Legal and Ethical Nursing Essay Example

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Legal and Ethical Nursing

Scenario 1

Peter who is a thirty year old man has a ten year history of bipolar effective disorder. It is evident from his history that during depressive stages he often becomes suicidal and over the last seven years, he has made numerous unsuccessful efforts to commit suicide. Peter stays at home with his aged and feeble mother who finds his sickness and non-compliance with prescriptions very hard. For the last week he has been very withdrawn and subdued and he paces around the yard shouting that he has a gun. Peter’s doctor recommends him to be admitted but Peter refuses to go to hospital claiming that he cannot be forced to agree to this. This case scenario will be assessed on the basis of legal requirements and nursing professional requirements in this paper.

In the nursing profession, nurses, doctors, and medical practitioners are obliged to meet various legal and professional requirements which include licensure, competency standards, Codes of Ethics, Codes of Professional Conduct, among other pertinent legislations. In this case scenario, Peter’s doctor has to consider all these before taking any action deemed important. It is true that peter is suffering from bipolar disorder, which is termed as one of the most persistent and severe mental illnesses. Studies reveal that, the illness is a serious lifelong struggle and challenge (Ramirez, 2006). In his situation, it is evident that, Peter is not in any capacity to make any decision. In the nursing profession, Peter can be termed as mentally ill. This refers to an individual whose illness makes him incapable of understanding the wrongness of his behaviour. In this case, legal considerations allow Peter’s doctor to refer him to a mental hospital where he will receive efficient care until he is not considered a danger to himself or the community anymore (Coady and Bloch, 1996).

The Code of Professional Conduct for nurses in Australia calls for medical practitioners to have a responsibility to the person, community, and to the profession in order to offer competent and safe nursing care that responds effectively to the needs of the society (Fry and Johnstone, 2002). In this case scenario, Peter has a history of bipolar disorder for the past ten years. As a requirement, his doctor has a responsibility to ensure that Peter is taken care of in and out of the hospital. As stated in the case scenario, Peter is not complying with the doctor’s medical prescription which means that his state will continue worsening if action is not taken. Peter’s aged mother is not in any capacity to take care for his ailing son, and as a result, the doctor, being the care giver should make certain that Peter is well taken care of.

Australian Code of Ethics requires nurses to accept individual’s rights to make their own decisions and choices relating to their care (Coady and Bloch, 1996). In this case scenario, Peter is not in a situation to make any decision regarding whether he should seek medical attention or not. As a result, the doctor has a responsibility in ensuring that this information is obtained from Peter’s mother, who will act as a substitute decision maker (Fry and Johnstone, 2002). Furthermore, medical practitioners have a role of informing individuals regarding the nursing care which is available to them, and individuals are at liberty to either reject or accept such a care (Fry and Johnstone, 2002). Medical practitioners on the other hand have a role to respect individual decisions. It is apparent that individual’s capacity to make certain decisions is compromised by certain illnesses or other factors. This applies to Peter’s situation whereby his mental illness (bipolar disorder), leads him to do various acts without considering the consequences. In this case, the doctor should ensure that Peter continues to have significant and ample information to enable him to make informed decisions regarding his care, diagnosis, and treatment in order to sustain an optimum level of self determination and self direction (Fry and Johnstone, 2002).

It is apparent that medical practitioners are required to follow certain legal and professional requirements during care. Peter’s doctor should therefore ensure that during his diagnosis and treatment for his patient he considers the above mentioned professional requirements. From the case scenario, Peter is a threat both to his life and the society at large. As a result, the doctor should consider measures of referring him to a mental hospital until he is deemed safe to be in the society.

Scenario 2

In this case scenario, the manager allocates Roger, who works in outpatient, to surgical ward as a result of staff shortage due to employee sickness. Roger claims that he is not confident on some of the responsibilities and routine of the ward but the manager assures him that he will be assisted by the senior staffs. Roger teams up with Joan and he is delegated the roles of providing physical care, treatments and medication rounds; while Joan takes up the preoperative cases. There seems to be delay in patient preparation and the manager steps in to assist in this, as Joan was preparing Casey a nine year old boy, who seemed very scared for surgery. Due to this Joan and Roger were engaged in a phone conversation where they talked about their problems, patient status and matters such as Casey being scared. Casey and his parents overheard this conversation and they were furious concerning being discussed at the same time frustrated with the delays and Casey suffering and they considered seeing a lawyer or writing a complaint. Roger however, documented in writing after the shift that all patients were attended to as required. In this scenario, this paper will consider the elements of negligence as per the ANMC competencies. Also to be considered are the legal or professional standards that were breached in reference to the matter of patient documentation.

The National Competency Standards produced by ANMC are meant to assess the performance of nurses in order to acquire or retain their license as Australian registered nurses (Australian Nursing Council Incorporated, 1993). Nurses are supposed to act as per the competencies of ANMC. In this scenario, the manager allocating Roger to the surgical ward can be termed as negligence. Roger works in outpatient and therefore he lacks the knowledge and competencies to be allocated in the surgery ward. Professional practice is one of the ANMC National Competency Standards which can be applied in this case. It is linked with legal, professional and ethical roles which necessitate accountability for practice, demonstration of an acceptable knowledge base, working in accordance with the legislation influencing health and nursing care and protection of group and personal rights (Australian Nursing Council Incorporated, 1993). It is true that, the manager allocating Roger to the surgery ward and Roger accepting to be allocated there knowing very well that he is not competent enough to be in that ward is an element of negligence.

Another element of negligence is in the provision and coordination of care. It is apparent that, in the surgery ward there was no coordination of care as the two patients who were waiting to undergo surgery were not prepared in good time, premedication’s were not given while IV’s had run out. The ANMC competencies call for provision of timely and efficient supervision and direction to ensure that care is provided for accurately and safely (Australian Nursing Council Incorporated, 1993). In this case, the manager should have been there to perform this role which could have resulted to better outcomes.

The fact Roger and Joan engaged themselves in a phone conversation concerning their problems and that of their patients can also be termed as an element of negligence. It is unethical for medical practitioners to discuss their patients in their presence. Nurses are supposed to practice in agreement with the nursing profession’s codes of ethics and conduct (International Council of Nurses, 2000).

The scenario reveals that at the end of the shift, Roger documented in writing for the three patients who went for surgery that all cares were attended and transfer to theatre per instructions occurred. In this case, Roger breached professional standards. The codes of professional standards requires nurses to practice in a competent and safe manner, avoid bringing discredit upon the reputation of the nursing profession, and carry out responsibilities in agreement with the outlined standards of the nursing profession (International Council of Nurses, 2000; Johnstone, 1998).


Australian Nursing Council Incorporated, 1993, National Competencies for the Registered and Enrolled Nurse. Australian Nursing Council Inc., Canberra.

Coady, M. and Bloch, S. 1996, Code of Ethics and the Professions. Melbourne, Melbourne University Press,

Fry, S. and Johnstone, M J, 2002. Ethics in Nursing Practice: a guide to ethical decision making. 2nd edition. International Council of Nurses, Geneva/Blackwell Publishing, Oxford.

International Council of Nurses, 2000. Code of Ethics for Nurses: International Council of Nurses, Geneva.

Johnstone, M. J. 1998. Determining and Responding Effectively to Ethical Professional Misconduct in Nursing: A Report to the Nurses Board of Victoria, Melbourne.

Ramirez, B M, 2006, The Bipolar Workbook: Tools for Controlling Your Mood Swings. New York: The Guilford Press.