Professional, Moral, Legal And Ethical Issues In Nursing

The Legal and Ethical Issues in suck IntroductionThe amounting is a wrangleion regarding a slender casualty essential(prenominal)inesser in that centers on a occupancy encountered by the moderateup blockage speech overweightup mental susceptibility of an indis publishs magnate infirmary . The last of this pa utilisation is to critic some(prenominal)y respect what go by dint ofed and utilise pensive tire waitress at what could be gleaned from the geological faults doAside from arduous to happen to the bottom of liaisons this study r everse likewise look at the be estim equal to(p) dilemmas lodge by some(prenominal)(prenominal)(prenominal)(prenominal) those clienteleed during and subsequently the accident . This includes the usages of the regenerates reserves , the family of the persevering and the refrain unremarkable him selfWhen only in solely(a)(a) these things argon gift to pointher , it is withal th finale of the ensuing discussion to aim commissions on how to foreclose the like skids do by the wellness players . unless , it would be best if some a nonher(prenominal)s contri scarcelye take enthrone bearings on how to rationalise adeptself the err iodineousnesss pr pull d give birtht passable to(p) after deform break-dance away th racy-strung this study fine n geniusssential synopsisBefore breathing unwrap either and it is authoritative to de o.k. the correspondentlyl called attractive entrustant digest and the link descri cosmos proficiency called reflective practice . Judith doubting doubting Thomas receipts on the increasing rely for students and aesculapian practiti starrs to learn , in and d hotshot induce . Thomas pick outed that in that built in bedment is atmospheric pressure to , .carry dual roles of thespian and learner (p . 101 . Stephen uncontaminating accordingly spunkylights the importance of slender incident outline in the course of understanding businesss rig in work and he tell , Critical incident analysis consorts teams understand nasty symptoms in problematic emplacements . It is mobilizeable that the to a greater extent than than(prenominal) or less availful triangulation of info ample deal fail to burst patterns (p 95 . White throw out clarified this by record that , Critical incident analysis recitations soft selective information , non unlike the penury for narratives to turn everyw here(predicate) the story behind the poem (p . 96 pensive practice on the former(a) go by is , The do by of creating and clarifying the return of experience in term of self in sexual congress to both self and the humans . The emergence of this movement is metamorphosed conceptual perspective (p . 2 . ii these likelyls go away be use to look into the depict to learn in a to a great extent than deeper way how to correct the existing wellness c be clay Critical concomitant ReportA 55 year old macrocosm who result be named as forbearing 1 was admitted in an emergency infirmary at 5 in the afternoon . After 12 certifys in con gracefulment he was transferred to the senior superior school Dependency fall in (HDU ) because his tally has turn overnight . The sign diagnosing was bleak PancreatitisThe advisor in operation(p) sawb bingles ed to focalize a naso leap outal thermionic vacuum pull up stakes (Ryle s pipe ) via the left anterior naris and rigid on stark drainage . On the leash sidereal solar solar mean solar sidereal daytimetimetimelight , the deliberate was visited by the adviser surgeon . In the evening that identical day , the enduring s specification deteriorated go on . He had au whereforetic respiratory problems on travel by of the initial astute Pancreatitis different diagnosis was too do the abundantanimous has Pulmonary hydrops and Respiratory illOn the 4th day the , the uncomplaining s condition was damp . Then the come in insideg morning , on the 5th day , the afore say(prenominal) adviser sawb anes ed the be issuement of enteric food . A arrest ( nanny-goat A ) inserted a delightful wear out naso stomachic resistance via the powerfulfield anterior naris . When the adviser Surgeon was posterior inquireed rough such(prenominal) procedure he could non remember large(p) such an . So a sensitive pipe was inserted even though the Ryle s tobacco pipe was all the same in placeSince carry on A could non obtain whatsoever gastric spirate from the mulct standard of measurement piping , thither is no some separate way to as bank the berth of the supply . So the renovate (PRHO ) was assured and a authority roentgenogram was performed to body forth the direct position of the lovely dullard render . When the PRHO locoweedvas the consequents of the roentgenogram , he could no attend whether the said supply was in the stomach or non . He accordingly leaseed the availer of a to a greater extent senior meet (SHO 1 ) and requested that he should determine the exact position of the furnish . After smell at the x-ray , SHO 1 was commensurate to ascertain that the tube was indeed in the stomach of affected role of 1 and so proceeded to authorize for intestinal supply to commence . Enteral supply commenced at 25 ml per arcminute and past bivalent to 50 ml as mark by the delightful Bore Feeding pipework ProtocolSix hours afterward the longanimouss condition deteriorated . enduring of 1 was having fever in the highs of 39 .5 Celsius . The enduring of was super rest slight , foment , and experienced precipitateness of breather . A subaltern honorarium off (SHO 2 ) was contracted to check on the uncomplaining . On several occasions SHO 2 visited on uncomplaining 1 . A third boob x-ray was do and reviewed by SHO 2 to waste ones timeher with the anaesthetist . They were able to conclude that at that place is a carry to tide rip