Introduction
The purpose of this paper is to explore a case scenario involving Janice, a senior nursing student who administers a medication to a patient. Her actions caused the patient to experience severe allergic reactions and permanent brain damage. Therefore, this paper aims to examine the problem of nursing student error, the legal basis for this issue, the laws and regulations that protect the healthcare team, and relevant ethical principles. It also aims to demonstrate how the Nursing Code of Ethics and provisions of the American Nurses Association (ANA) relate to the scenario.
Case Scenario
The case scenario for consideration revolves around Janice, who was assigned to follow Diane, an RN, in the ICU for a period of three weeks. She is in week three, and since she has proven to be highly reliable, Diane entrusts her to watch over her patient while she is on a lunch break. Janice, together with another nurse on the unit, administers pain medication to the patient, which the patient is highly allergic to, resulting in anaphylaxis and the patient’s code. Although the patient was resuscitated, they suffered permanent brain damage.
The problem, as evidenced in the case, revolves around a nursing student’s error. Janice administered a medication to which the patient was highly allergic, resulting in a severe allergic reaction and subsequent harm to the patient. The problem occurred due to poor communication and information discrepancies. For instance, although an order for the pain medication was placed when the patient was admitted, another medication was ordered shortly after the allergy was discovered. The presence of an allergy sticker on the front of the chart indicates poor communication, as there was no corresponding allergy band on the patient.
Legal Basis
After a closer examination of the case scenario and the identified problem, it emerged clearly that several laws were violated. The first law, negligence, is defined as the failure to exercise reasonable care, resulting in harm to another person (Dahlawi et al., 2021). For instance, Janice administered the medication without verifying the patient’s allergy status. The second law relates to the duty of care – care providers have a legal obligation to provide reasonable care to their patients. Janice had a duty of care to ensure the patient received high-quality and safe care by avoiding any actions that could cause harm.
Several laws and regulations exist to help protect the healthcare team. Firstly, informed consent is an important principle in medical law that requires healthcare professionals to obtain informed consent before administering any treatment (Pietrzykowski & Smilowska, 2021). This law protects them by ensuring that patients are aware of the risks and benefits of the proposed interventions. Secondly, the scope of practice is a crucial regulation that defines the authorized roles and responsibilities of healthcare providers. By following the recommended scope of practice, healthcare professionals are protected from legal issues that may arise in line with task performance.
Other regulations exist to protect healthcare teams, including those related to documentation and adherence to established policies and protocols. Regarding the former, healthcare providers are encouraged to maintain proper documentation to ensure accurate recording of patient information, interventions, and outcomes. Clear documentation protects providers by facilitating effective communication among the healthcare team (Kasaye et al., 2022). The latter requires healthcare teams to follow policies and protocols established by institutions, which guide the delivery of high-quality and safe care. Examples of policies include infectious disease policy and information security policy. Adhering to these policies reduces the risk of errors or omissions.
Ethical Principles
Ethical principles play a crucial role in healthcare settings, providing a framework to guide decision-making processes. Chapter one of Pozgar’s (2019) book provides a detailed discussion of these principles. The first principle is autonomy, which acknowledges the patient’s right to make decisions. Secondly, beneficence emphasizes the need to act in ways that promote the patient’s well-being (Pozgar, 2019). The third principle is nonmaleficence, which strives to ensure that care providers avoid harm and minimize potential risks. The last ethical principle for consideration is justice, which requires care providers to ensure fairness, equality, and impartiality in the delivery of care.
The ethical principles relevant to the case scenario include autonomy, beneficence, nonmaleficence, and justice. Autonomy was compromised following the administration of an allergic medication, which affected the patient’s ability to make informed decisions about their healthcare. Janice violated both beneficence and nonmaleficence because the patient ended up suffering harm as opposed to receiving the much-needed benefit of pain relief.
Lastly, the principle of justice was adversely breached because the care provider failed to safeguard the patient’s right to receive appropriate and safe care. Care providers have a responsibility to respect patient autonomy by prioritizing their well-being and ensuring equal access to healthcare services.
