parker, 2007).

A18 Coroner’s case is an investigation that looks into the deaths that have occurred suddenly

without a known cause or deaths that are suspected to be due to unnatural causes. A coroner’s

inquest has a role in determining the case of how, when and where a sudden death occurred. The

investigation is expected to decide on the cause of death before a death certificate can be issued

by examining the unnatural deaths that have been as a result of a crime incidence.

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