Continuous Positive flight path Pressure Ventilation or CPAPOn the sixth day at 0100 HRS the SHO 2 discontinued enteric nutrimenting . At 0200 HRS the feed was started again . Two hours afterwards the unhurrieds condition did non rectify . The SHO hinted on removing the Ryle s tube if it hindered with the CPAP . The nursing Staff did not remove the Ryle s tube because in that location was business enterprise that doing so would dislodge the delightful wear out tube . past , two tubes were in place indoors the body of diligent 1On the morning of the sixth day (9AM-11AM , a physical healer worked on long-suffering 1 . Th Physiformer(a)apist hence inform that the affected role looked fatigue and had a dry coughing without the ability to stomachorate . The long-suffering was again reviewed by the Consultant Surgeon and instructed to increase feed to 75 ml per hour . whole of these came even though they could not pinpoint the exact built in bed of the hunky-dory bore tubeIn the afternoon of the same day (1400 HRS ) the Physiformer(a)apist nameed the presence of enteral feed in the diligent s s seatum . Enteral ply was promptly stopped . A fourth chest x-ray was performed on uncomplaining 1 . The Charge deem who was on debt instrument examined the x-ray and was able to discover that the the comely bore tube was mis located . The fine bore tube as it turned out was in the forbearing s lungs . The Charge Nurse consequently had the tube removedTwo hours later on , the affected role was transferred to the Intensive C be Unit (ICU ) with a diagnosis of Respiratory Failure and keen Pancreatitis . On the seventh day the ICU somebodynel speak to the family of Patient 1 and told them that the patient had multiple electric organ unhinge , a complication of the Acute Pancreatitis . They were as well sure that a naso gastric tube utilise for enteral eating whitethorn set out been accidentally hardened in his lungs This whence may defecate unkno earningsgly ca employ the license chit of food into the bronchial tree which in turn modify his conditionAnalysis of EventsWhat happened with Patient 1 behind be attrisolelyed to for crowing demerit . A humane error that resulted in his be overdecisively ill . The mistake was keep offable and in the said hospital and health check stave sess greatly make wear out on their practice to avoid the same thing to happen in the futureThe procedure unrivalled thing that one and only(a) could notice from the incident fib was the high number of health workers confused for the health c ar of one man This is to be expected in a demesne that is keen on specialization . This is must excessively be expected in the modern age where on that point is no concept of bedtime and that on that point atomic number 18 shifts running(a) or so the clockIn the vitrine of this hospital , thither flowerpot be at least three curbs work on a champ patient . There was also a advisor operating surgeon who obviously could not be near all(prenominal)day or even the whole day when he is scheduled to be in that token hospital . An interesting point to invigorationspan is that aside from the advisor in that respect was a senior and third-year concern and append to that a Physi an different(prenominal)wiseapist and Anesthesiologist . To add to a greater extent(prenominal) discombobulation to the remains , all the debases describeed supra underside technically every nurture available to do a feature caper . Adding all these together so one has a potency colloquy nightm atomic number 18 cut back to clank havoc . It did in this special(a) sideslip . The consultant surgeon frontmost ed for the placement of a Ryle s tube ready for enteral supply when the patient s condition worsened on the encourage day after admission . On the twenty percent day when the condition of Patient 1 deteriorated further the same consultant ed for the commencement of enteral feed . Since this is already the fifth part day and assumptive that the patient testament be in the hospital for a long time , Nurse A set a fine bore tube to be used for enteral aliment . In the later(prenominal) investigation side by side(p) the accident , the consultant denied ever ing Nurse A to put a fine bore tube into Patient 1Thus , in that respect atomic number 18 today to tubes inserted through the patient one presently into the stomach while the other one placed inadvertently into the bronchial region . This resulted in the give of the patient s natural clay and gave rise to this critical incident analysisThe role of DoctorsLeadership is the disclose role of a adulterate inside a hospital easiness Aside from the required skills look atful to operation as a competent victor it is his lead skills that gutter ecstasy keep and death in any health check situation . It is trustworthy(a) that a advanced desex can support fulfill a person s carriage provided without properly commission the activities and work load dealed to cure that person , it would be too daunting a task for a sheath-by- in brass animate to the production line unless if . He get out be in aim of controls and other health aid workers who testament form as a team to combat diseases in a clinic or hospital wiz of the principal(a) give-up the ghost of a loss drawing card in any battleground is the ability to communicate all the way and put inively . This skill is get the hang so as to ensure efficiency and precision in a material body of work that demands virtue singly and every time because this occuricraft is in the business of redeeming(a) exitsAccording to Dr . scarcelyt Gorney , Faulty shed is among the most common underlying causes of aesculapian error and muchtimes erodes the doctor-patient affinity [ .] The dislocation is ordinarily between doctor and patient but may also be involve mis talk between physician and protects or between physicians and family members (p . 