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Introduction - Navigating Legal and Ethical Requirements in Nursing Patients with Complex Needs
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- Caring for patients suffering from intellectual disability and motor neurone disease.
- Encouraging patients are suffering from the disease and making them imbibe positivity.
- Ethical dilemma faced by a nurse while treating David for his intellectual ability and motor neurone disease.
- Abiding by the rules and legislations formed by the government.
S.N: A nurse faces an ethical dilemma while caring for a patient, suffering from intellectual disability and motor neurone disease. David is 38 years old, but due to his condition, his mental age is of a 10-year-old. David lives in a caring home where nurses take care of him, but for his disease, he has to be shifted to the hospital, and he does not want to go to the hospital but wants care from the nurses.
Slide 2: Possible ethical dilemmas based on case scenario
- David needs to be hospitalised for his disability and condition.
- David wants care from the nurses in the caring home.
- Utilitarianism theory focuses on morality and outcome (Williams et al. 2022)
- Nurses are bound by the ethics code of respect and the decision of patients (Safetquality, 2022).
S.N: Nurses face the dilemma as David wants care from nurses over hospital treatment. For a better treatment of David his condition, doctors have advised hospital admission; however he wants the care of the nurses. As per NMBA standard 3, a nurse needs to maintain their capability while delivering patient care (NAMB, 2017). Based on utilitarianism theory, The nurses need to deliver core values by taking effective decisions on the patient's condition and their choice. They are also bound by the code of quality nursing and health care for all.
Slide 3: Legal capacity and competencies
- As per the legal competencies of registered nurses, they need to follow the regulatory framework
- Need to provide quality care based on prescribed education under governmental law (NAMB, 2020)
- Respect patient’s legal capacity and autonomy as per NMBA standard (DHAC, 2022)
S.N: As per Australian nursing standards, it is the responsibility of the registered nurse to build relationships with patients to deliver value on their cultural values and beliefs. As per NMBA standard 1, it is the responsibility of a registered nurse to determine personal thinking and analysis on it. As per the case study, David is unable to understand his condition and cannot explain it. In this case, as a registered nurse, it is my duty to understand his problem and deliver accurate care to him.
Slide 4: Beneficence, Non-Maleficence, Autonomy, Justice
- In beneficence, need to be good and betterment for David.
- In non-maleficence, follow safety measures while caring for David
- Deontology theory guides to understand to understand rules and regulations of the nursing profession (Emmanual et al, 2021)
- Provide value to the decision taken by David and deliver treatment in terms of autonomy.
- In justice, avoid discriminating against David while caring for him.
S.B: David wants the treatment and care of nurses rather than from the hospital; his decision and choice should be respected. The nurses should keep in mind his condition while treating him. Safety measures are needed to be implemented while treating him without any discrimination. As per Deontology theory, health care professionals need to follow human rights and outline as per patient's obligation.
Slide 5: The elements of informed consent
- It is considered a professional’s decision based on a patient’s problem (Wilson et al, 2020)
- Identifying benefits, and risks, and developing a degree of significance based on treatment (NSQHS, 2020)
- Informed consent based on David’s condition has been achieved through potential outcome
S.N: In this slide, it informed consent is discussed based on David’s intellectual disability. As per nursing standard 7, it is the duty of a registered nurse to understand David’s needs as he needs quality care however he disagrees with going to hospitals. In this case, a nurse needs to take the decision as per the patient’s condition and prescribe proper health care treatment.
Slide 6: Veracity and fidelity
- Nurses need to be honest regarding the condition and not give any false assurance (West, 2020)
- Build up a practice as per the patient’s condition (ACN, 2018)
- As per the code of ethics, we need to take action by considering patient acceptability (NAMB, 2021)
- Nurses need to avoid misbehaving with patients regardless of their behaviour and nature.
S.N: As per Australian nursing rules, nurses treating David should exhibit honesty towards him without giving false assurances. Personal interaction with David should be done by the nurses while fulfilling his wishes and satisfying him. As per NMBA standard 4, nurses need to take information as per David’s physical status and measure his vital sign and symptoms and medicate accordingly.
Slide 7: Component of Negligence
- Nurses need to follow their legal duties and follow “Duty of care”
- May provide the wrong medicines (McLennan et al, 2018)
- Nurses need to monitor David’s condition at regular interval
- Communicate properly as per patient’s approaches (Allan and Allan, 2020)
S.N: While treating David, he might be subject to negligence from the nurses. Nurses may not be able to communicate with David and can provide the wrong medicines. Based on NMBA 6, it is responsibility of registered nurse to deliver quality and safe care to improve patient’s condition. However, due to work pressure or any other reason, the nurses may not be able to monitor David at regular intervals. They might fail to call the doctor at the time of an emergency.
Slide 8: Scope of Practice
- Assessment of Patients- Regular assessment, like physical assessment, is needed.
- Implementing care plan- For treating patients like David, goals are set with the patient.
- Administering proper medicine
- Implementation of specialism
S.N- Regular assessments are needed to be done. Specialized care like critical care is needed with the proper administration of medicine. Particular goals for improvement are needed to be set.
Slide 9: Recommendation
- Proper medicine administration with regular assessment
- Respecting decisions of David and ensuring safety
- Personal interaction with honesty
S.N: Regular assessment is needed with proper medication. Decisions taken by David should be respected to ensure his safety. Personal interaction is needed with honesty and belief.
Conclusion
- Special care is needed with proper medication.
- Honesty is needed to be shown with personal interaction
- Discrimination should be avoided regardless of the behaviour of David
S.N: As David does not want hospital admittance, his decision should be respected. Proper treatment with specialized care is needed. Honesty should be exhibited with personal interaction.