Nursing Code of Ethics: Relevant Provisions
ANA provisions are guidelines that outline the expectations for nurses in various healthcare settings. There are a total of nine provisions, which emphasize the need to provide safe, competent, and compassionate care (ANA, 2015). Most importantly, these provisions exist to address issues related to patient advocacy, collaboration with other healthcare professionals, maintaining confidentiality, and promoting patient autonomy. They reinforce the importance of continuous professional development, ethical decision-making, and accountability in the nursing profession. In other words, nurses who adhere to these provisions are capable of ensuring high-quality patient care and upholding the integrity of the nursing profession in healthcare settings.
The first provision is Provision 1: “The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person.” More specifically, Janice violated this provision when she administered medication to which the patient was highly allergic. This shows that she lacks respect for the patient’s dignity and well-being. The second provision in question is provision 2: “The nurse’s primary commitment is to the patient, whether an individual, family group, community, or population.” Janice’s decision to administer medication without confirming potential allergies and risks demonstrates a failure to prioritize the patient’s interests and safety.
Provisions 3, 4, and 5 are also in question regarding the case scenario. Provision 3 requires the nurse to promote the rights and safety of the patient. Janice’s failure to protect the patient’s health and safety occurred when she failed to confirm the patient’s allergies and administer the medication without verifying the information. Provision 4, which relates to nurses’ authority, responsibility, and accountability, is equally in question (ANA, 2015). Lack of accountability is demonstrated clearly in Janice’s failure to administer medication without proper verification. Finally, Janice violated Provision 5, which states that nurses owe the same duties to themselves as they do to others.
Christian Perspective
From a Christian perspective, the principle of love and compassion was compromised. More specifically, Janice failed to demonstrate love and compassion towards the patient by not ensuring their safety and well-being. Secondly, the principle of honesty and integrity applies to this situation. Janice’s actions could be viewed as a breach of trust, both towards the patient and her supervising nurse, Diane.
The principle of justice is also critical from a Christian perspective. In Christianity, justice entails treating other people with fairness and equity. Janice’s failure to provide appropriate and safe care to the patient resulted in permanent brain damage, which is an injustice.
Healthcare professionals have a duty to ensure equitable access to healthcare services and to advocate for patients’ well-being. However, Janice’s actions contradict this principle – she ultimately deprived the patient of the right to receive appropriate care. Overall, Janice needs to reflect on her actions and take responsibility for the harm caused to the patient.
Conclusion
It is clear from the paper that Janice’s actions resulted in severe consequences for the patient. The paper emphasized the importance of effective communication, information accuracy, and adherence to protocols in healthcare settings. Laws and regulations exist to help protect healthcare professionals and ensure patient safety. Similarly, ethical principles, the Nursing Code of Ethics, and ANA provisions provide frameworks for making ethical decisions and ensuring accountability. Overall, the principles of love, compassion, honesty, integrity, and justice are essential to Christians working in healthcare settings – they guide them in their interactions with patients and colleagues.
References
American Nurses Association (2015). Code of Ethics for nurses with interpretive statements. Washington, D.C. American Nurses Publishing.
Dahlawi, S. M., Menezes, R. G., Khan, M. M., Waris, A., Saifullah, & Naseer, M. M. (2021). Medical negligence in healthcare organizations and its impact on patient safety and public health: A bibliometric study. F1000Research, 10(1), 74-100. Web.
Kasaye, M., Beshir, M. A., Endehabtu, B. F., Tilahun, B., Guadie, H. A., Awol, S. M., Kalayou, M. H., & Yilma, T. M. (2022). Medical documentation practice and associated factors among health workers at private hospitals in the Amhara region, Ethiopia, 2021. BMC Health Services Research, 22(1), 33-56. Web.
Pietrzykowski, T., & Smilowska, K. (2021). The reality of informed consent: empirical studies on patient comprehension—Systematic review. Trials, 22(1). 33-133. Web.
Pozgar, G. D. (2019). Legal and ethical issues for health professionals. ( 5th ed), Jones & Bartlett Learning.