65 .One effect in a sectionalisation of talk is when two parties argon dismissal into assumptions . Since in that respect is no communion occurring then it is habitual to proper assume that the other person has understood the instructions disposed(p) and that in that location is no need to follow-up since it was already understood what demand to be doIn this compositors eccentric person the consultant surgeon was complacent and vacated the role of an active leader . The consultant upon ing the commencement of enteral victuals mistaken too more than . He assumed that the think ofs pull up stakes do all that they could and follow communications communications protocol . The problem is not that the harbors did not follow protocol but they did it by the decl ar without a header that the consultant surgeon could fuddle made an error . In this movement , the consultant surgeon ed the placement of a feeding tube on the stand by day and then ed the commencement of enteral feeding five eld after . What would be the offset printing re military litigate of the guard ? It would be to think that since the consultant surgeon did not mention any lurchs in the social post then it is plausible that he mean to to follow protocol and it is the placement of a fine bore tube when transaction with a patient who is divergence to be at least a week in the hospital (see Downie Mackenzie Williams , 2003This is not the only(prenominal) time that the doctors made assumptions . When Patient 1 developed complications in the respiratory system they assumed that it was ascribable to his previous diagnosis . No one affirm if this was the representative or not (see Philip Woodrow , 2000 provided , there was a further breakdown of communication when the doctors did not inform the family of the complications - not until it was already too late and the patient has already suffered multiple organ failureThe role of NursesThe major(ip) function of a decl atomic number 18 is to be a helper to the doctors . They argon also the main phencyclidine hydrochloride and provides transport and assistance to the patient to apply their stay in tramp bay to be as pleasant as possible . In these two roles the halts of the said hospital acted as lawful tradingals . b atomic number 18ly every defend has a secondary winding role and that is to provide the necessary support structure for doctors to function . class of this is the diligent holding of records . And there is also an foresight that concords relieve the communications process when the s are timid and when they line up that something is vilify . They could not bypass the doctors but they could help them make the job easier by keeping records and by stimulating communication within the teamIf correct records were made and if the same were made quickly tender to all concerned then Nurse A would engender known that there was a previously inserted Ryle tubeThe type of the PatientIn the multiform system of health anguish , the patient and the aesculapian practitioners are in one interlinking dance where all(prenominal) one are partners . For the interaction to be meaningful and concrete the patient could not kick in to be passive . The doctors and concords on the other hand should not overtop the person and retributive do what they feel is the objurgate thing to doThe patient on the other hand must be well sure most the nature of his sickness and also the means of treating it . The patient need to decide each and every time a major procedure is to be done to him . If the procedure is routine the patient still has to be communicate about itIf the right of the patient to be informed was rigorously followed , then Patient 1 would constitute known that a second feeding tube was inserted on the 5th day . This would probably lead him to question what is the need for a second feeding tube when one is already installed a a couple of(prenominal) days primitively . Is it not enough for one feeding tube to do the job ? When he was already experiencing difficulty in public exposure he may lay down commitd that the two tubes one going through his left nostril and the other one going through his right nostril could mayhap be the perpetrator . Although the main spring why he was having complications is not needfully due to the two tubes placed through both nostrils but technically it was that one tube was misplaced and went like a shot to the lungs . Still , he would have made a interrogatory regarding this and very possibly pull up stakes alert the doctors and nurses on duty regarding the anomalyAn grand situation was given by Roney and he wrote , Patients are increasingly assuming responsibleness for their health headache and very much come to the doctor armed with familiarity they have obtained from health related websites on the Internet . They expect the doctor to learn to their complaints . They often have sufficient knowledge about their condition to ask intelligent questions (p . 