Legal and Ethical Issues in Nursing: Individual Case Analysis

Legal and Ethical Issues in Nursing – Individual Case Analysis

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Legal and Ethical Issues in Nursing – Individual Case Analysis

Overview of Andrea’s Nursing Case

This paper takes a closer look at the case of Andrea, a nurse employed at a long-term facility in Canada. Despite being overworked and having given her resignation to the manager at the facility, she chose to stay with the patients on the night she administered drug over dosage to the resident patient, Mrs. Smith, as there was no nurse stationed for the night duty. The first part of this case discusses whether Andrea was completely responsible for the patient’s death, followed by the role of coroner in the death case investigation and the last part would investigate about the resources that Andrea could use in response to the charges of professional misconduct, malpractice, and a criminal charge.

Part 1: Nursing Malpractice and Responsibility for Patient Death

Andrea’s case is an example of Nursing Malpractice as the case relates with the failure to carry out her duties in a responsible and careful manner (Legal and Ethical Issues in Nursing, 2021). According to Keatings and Adams (2019), the nurse who fails to take charge of the safety of their patients, shares subsequent responsibility of the consequences caused due to such an incompetence on their part. Thus, Andrea is responsible for the death of their patient. However, considering the scenario, Andrea had already given their resignation and stayed at the facility as there was no nurse to take care of the patients, the Manager and the management of the facility are also vicariously liable for the death of the patient. In one of the trials, the judge of the court explained that the hospital can be liable for the negligence of their conduct or vicariously liable for the conduct of their employees when they act in the scope of their employment (Legal and Ethical Issues in Nursing, 2021). Despite Andrea’s complaint about the nurses’ overburden, the manager persuaded them to stay with the patient and thus, the management is vicariously liable for the death of Mrs. Smith. In this case, Andrea should accept her medical negligence but should also let the legal authorities know about the situation prevailing at the facility where the nurses are overburdened with taking care of 40 patients at a time in one shift. 

Part 2: Coroner Investigation and Determination of Cause of Death

In Andrea’s case, the coroner was called on the next morning when Andrea administered Mrs. Smith with the wrong dosage of Morphine. A Coroner is an independent judicial officer who investigates the matters of death, reported to them (nidirect.gov.uk, n.d.). The circumstances under which the coroner is called in include, if the doctor did not treat the patient last night or there is a case of negligence or the patient died because of administration of an anesthetic (nidirect.gov.uk, n.d.). A coroner should be called upon when there is a case of death under suspicious circumstances or a death is unexpected or unexplained (nidirect.gov.uk, n.d.).

  In Andrea’s case, since the death of Mrs. Smith occurred post administration of evening dosage of the drug after Andrea left the facility, and it was unexpected, it therefore, required a coroner to investigate the case. As evident from the medication record of coroner, the narcotic count that Andrea had given to Mrs. Smith was 100 mg of Morphine instead of 10 mg, as ordered. This proves, that Andrea was at fault. The next steps that the coroner would take, include, signing of medical certificate by a doctor, followed by taking the medical certificate to the registrar to register the death and finally, the coroner would issue a certificate to the registrar if a post-mortem is not needed (Gov.uk, n.d.). Since, in Andrea’s case, it was evident that Mrs. Smith died of Morphine over dosage, post-mortem was not required. Lastly, since the cause of death of Mrs. Smith is Respiratory arrest because of over-dosage of Morphine, Coroner’s report would include incidence of nursing malpractice i.e., History of Morphine over dosage by the nurse that led to the respiratory arrest of Mrs. Smith.

Part 3: Legal Resources and Response to Professional Charges

As evident, Andrea made a mistake by administering the higher dosage of Morphine, against what was ordered and that led to the death of her patient, Mrs. Smith. The first step that Andrea should take is to contact the healthcare provider or her manager, carry out their orders, assess and document the actions. The fear of lawsuit would definitely creep in Andrea’s mind and she would have to face the charges of malpractice, professional misconduct and a criminal charge. In such a situation, after notifying the manager, Andrea should contact her insurer who could guide her best about how to respond to the incident (nursingcenter.com, 2003). She must admit her mistake and should act as a prudent nurse should act in the given situation. The resources that could best help her out of the situation could be state’s nurse practice act, other statutes, regulations governing nursing, the law’s governing patient’s rights, confidentiality of medical records and finally, non-discrimination for employees (nursingcenter.com, 2003).

Conclusion

Andrea’s case is a case of professional misconduct, malpractice and negligence. The case shows that Andrea was overburdened of work, such that the facility she was working in would cater to 40 patients per one nurse in each shift. This would have definitely impacted her state of mind and that could have led to administration of over dosage of drug to the patient, Mrs. Smith. Although, the case is an example of professional misconduct and malpractice on the part of the nurse and vicarious liability on the part of the facility, the case had to be registered by the coroner owing to the unexpected death of the patient. Although, one must be utmost careful while handling patients and should be wary of administering drugs, in particular. However, if such cases arise, the nurse must contact their supervisor and manager for the advice and should follow the required laws and statutes that could protect them.

References

Gov.uk (n.d.) When a death is reported to a coroner. Gov.uk. Available at

https://www.gov.uk/after-a-death/when-a-death-is-reported-to-a-coroner

Kestigian, A. & London, A.J. (2016). Adversaries at the Bedside: Advance Care Plans and 

Future Welfare. Bioethics, 30 (8), 557-567.

http://onlinelibrary.wiley.com/doi/10.1111/bioe.12263/abstract?campaign=woletoc

Legal and Ethical Issues in Nursing (2021) Lesson 4: The Nurse’s Legal Accountabilities and 

End-of-Life Issues. 

nursingcenter.com (n.d.) Nurse’s Guide to Malpractice: Module 3. Nurses Service Organization.

Available at https://www.nursingcenter.com/upload/journals/documents/200303nsoce3sued.htm

nidirect.gov.uk (n.d.) Coroners, post-mortems and inquests. Nidirect government services. 

Available at https://www.nidirect.gov.uk/articles/coroners-post-mortems-and-inquests