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1 – Explore the ethical, legal and professional frameworks that underpin professional nursing in Australia.
2 – Discuss the application of these frameworks in relation to scope of practice and professional nursing practice.
3 – Identify the legal and ethical roles and responsibilities of professional nurses, including responses to critical incidents and vulnerable populations.
Critically identify and discuss the relevant legal and ethical considerations in relation to the case study.
Focus on the following areas:
Doris, a 79 year old female who lived with her 88 year old husband, Peter, was brought into hospital via ambulance following a fall at their home. Prior to the fall, she was active and mobile, caring for both herself and Peter at home independently.
Following assessment in the Emergency Department, x-rays revealed that Doris had fractured her right hip and required surgery to repair the fracture. Doris was confused and agitated, did not know where she was or what had happened to her. She was admitted to the orthopaedic ward and Peter was with Doris when the orthopaedic surgeon came to see Doris. The doctor did not explain the proposed procedure and Peter was asked to sign the blank consent form for Doris as her next of kin.
The nurse caring for Doris spent time talking with both Doris and Peter. During the conversation, Peter identified that he had problems with his memory too and sometimes got lost when driving home from the shops and couldn’t find his way home. On one occasion a neighbour found him sitting in the car and drove him home. He also said he sometimes forgot how to turn on the washing machine and had forgotten to turn off the stove a couple of times. Peter said that he hadn’t told his General Practitioner as he didn’t want to bother him.
The nurse had concerns about Peters’ ability to understand the proposed operative procedure and to legally provide consent for Doris and contacted the surgeon. The surgeon replied that as the consent form had been signed that was sufficient and the surgery would proceed. The nurse discussed her concerns with her Nurse Unit Manager who told her to document them in Doris’s medical chart.
Before Doris went to the operating theatre, Peter and Doris’s neighbour, Bert, came to visit Doris. Bert stated to the nurse that he had lived next to Doris and Peter for over 25 years and for the past two years had dropped in every day to see how they were. He said that he regularly helped them with their shopping, paid their bills and that they considered him their unofficial son. Bert said that he would be happy to sign a consent form if needed. The nurse went off duty and did not take any further action regarding the consent form for Doris’s procedure.
The orthopaedic surgeon decided to take the afternoon off duty to play golf and delegated Doris’s operation to a junior doctor to perform alone. Due to his inexperience, the junior doctor significantly injured Doris’s hip and she suffered continual pain and decreased mobility following the procedure.