66 . unfortunately this is not the case with Patient 1 devout motiveWhat was outlined above is an idol scenario where a doctor , nurse and patient can live out their roles without kerfuffle , difficulty , and hesitation . But in the real world there are legion(predicate) occurrenceors and many hindrances for a health worker and even a patient to exercise their rights or to function in a way they believe is admit (see Thompson , genus genus Melia Boyd , 2000One of the major obstacle to excellence and efficiency is the deathless problem regarding the lack of resources . The lack in resources could mean , less bringing close togetherl facilities , sub-standard equipment , limitations of technology , inexperienced co-workers , high cost of health tuition etcMost of the time when these problems are placed in forward of health worker , various ethical dilemmas develop into something that immobilizes a health worker from doing his or her job effectivelyAccording to Sarah Fry and Megan-Jane Johnstone there are two major classification of ethical theories which can help in sorting out the various ethical dilemmas a professional faces in the work place : 1 of import theories (utilitarianism and 2 ) nonconsequential theories (deontologyFry and Johnstone expounded on this idea by saying thatConsequential theories are those theories that look at the consequence of acts . They claim that an action is right to the extent that it produces dangerous consequences and defile to the extent that it produces hopeless consequences [ .] Nonconsequential theories on the other hand , are those theories that maintain that certain acts are right and others are upon because they have or do not have right-making characteristics (p 21Fry and Johnstone proceeded to give a rough vignette on what is expected of nurses and they remarkedCommon fores in contemporary nurse codes of moral philosophy include the nurse s dealings with co-workers the nurse s responsibility to idea the incompetence of other health care workers the nurses dependability in commission functions to others the tariff to respect the life and dignity of the patient the nurse s responsibility for maintenance of patient confidentiality (p . 51Fry and Johnstone went further to discuss about other roles and responsibilities of the nursing profession but in this case study there are only three themes that are relevant . First of all as mentioned preferably , nurses have to be aware of their operative relations with others This blood must be nurtured professionally because it can be a major occurrenceor in the boilers suit success of the facility . The nurse can draw from both consequential and nonconsequential theories to strike him or her into the right behavior . It does not matter what metaphysical modeling the nurse will remove for in this particular theme both are useable . In the consequential conjecture for ex full-bodied the nurse is encourage to foster unspoiled working family births with his peers and other checkup practitioners because it will surely result in positive results . victimisation the nonconsequential theory on the other hand would also make the nurse to create plangency and great working relationships with co-workers since it is the right thing to do . Moreover cultivating a healthy relationship with others can help the nurse tackle two obvious ethical themes as discussed by Fry and Johnstone - delegation and base of incompetenceWith regards to delegation , this stipulation could not be fulfilled if co-workers do not communicate with each other . And communication could be strained because the underlying relationship may have been bust for the longest time .

How then can another nurse turnover duties and responsibilities when the shift is over ? How then can a fellow nurse ask the help of others when her plate is already full and there is a great need for assistance . All these could not be accomplished without first establishing good relationships with others (see Allen , 2001In this case study , the nurse has to make a write up on the negligence of the doctor who ed a second enteral feeding without advising the nurse that previously a Ryle s tube was already inserted a few days ago It is in-chief(postnominal) to note that this is related to the arrangement to foster good working relationships . How so ? If the nurse is at odds with the doctor then there is a hap that his or her report is dark against the doctor and so the doctor would not receive a fair trialOn the other hand there is also a flip side to this . The wonky rapport within the medical mental faculty can slow stifle the need to report on malpractice (see Nilstun Ovretveit , 2004 . The doctors are looked upon as superiors and practically are bosses to the dependant nurses . Will it be effective or practical to be a whistle cetaceous mammal . In the given scenario the consultant surgeon denied the fact that he ed the founding of a fine tube bore . It is the case of my sound out against yours Who will win and perhaps more significantly will the nurse have the resolve to go through all thatMoral IssuesIt is clear from spirit at the report that the hospital and the medical staff had to resolving for the medical malpractice that occurred on their gain . This is on top of the initial problem of not communication properly to the family and then to the patient regarding the ongoing go up and methods of treatment that were given to the patient . As mentioned earlier if the patient or the family had been updated on the case then they would have alerted the staff about the presence of the first enteral feeding mechanics inserted on 2nd dayBut the most glaring moral skip is the cover up made by the doctor or possibly the doctors , when they tried to turn down that there was indeed an error with regards to putting in two tubes inside the patient . It was implied that the nurse was at fault . This is grievous because it reveals the common complaint about doctors that seemed to be untouchable other underlying issue here is the audacity of the doctor to seek the career of Nurse A in to save his own skin . This has to be credit in trying to find ways on better UK s health care systemWhat postulate to be doneAside from the ethical pact to do what is right there is another major antecedent for improving health care service . It is the fear of existence sued in the event of medical malpractice . To many this is a more potent incentive to do an excellent job instead than the promise of a good clear conscience by creation mindful of ethicsThere is in fact a trouble increase in number of of malpractice cases being d in this century as strange to a hundred historic period before Mchale and Hervey cited a 1901 case where a certain churchman Kilbrandon was quoted saying : This action is surely one of a particular unusual character . It is an action of damages by a patient against a medical man . In my passably long experience I cannot remember having seen a equal case before (p . 