Ethical and Legal Issues in Nursing Nursing as a profession, holds itself to a standard of practice and a code of ethics that governs this discipline. It was well put by Nicholson (2012), “Nonprofessionals cannot be held to the standards of the medical professions, but persons who have been specially trained, educated and licensed are accountable for performance that deviates from the customs of their field. ” To function effectively, nurses need to be aware of their contents and incorporate them as a guide for their professional decisions. A wise nurse who is aware of deep personal values and moral standards will make decisions regarding practice setting so that the nurse’s own personal integrity remains intact, while putting patients and their needs first” (Chitty & Black, 2010, p. 101). A person’s value system is initiated by the beliefs held by his or her family, and as growing occurs the person is exposed to other cultures, belief systems, peers, and societal norms, that may be incorporated into his or her value system. A nurse is expected to make ethical decisions.

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Having the ability to make ethical and responsible reasoning, involves rational thinking. It is also systematic and based on ethical principles and civil law. Ethical decision making can’t be based on emotions, intuition, fixed policy, or an earlier occurrence. (Blias & Harris, 2011, p. 61). A nurse is not exempt from developing values, and belief systems that shape how they may view their patient population. Individuals must be wise when offering advice or providing assistance to a family or patient involved in a difficult decision making process.

The nurse’s personal values, societal views, and personal experiences can negatively influence a patient or family decision if his or her views regarding the decision are conflicting in nature. A nurse must stay focused on the best outcome for the patient and family regardless of how he or she may feel personally. The following two scenarios will offer viewpoints on how each is affected by the above. Case Study #1 Marianne The role of the nurse according to American Nurses Association Code of Ethics is to “promote, advocate and to protect the health, safety and the rights of the patient” (Chitty & Black, 2010, p. 9). In this case, no advance directives or living will is available and the husband and children are at odds regarding what direction to go. The ethics committee was called to assist the family in making an educated decision. The committee provides a multidiscipline approach to addressing the issues at hand. It is during this meeting that the case is reviewed and a discussion held reflecting on other factors that may affect it: cost, therapies, alternative treatments, end-of-life issues, counseling, and legalities.

Some of the legalities that can be addressed are: do not resuscitate (DNR) orders, medical power of attorney, and the withholding of artificial means of breathing. The desired outcome of the meeting once everyone understands the facts is a “good decision that is in the client’s best interest and at the same time preserves the integrity of all involved” that is supported by the Nursing code of ethics (Chitty & Black, 2010, p. 61). Case Study #2 Malpractice

Provision Six: The nurse participates in establishing, maintaining, and improving health care environments and conditions of employment conducive to the provision of quality health care and consistent with the values of the profession through individual and collective action ("Nursing World", 2012). According to Wikipedia (2012), there are five principles stated within the Nightingale Pledge. They are fidelity, nonmaleficence, beneficence, justice, and confidentiality.

This case is about negligence, “understanding how negligence is defined in nursing helps understand the expected roles and standards, as well as what may be construed as negligence”, according to Stern  (2012). “Negligence is a failure to act to avoid causing injury. A nurse’s action constitutes negligence when he or she breach a duty of care owed to the patient”, defined by Nicholson (2012). The nurse in question not only violated the code of ethics of practice but also to the pledge vowed once becoming a nurse.

As a witness to the negligence to the client, it is the obligation of the nurse to uphold the patient’s rights first and foremost. The witness first made evidence of this when reporting to administration the breach in the performance of the standard of practice held by the facility. Though the incidences were prior to this patient, they were the precursor to this suit. What are not mentioned are the disciplinary actions, if any, taken by the hospital in regard to the defendant, and also was this incident reported?

The obligation the eyewitness has to the facility is to follow the practice and procedure guidelines, code of conduct, and the hospital policy manual as long as deemed safe by the governing laws of the state where the practice is held. The hospital is also a defendant in this case. The witness has the obligation to hire an attorney to guide and direct him or her through the suit. “In any case, it is the nurse’s professional responsibility to provide accurate testimony during the discovery phase and the trial phase of a legal action” (Blais & Hayes, pp. 90-91).

According to nurse practice act, the nurse should practice only within their scope of practice. Acting as a liaison between patient and physician, safe administration of medication, and obtaining informed consent are some of the legal responsibilities of the nurse in a work setting. It is the nurse’s responsibility to identify the common areas of malpractice and negligence to prevent the occurrence of malpractice. According to Strader (1985) these areas are lack of proper communication, improper use of nursing skills, and failure in identifying actions which can result in potential harm to the patient.

Conclusion The American Nursing Association (ANA) states nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and population (“Nursing,” 2012). In both scenarios, the client was the core component of the decision-making process. The nurse upheld the code of ethics by maintaining the integrity of the profession.

The nurse held to the core beliefs, maintained the patient and family autonomy, maintained the standard of practice and “improved the healthcare environment and condition of employment conducive to the provision of quality health care consistent with the values of the profession” (Chitty & Black, 2010, p. 59). References Blais, K. K. , & Hayes, J. S. (2011). Professional Nursing Practice: Concepts and Perspectives (6th ed. ). Upper Saddle River, NJ: Pearson/Prentice-Hall. Chitty, K. , & Black, B. (2010). Professional Nursing: Concepts and challenges.

Retrieved from The University of Phoenix eBook Collection. Nicholson, J. (2012). www. ehow. com. Retrieved from http://www. ehow. com/about negligence Nightingale Pledge. (2012). In Wikipedia. Retrieved from http://en. wikipedia. org/wiki/Nightingale_Pledge Nursing. (2012). In Wikipedia. Retrieved from http://en. wikipedia. org/wiki/Nursing Stern, D. (2012). What is Negligence in Nursing? Retrieved from http://www. ehow. com Strader, M. (1985, November). Malpractice and nurse educators: Defining legal responsibilities. Journal of Nursing Education, 24(9), 363-367. .

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