...NURS 6565 - Main Question Post: Week 4: Discussion – Clinical Challenges for the NP Case Study One: Dismissing the non-compliant patient. Gwen, a 52-year-old Caucasian LPN, recently joined your practice as a new patient. She currently has a BMI of 32, B/P of 142/88. Pulse is 89, the Respiratory rate is 22, Pulse Ox is 96% on Room Air. She is taking Lisinopril 10mg PO daily (when she can remember), Metformin 1000mg PO BID and refuses lab work. Her physical exam is unremarkable and foot exam is normal. She refuses all vaccinations including Prevnar and Influenza. Gwen’s last mammogram and Pap smear were “years ago.” The case study above is a description of health scenario of Gwen an LPN whose health is at peril. According to Westrick and Jacob (2016), this is a description of health care advice of patient non-compliant behavior. Gwen is an LPN who indeed understand her health conditions, however, fails to comply with the appropriate medical process, problem conforming to treatment care modality thus Gwen fails to accede to what is properly related to negligence. The Legal Implication and Key Component of Malpractice Policy in this Case There are indeed two components of malpractice policy related to...
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...The roots of hospice care began in the 1960s as a benevolent movement to provide dying patients more time with their families in a dignified manner. The hospice industry is now a fourteen-billion-dollar industry, run primarily by for profit industries. Hospice facilities play a crucial role in delivering palliative services to patients and their families. In the United States, about half of all deaths happen in a hospice program. When a patient is certified by their primary care physician and a hospice medical physician that they are terminally ill and has six months or less to live, they are then qualified to receive hospice benefits. Hospice care encompasses nursing, home health aide, social worker, and counseling services; most hospice care is provided in the home setting. As part of the health care industry, hospices are also subject to negligence cases. Negligent tort cases can arise when there is an “unintentional failure to live up to accepted standards of behaviors”. The four key elements to any negligence case are duty of care, breach of duty, harm, and causation. A legal study of various hospice negligence cases will be conducted to...
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...Policy Law and ethics Abstract The Snow Storm Lawsuit is a case of Negligence, Duty to act, and wrongful death. This paper will explain the legal, ethical and professional considerations. The Chief Executive Officer of a small non-profit community hospital were on vacation in the Bahamas, the are was hit by a large snow storm, in this case, many of the hospitals health care providers were unable to make it to work, as a result. This paper will explain how the employees reacted, and how the patients ethically, legally and professional suffered from the unexpected incident. While the Chief Executive officer of a small non-profit community hospital was vacationing in the Bahamas, the area was hit by a large snow storm. Many of the hospitals health care providers were unable to make it in to work, 3-11 and 11-7 shifts. As a result the patients units were understaffed and days shift personnel were required to remain on duty until relieved. During this snow storm, several patients sustained minor injuries from falls out of their bed, and one patient died after being given the wrong medication, the nurse on duty also left the hospital to go to Wendy’s to buy dinner, after one year, the families of these patients sued the hospital on the behalf of their deceased relatives. The three legal considerations are, during the snow storm, many of the hospital health care providers were unable to make it to work, and patients were not attended properly...
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...for patients who fail to be compliant with their discharge instructions. III. Facts 1. In order to prove negligence or medical malpractice, the plaintiff must prove the: A. The requisite standard of care. B. A deviation from the standard of care C. A causal connection between the deviation and the claimed injury. 2. The hospitals rules, regulations, and policies do not establish a standard of care. However, a hospital’s failure to follow its own rules, regulations, and policies is evidence of negligence. 3. Discharge instructions can be construed to be part of a hospital’s rules, regulations and policies. 4. Unclear, or ambiguous discharge instructions can place the hospital at risk for increased liability for negligence if a casual connection can be made to a patient’s injury. Therefore, to protect itself, hospitals should be proactive in establishing clear discharge protocols and individualized discharge instructions. IV. Review of the Law In the case of Earline Therry, et al v. State of Louisiana, through the Department of Health and Hospitals and University Medical Center of Lafayette, Louisiana, a summary judgment was granted for the defendants based upon the plaintiff’s inability to establish a causal connection between a breach of the standard of care and any resultant injuries. In this case, Mrs. Therry accused the Defendants of negligence for allowing her to develop digitalis toxicity due to a one-day delay in returning to the hospital. Mrs. Therry’s...
