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.