Law and Ethics in Health
Assessment - Case study analysis - Assignment brief
Case study:
It is a busy morning on the surgical ward, it is coming up to morning tea time, and the nurses on the floor are all attending patients and answering call bells. One of the patient's, Mavis, is a 60 year old retired nurse, she has undergone a laparotomy for an acute bowel obstruction. She is first day post-op and her recovery so far has been uneventful; her vital signs have all been within normal limits. Mavis was visited by her family last night, and there has been nothing remarkable to report.
This morning however, her vital signs have altered somewhat; her heart rate has increased to 92bpm, her blood pressure has decreased to 105/70; her temperature is 38.oC, although she looks a little pale, she has not passed urine since midnight (but was checked at 4:30 am) although she has an IV infusion in situ. When the nurses came to take her vital signs this morning, Mavis seems quite confused, is disorientated and anxious, and this is quite a marked difference since Mavis was washed an hour ago when she was talking and seemed fine then. Mavis tells the nurse "she wants to go home, as she is due to start work soon". Mavis becomes frustrated with the nurse and speaks quite aggressively in a loud voice, she tells the nurse to ‘go away'. This is unusual for Mavis who is usually quite softly spoken.
The ward is very busy, there are many patient discharges and admissions following surgery's this morning, the patients are being attended, the acuity is high, and many call bells are ringing. The time is 11:00 when it is noted that Mavis has left her room (approximately 45 minutes since last seen), and is found sitting in the visitor's room. As the nursing staff (an R.N and student nurse) approach Mavis, it is noted her gown is open (and back to front), has removed the dressing from her wound site, and is smearing faeces across her abdomen and onto her surgical wound. Additionally, she has pulled out her IV cannula and is bleeding at the insertion site.
The nursing staff immediately go to close the visitor's room door to give her privacy. The nursing staff tell Mavis they need to attend to her hygiene needs and inform her they need to give her a wash. Mavis refuses to return to her room, and tells the nursing staff "I don't want a wash". The student nurse and the RN preceptor go to touch Mavis to try to encourage her back to her room, she yells "leave me alone and go away, don't touch me, I need to get home or I will be late for work".
Assignment brief:
The assignment brief is structured under the same headings as the marking rubric, please consider both documents carefully as you construct your essay.
Content
You need to consider:
• The legal and ethical concerns that the situation in the case study raises.
• The possible actions or inactions that could be taken and the implications of those actions.
• You do not need to provide the ‘right' answers, what you will be assessed on is your ability to determine the implications of different actions or inactions from a legal and ethical perspective.
Firstly, think of the possible courses of action (or inaction) that could be taken and then consider, do any ethical theories support (or not) the actions that you discuss?
Which ethical principles, doctrines or concepts apply to the actions/inactions put forward and if so, how?
Do any of the ethical principles conflict with each other or with the law?
Which torts or other legal concerns apply to your suggested actions/inactions?
10 apa reference.