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...12 Law and Health Care System Administration Jayme Blackwell Mary Jane Granoff Health Care Policy and Law Et. 12 Law and Health Care System Administration Jayme Blackwell Mary Jane Granoff Health Care Policy and Law Et. A relationship is a connection or association. To me a relationship is very important and healthy for an individual to form. A relationship is extremely important among physician and patient and hospital and patient. I thank communication and interaction is the most important factors in a relationship. These factors are very important when forming a relationship between physician and patient and hospital and patient. In relationships communication is very important and is essential among physician and patient. There are several types of communication and all are essential when it comes to dealing with the health of an individual. With communication comes interaction, which is also very important. Many feel bitter about their visits, because they are paying money for a service so that is what they expect. So when a relationship is formed they become surprised because that is not what they expected. So the relationship to them becomes so what special, and out of that relationship a patient builds confidents, trust, respect, and becomes relaxed. Once a patient builds a good relationship with the physician then they can create a relationship with the hospital. These will make the experience easier for all parties and build strength within the overall relationship...
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...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. 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...
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... Liability Issues Affecting Registered Dietitians: Measures to Avoid and Prevent Negligence For this application paper, the allied health care professional I chose as the subject is a Registered Dietitian. According to the Academy of Nutrition and Dietetics, “a Registered Dietitian (RD) is a food and nutrition expert who has met the minimum academic and professional requirements to qualify for the credential RD” (Academy of Nutrition and Dietetics, 2015). The main responsibilities for an RD is to learn about the patient’s health, history, diet, and how often they exercise. Once they know all of this information, they are able to help individuals create and establish goals. The patient then has to make sure they visit their RD to monitor their progress. Patients could visit his or her RD at a hospital, private practice, health care organization or facility. Most of the Registered Dietitian’s have a graduate degree and are certified in fields such as renal, pediatrics, food allergy, or sports (Ansel, 2014). Since they have gone through highly specialized training, they are expected to undertake new challenges by diving into practice areas they are unfamiliar with. One of these challenges is to try and avoid being held liable for professional negligence. A myriad of cases that involve RD is when he or she fails to act in a reasonable manner. In order to prove that negligence it is essential to know the main reason behind it. There could be many reasons such as the...
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...their personal beliefs and listen and respect the beliefs and traditions of others. Legally Nursing implications require nurses to maintain licensure, obey state and federal laws and to remain within their scope of practice. Within these legal and ethical issues the American Association Code of Nursing ethics, personal and societal values, legal aspects and legal responsibilities all affect decisions. Two different cases will be discussed and explored; an advance directive case involving a woman by the name of Marianne, and a malpractice case involving a nurse and the involved healthcare organization. The American Nurses Association Code of Nursing Ethics can influence the final decision made in the case study involving Marianne’s family by designating a surrogate. According to "American Nurses Association" (2011), “The nurse supports patients self-determination by participating in discussions with surrogates, providing guidance, referral to other resources as necessary, and identifying and addressing problems in the decision-making process” (1.4). In the case study involving malpractice, the nurse being called upon as a witness, has a duty and responsibility to report the incidents to the employer. The "American Nurses Association" (2011) website further states,” all nurses have a responsibility to assist those who identify potentially questionable practice” (3.5). If the hospital fails to correct the actions, the...
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...Ebony Stewart May 7, 2014 Estimating Health Care Associated Infections and Deaths in U.S Hospitals as Oppose to Medical Malpractice Epidemiology Introduction This study was conducted for two important reasons. Deaths in the United States as well as an estimation to provide information for the number of healthcare-associated infections (HAI) were the purpose. The data sources used were 1) National Nosocomial Infections Surveillance 2) National Hospital Discharge Survey and 3) American Hospital Association all of these sources were used by Centers for Disease Control and Prevention’s. HAI occur in many different healthcare settings: acute care within hospitals, same day surgery centers, long-term facilities, and ambulatory outpatient care in health care clinics. HAI has resulted from and adverse reaction to toxins and evidence of infection isn’t presented during time of admission to hospital. Surveillance has also been a research base for HAI. NNIS is an ongoing system that has collaborated with CDC to monitor data on HAI”S and other nosocomial infections. It covers intensive care units, high risk nursery, and surgical patients. A major goal of NNIS is to develop data to prevent and control nosocomial diseases. NHDS was designed to meet needs of patients from non-federal hospitals that stayed only for a short period of time. The data collected from these surveys is collected to examine the importance of public health. The survey is conducted in three difference...
