Read The Case Study Below And Answer The Questions 043878
Read The Case Study Below And Answer the Following Questions
Read the case study below and answer the following questions: a. What legal or ethical issues are involved in this scenario? b. Can you identify an ethical dilemma at work here? c. What kinds of professional nursing legal standards are in danger of being violated here? d. Do you think that Linda could lose her license? How could she avoid this?
Linda is a registered nurse in charge of a large psychiatric unit. At any given time her unit houses an average of twenty-two patients with a variety of diagnoses, ranging from drug dependence to acute psychoses. The unit is usually staffed by one registered nurse, two licensed practical nurses, and two nursing assistants.
Hospital policy requires that the registered nurse evaluate each patient’s physical and mental status twice per shift, supervise the administration of all psychotropic medication, participate in group activities, supervise the implementation of each patient’s plan of care, and be available to individual patients for one-to-one interaction. There are additional standards that describe the appropriate care for patients who are potentially suicidal: “Patients who are identified as suicidal will be isolated in private rooms and continuously monitored by a registered nurse.”
On one particular day two of the patients are identified as potentially suicidal, six geriatric patients with dementia need to be fed and ambulated, one patient is exhibiting violent behavior, and all the patients need individual assessment. Linda calls the supervisor for assistance but is told that there is no one available to help her. The reader will no doubt have noticed that in addition to the other duties, Linda is required to simultaneously and continuously monitor two patients in separate rooms—a physical impossibility. Linda tries to meet all of her obligations under these very strict standards, yet while she is answering a question raised by one of her staff members, one of the suicidal patients manages to injure herself attempting to jump out of a window.
Paper For Above instruction
The scenario presented underscores several critical ethical and legal issues within the nursing profession, particularly concerning resource allocation, patient safety, and professional standards of care. At its core, this case highlights the profound ethical dilemma faced by Linda, a registered nurse responsible for a demanding psychiatric unit under staffing and resource constraints.
Legal and Ethical Issues
One of the primary legal concerns here involves the potential neglect of duty in patient supervision, especially for high-risk patients identified as suicidal. The nurse’s obligation, dictated by both legal statutes and professional standards, is to prevent patient harm—here, exemplified by the patient's injury attempt. Staffing inadequacies and the inability to monitor all patients adequately may constitute violations of legal standards such as neglect or deviation from established care protocols (American Nurses Association [ANA], 2015).
Ethically, the scenario raises questions related to the principle of non-maleficence—"do no harm"—and beneficence—acting in the patient’s best interest. Linda’s inability to fulfill her monitoring responsibilities due to insufficient support compromises these principles, potentially leading to harm. Furthermore, the ethical issue of justice emerges, considering the equitable distribution of care and resources to each patient, especially when staffing shortages prevent uniform, continuous supervision.
Ethical Dilemma at Work
The core ethical dilemma involves balancing the duty to provide safe, individualized care against the reality of inadequate staffing and resource constraints. Linda faces a dilemma: should she attempt to prioritize and delegate tasks, risking some standards of care being unmet, or do nothing and risk further harm to patients? This conflict illustrates the challenge nurses face when institutional policies and available resources hinder their ability to adhere fully to ethical standards and safety protocols (Fitzpatrick, 2017).
Additionally, Linda's decision to attempt to do everything herself, despite the impossibility, exemplifies moral distress—being aware of the best course of action but unable to implement it due to systemic limitations. Such distress can lead to burnout, job dissatisfaction, and potential legal liability if patients are harmed due to neglect or errors (Koike, 2018).
Professional Nursing Legal Standards at Risk
Several professional legal standards could be compromised in this scenario. First, the standard of competence mandates that nurses provide safe and effective care within their scope of practice (California Board of Registered Nursing, 2020). Failure to supervise at-risk patients adequately due to staffing shortages could be viewed as a breach of this standard.
Second, the standard related to patient safety and risk management is at risk; neglecting to monitor suicidal patients properly breaches legal obligations to prevent foreseeable harm (ANA, 2015). Third, documentation and record-keeping are vital in demonstrating adherence to standards; inadequate supervision and documentation could lead to legal liability.
Potential for License Loss and How to Avoid It
Linda could face disciplinary action, including license suspension or revocation, if found negligent in her duty or if her actions—or inactions—are deemed to have contributed to patient harm. To avoid this, she should escalate staffing concerns and document her efforts to provide care under challenging circumstances (Kovner & D’Aoust, 2018). It is also critical for Linda to communicate openly with management about resource limitations and advocate for additional support, aligning her actions with the ethical duty to ensure patient safety and uphold standards of care. Maintaining detailed records of her decision-making process and the staffing challenges faced can serve as legal protection, demonstrating her dedication to her patients despite systemic failures.
Furthermore, nurses are encouraged to seek institutional remedies, participate in ongoing education about managing care under resource constraints, and adhere strictly to safety protocols whenever possible. If unresolved staffing issues persist, reporting to oversight bodies or professional associations may be necessary to prevent future failures and protect her licensure.
Conclusion
In conclusion, this case vividly demonstrates how systemic issues such as staffing shortages can create ethical dilemmas and threaten legal compliance in nursing. By understanding the core principles of professional standards, advocating for resources, and documenting carefully, Linda can navigate these challenges while upholding her ethical responsibilities and protecting her licensure.
References
- American Nurses Association. (2015). Nursing: Scope and Standards of Practice. ANA Publishing.
- California Board of Registered Nursing. (2020). Nursing practice standards. California Department of Consumer Affairs.
- Fitzpatrick, J. J. (2017). Ethical dilemmas in nursing practice. Journal of Nursing Ethics, 24(2), 245-256.
- Kovner, C., & D’Aoust, R. F. (2018). Ethical challenges in nursing: A review of current issues. Clinical Nursing Research, 27(1), 3-5.
- Koike, S. (2018). Moral distress among nurses: A literature review. Japanese Journal of Nursing Science, 15(4), 345-354.