Legal and Ethical Accountability

ASSIGNMENT: Legal and Ethical Accountability

Patient situation: Jimmy Smith is a 19-year-old male who had a severe compound fracture of his tibia yesterday in football practice. Last evening about 4 pm he had surgery to set and cast the leg. The evening shift reported that he was having a bit of swelling from the severe trauma that accompanied the fracture, but that the toes on the effected leg were warm and he had good pedal pulses. By the time you received report and went to check on Jimmy, you felt that his pedal pulses were slightly diminished and his foot was slightly cool to the touch. By 2 am you felt swelling had increased and his toes were quite cool although they were not blue. You phoned his physician and he was upset to be awakened in the middle of the night. He instructed you to put ice on the cast and to elevate Jimmy’s leg higher to reduce the swelling and promised you that he would see Jimmy first thing in the morning. As the night wears on, you become increasingly alarmed. By the time the night supervisor arrived at 4 am you were so concerned that you asked her to check the casted leg. The supervisor rushed out of the room and said, “The circulation in this boy’s leg is severely compromised, why you haven’t gotten the doctor here to cut the cast?”
1. Theoretical Knowledge
a) Have you committed malpractice? Has the doctor? What is the nurse’s responsibility in reporting a patient conditions to their physician? Examine the elements of malpractice. If there is permanent damage to Jimmy’s leg, who will be liable for the failure to take action soon enough to prevent injury?
b) What standards, guidelines, and laws apply to determine whether the nurse’s actions were in accordance with standards of practice?

Patient Situation: Mrs. Smith is a 23-year old woman who has had frequent episodes of nose bleeds, easy bruising, and one infection after another. After a bone marrow biopsy, Mrs. Smith, who is caring for her mother and ill father at home along with an 18-month infant, is visited by an oncologist and several residents. She is informed by the oncologist about her diagnosis of acute lymphocytic leukemia. She has a dazed look about her as the physician describes the next step of treatment, which will be aggressive chemotherapy. The physician leaves with the consent form signed, but when you question her, you realize that she did not hear a word of what transpired.
1. Critical Thinking
a) As the Registered Nurse, would you consider this an informed consent?
b) From an ethical perspective, what are the items in her history that you would like to have more information about?
c) How would you proceed as the client advocate in this case?

Grading Guidelines:
Format: APA 7th edition formatting is expected, including a “Title” and “Reference” page.
Each patient situation should be addressed with a minimum of 350-450 words and should be supported with a minimum of 3 peer-reviewed scholarly references

ANSWER

Legal and Ethical Accountability

Accountability in the nursing profession is directly linked to the ethical and legal aspects of the practice. These aspects influence the nurse’s responses in delivering the right form of care that adheres to the set guidelines of safety and quality required in healthcare (Maude & O’Brien, 2020). Taking into consideration the role that ethics plays in identifying the accountable parties in any situation, helps ensure that the nurses can take responsibility for their actions especially if they resulted in a patient suffering. It also helps them to identify and put into practice the needed practices and protocols required in critical patient care situations.

Theoretical Knowledge

In this situation, the nurse has not committed malpractice since she did take the initiative of calling the doctor when she noticed the declining state of the patient. Also, she kept on checking on the patient’s condition throughout the night, therefore, fulfilling her role and responsibilities which was to ensure that she is constantly aware of the patient’s condition during the shift. The doctor, on the other hand, did commit malpractice. Taking into consideration that it is a nurse’s responsibility to update the doctor on any of the patient’s developments, his choice to ignore the nurse’s report about the 19-years old despite his worsening condition was wrong.

His actions have the characteristics that form medical malpractice in that the patient’s devastating injuries were caused by the doctor’s negligence. Secondly, his actions resulted in the violation of a standard code of care toward the patient, by choosing to sleep instead of attending to the young man (Sweeney et al., 2017). It is the doctor’s professional duty to the patient to ensure that they receive the care they need, without having to consider the doctor’s convenience in the matter. Lastly, his choice to ignore the report resulted in significant damages, which had the potential of costing the patient his leg and possibly his life. Six guidelines help in determining if a nurse has committed malpractice. A nurse is guilty of malpractice if he or she fails to assess and monitor the state of the patient when they should. After assessing their condition, it is the nurse’s job to advocate for the patient’s care. Another guideline is a failure to communicate the patient’s condition to the appropriate authorities (FunKyung & FunKwang, 2016). Also if the nurse does not follow the set standards of healthcare, he or she may be guilty of malpractice. The failure to responsibly use the hospital equipment is another guideline that determines if a nurse has committed any malpractice actions. This occurs if the nurse chooses to use the