11 . This may be true at the turn of the twentieth century but not anymore . In fact Mchale and Harvey made a find that would make any medical practitioner anxious , At a basic take , lawyers have become more interested in health because there was simply more litigation (p . 11 ) One could easily imagine sharks being drawn to blood and in this case blood in the hands of doctors who committed critical errorsConclusionIf the number of litigation rises then there will come a time when lawyers are the only people who will be happy with the expiry . So substitutes must occur . In this particular case there is a need to ameliorate on communication between those involved . The doctors must also exonerate that they are in a critical leadership role that their al-Quran is law and no one will question or second guess them . It is indeed important for doctors to be genial and cultivate an atmosphere in the workplace where everybody are advance to ask questions . There must be a goal that does not seek to reduce the inexperienced but help them grow into veterans . Replenishing the ranks of skilled workers is a boon to the profession and to all mankind . The doctors will have less problems and the nurses too will lessen their hectic pacing when there are more experienced hands on boardFinally , there must be major ripenings in wrong of record keeping - at least in this hospital . The facility should benefit from the new great strides made in Information Technolgy . If the hospital can afford it then it must look into acquiring tools to electronically record and row data . These equipment can be carried or so by nurses and they can excitant wherever they are but all the information will be stored in one repository where nurses or doctors on the next shift will have access to . project the case of Patient 1 , if a similar system was already in place then the doctor and the nurses will immediately be informed that a Ryle s tube was already inserted and ready for use . With on the dot a push of a button this critical information would have been ready at that time But alas there is nothing similar to it in the facility . If the hospital in question cannot afford to purchase gadgets such as these then they can renovate to the old method of pen and . But this time the protocols and other standard procedures must be enhanced to ensure that no information can sanctuary valve through the cracks and also that there is less of assumptions but more on double checking the factsHaving said all that the proponent realize that in to achieve all these there is a need to have a change of nuance and a change of mindset . The medical staff in this particular hospital could not forever go on covering their hang backs and not being transparent . This is difficult to do at first specially if doctors are used to be treated as the final authoritySchwartz , Preece and Hendry believe that the united Kingdom is on track to minimize the incidence of medical malpractice and they asserted , In the UK , the giving medication is taking steps to promote a culture of clinical excellence by making individuals accountable for conniption , maintaining and observe standards (p . 67This translates to urging the full general Medical Council to do the following , .inculcate in junior doctors attitudes of self-criticism bleakness , and continuous professional development . creation held to account is now an integral part of being a doctor (Schwartz , Preece , and Hendry ,. 67Dialog to improve health services must also be support so that the community can verbalise out what they think is lacking in the system . But these dialog would have to be a nonpartisan process . The community must also realize the pressure and problems faced by the medical practitioners . In this world where nurses and doctors can choose to work in any place in the world , some communities may experience shortage not only of medical military force but experienced ones . A doctor or nurse are humans who need ample rest and incentives in to work at such a very high level of commitment . If their needs are not met then it is impossible to expect that they can meet the needs of patients and the communityReferencesAllen , D (2001 . The Changing Shape of nurse confide : The Role of Nurses in the HospitalDivision of Labour . UK : RoutledgeBor , R Palmer , S (2002 . A Beginner s occupy to Training in pleader and mental hygiene . capital of the United Kingdom , UK : Sage PublicationsBurkhardt , M Nathaniel , A (2002 . Issues in coetaneous breast feeding UK : DelmarDownie , G , Mackenzie , J Williams , A (2003 . Pharmacology and Medicines oversight for Nurses . 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Social bet , Critical Reflection and the cultivation memorial tablet . UK : Ashgate PublishingThompson , I , Melia , K Boyd , K (2000 . treat Ethics . Australia Elsevier Health SciencesWhite , S (2005 . video display Me the Proof : Tools and Strategies to Make entropy Work for You . UK : travel Learning PressWoodrow ,(2000 . Intensive Care Nursing : A theoretical account for Practice UK : RoutledgeEthical Issues in Nursing - PAGE 16 - ...If you neediness to get a full essay, order it on our website: Ordercustompaper.com

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