Introduction
In nursing practice, it is important that the conduct of a nurse is guided by identified and laid down ethical and legal considerations in the administration of care to the patients. The patient has the right to understand the course of action intended for them, and consent to its implementation. The American Nurses Association has developed a list of code of ethics that act as a guide in informing the decisions taken by the nurses in administration of care and treatment. Some of the issues it lists as pertinent for nurses adhering to ethical conduct are;
- Respect for the patient’s decision (Autonomy and self-determination)
- Adherence to the principle of beneficence, or doing good
- Adherence to the principle of non-malfeasance, or avoiding harm
- Application of justice and fairness
- Fidelity/ remaining true to the nursing profession
- Adherence to veracity/truthfulness (US Advisory Commission, 1998).
While the above guidelines serve as an example of the guidelines that nurses can follow to achieve the best practice, complexity of the nursing profession offers instances where distinction between ethics and the law are blurred. This paper seeks to evaluate the issues involved in administration of recommended procedure to a depressed and un-cooperative patient.
He’s also depressed and uncooperative.
His day-shift nurse reads on his chart that the physician ordered an enema.
Disgruntled and surly, Mr. X has other ideas.
He bluntly tells the nurse “Leave me alone. I’m not getting an enema now!”
Despite his protests, the nurse gently turns him in his bed and administers the enema
Background
The United States patient’s bill of rights states that the patient has, inter-alia, the right to know their treatment options and take part in their care. Further, the patient has the right to choose a representative, either a parent, guardian a family member of legal age, or any other individual they would trust with their medical decision making in case they are unable to make these decisions on their own. The patient is also afforded the right to considerate and respectful care from their health care providers, i.e. nurses and doctors. The final right that applies to the case study is the right to a fair, fast and objective review of a complaint raised against doctors, hospitals, and any other health care personnel involved in the patient’s care.
Discussion
His son expresses his concerns to the head nurse of an intended instigation of legal action against the nurse who administered the enema. The nurse would not be liable, as an individual, since the procedure is conducted under the orders of a physician; thus the hospital is understood to have the full knowledge of the condition the patient is in. The hospital, as an institution would, however, be found liable in administering an un-agreeable procedure.
The presence of the son and his action of raising concern about the level of care afforded to his father imputes that he can make medical decisions on behalf of his father. If the hospital had the prior knowledge of his the patient delegating his decision making to the son, the nurse would be liable under the tort of battery, through the non-consented touching of the patient (Guido, 2012).
References
Caregivers' Rights and Responsibilities. (2011, March 12). Retrieved March 15, 2014, from http://www.caringtotheend.ca/body.php?id=194&cc=1
Guido, G. W. (2010). Legal & ethical issues in nursing. Boston: Pearson.
US Advisory Commission on Consumer Protection and Quality in the Health Care Industry (1998). Patient's Bill of Rights What is the Patient's Bill of Rights?Retrieved March 15, 2014, from http://www.healthsourceglobal.com/docs/Patient%20Bill%20of%20Rights_merged.pdf
WebMD (2012, February 1). WebMD 5: Gastrointestinal Disorders. Retrieved March 15, 2013, from http://www.webmd.com/ibs/features/webmd-5-gastrointestinal-disorders
WebMD (2012, February 14). Depression Link to OCD, Anxiety, Schizophrenia, Phobias, and More. Retrieved March 15, 2014, from http://www.webmd.com/depression/guide/link-to-other-mental-illnesses
