This paper explores the legal and ethical nursing issues surrounding two different health care case studies. The first case study is regarding the decision-making process of a family for aggressive vs.. Palliative measures for a patient without advanced directives. The second case study is regarding a nurse’s obligation to report witnessed negligent actions of another nurse being sued in a malpractice case. This paper describes how each case study is influenced by the American Nurses Association (ANA) Code of Nursing Ethics and personal and societal values.
It also delineates the legal aspects of each study and the legal responsibilities of the nurse involved in the malpractice suit. American Nurses Association Code of Ethics The ANA code of ethics would influence the final decision in both cases by directing the nurse to become the patient’s advocate. In the first case study of the 79-year-old woman, the patients value system and religious beliefs should be considered when delivering care to the patient. The nurse does not have to agree with or condone the patients choices, but be successful of them (ANA, 2001).
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Nursing must aim to extend supportive care to families and significant others across the continuum of care by meeting their stated needs. This is vital in the care of the patients and families, especially at the end of life, to prevent and relieve the cascade of symptoms and suffering commonly associated with dying (ANA, 2001 The nurse supports the patient’s self- determination by participating in discussions with the surrogates, providing guidance and referrals to other resources. Identifying and addressing problems aids in the decision-making process ANA, 2001).
Nurses should recognize some cultures place less weight on individualism and choose to defer to family or community values in decision- making. The nurse’s primary commitment is to the health, well-being and safety of the patient across the life span and in all settings in which health care needs are addressed (ANA, 2001). The ANA Code of Nursing ethics would influence the final decision in both cases by ensuring the nurse stays impartial in delivering nursing care while advocating for patient’s rights, respecting their individual Legal Responsibilities of Nurses
Legal responsibilities of nurses are defined by the specific nurse practice act for the state that the nurse is licensed in. The responsibilities and requirements are outlined in a clear manner. The acts vary from state by state, but generally they are mostly the same. In 1981 The Nursing Practice Act: Suggested State Legislation was published by the American Nursing Association to provide guidelines for states to develop their individual nursing requirements (Blabs, Hayes & Oozier, 2011).
For example, North Carolina’s nurse practice act called the Components of Nursing Practice for the Registered Nurse defines a nurse’s responsibilities and breaks them down into sections. Some examples of these sections are assessment, planning, implementation of nursing activities and evaluation of the patient and treatment (NC Board of Nursing, n. D. ). Nurses are legally required to assess their patients using subjective, objective, and laboratory data. This information allows the nurse to serve as the patient’s advocate to ensure proper and excellent care.
The nurse is obligated to create a care plan that is well thought out, professional and facilitates safe treatment of the patient A nurse should also be knowledgeable enough to identify errors in orders to prevent adverse outcomes for their patients. The nurse is expected to prioritize tasks and ensure the most critical tasks are performed first. Furthermore, the nurse is legally expected to evaluate the patient outcome to identify any problems and communicate their findings to the appropriate staff. Last, documentation is a legal obligation of the nurse as well as obtaining consents for various tests, labs, and procedures.
Conclusion The American Nurses Association Code of Ethics guides nurses in making ethical decisions in cases such as these by directing and ensuring nurses are unbiased patient advocates. Nurses must be aware of their own personal values and not impose their beliefs in the decision-making process Of the patients and their families. Nurses have a legal responsibility to report any observed actions believed to be negligent and can lead to malpractice. Nurses are unbiased when they assist families to make informed decisions based on the best interest of the patient.
Legal responsibilities of nurses are outlined in each statss nurse practice acts and define the nursing process.