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...mother calls you to tell you she thinks Peter is going to kill himself as he is pacing around the yard and shouting that ‘he has a gun’. Peter has been very subdued and withdrawn for the last week. You call an ambulance after speaking to Peter’s doctor. The doctor has recommended urgent admission and has notified the hospital. Peter refuses to go to hospital; he claims he cannot be forced to consent to this. The economic burden of mental health treatment in Australia is enormous. The Australian Institute of Health and Welfare reported that the national expenditure on mental health services in 2006-07 was estimated to be $4.7b (AIHW, 2009). Chronic mental illness can impact all aspects of a person’s life. Mental illness can be a debilitating barrier to goal establishment, realisation of self expectations and ultimately the perception of a meaningful life. Economic hardships and social problems such as stigma, isolation, loneliness and victimisation all negatively affect the quality of life of sufferers of mental health disorders. Furthermore, patients with chronic mental illness are at greater risk of co-occurring physical illnesses (such as hypertension or diabetes), reduced life expectancy, depression, suicide and substance abuse (Herzog & Shoemaker, 2010, p. 681). Mental illness is mainly attributable to non adherence to antipsychotic medication, which has consistently been...
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...Radiology – Leader in Allied Health Negligence Radiology as an applied health field is an essential part of the diagnoses to many health care professionals. The areas where negligence can occur are many within this field and thus the rate of occurrences are higher than other comparable fields. Negligence can be as simple as a misinterpretation of films to as complex as miscommunications between the physician and the radiologist. Many instances have occurred where there is a breakdown in communication between the readings to the actual “receipt of information” by the physician in charge of the patient. Everyone is considered liable or responsible for their actions (Fremgen, 2009), which is why the responsibility of the Radiologist to the patient falls equally, in addition the that same responsibility of the physician. “Approximately 4% of radiologic interpretations rendered by radiologists in their daily practice contain errors. Fortunately, most of these errors are of such minor degree, or if serious are found and corrected with sufficient promptness, that they do not cause injury to patients.” (Berlin, L., 2007) Despite these errors, the actual harm to the patient is limited in the radiologic field, and yet the occurrence for medical malpractice lawsuits is still relatively high. In many cases a judge can rule that the diagnostic error was committed by a radiologist thus was the result of negligence and therefore the radiologist will be held. The medical practice of x-ray...
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...Negligence Paper HCS478 September 22, 2014 Amputation Mishap The article of the "Amputation Mishap," located in (Pearson Health Science, 2014) Neighborhood News, season 3 episode 7 is about a 62-year-old gentleman who went into the hospital to have his right leg amputated, but instead the wrong leg was amputated. He received a below the knee amputation of his left leg. The reason that he was having his right leg amputated was because he is diabetic and has poor circulation in his right leg. The surgery did not correct his problem but instead created bigger problems, because he still has the leg with the poor circulation and will most likely still need his right leg amputated. This was a huge mistake that the hospital staff has made. The incident of the wrong leg being amputated is a result gross negligence. This paper will be discussing the difference between negligence, gross negligence, and malpractice. It will also cover my opinion about the situation, deciding whether it was a mishap or negligence, the importance of documentation, the ethical principles that serve as a guide in the nursing practice in this situation, and how documentation should be done to satisfy ethical and legal requirements. For negligence or malpractice to be present there is a couple of things that needs to be proven such as a duty owed to the patient, breach of duty to the patient, foreseeability, causation, injury and damage. In order for there to be negligence, it has to be an injury...
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...responsibilities of the nurse in the case of Marianne who has had a stroke and the decisions that the family is facing for treatment or end of life care. The legal and ethical issues in a malpractice case that occurred several years ago and the responsibility of the nurse to her employer, the nurse being sued, the client in question, and the institution’s client will be reviewed. The areas that will be reviewed include how the American Nurses Association Code of Ethics would influence a final decision in each case study, how personal and societal values can influence the ethical decision making, the fundamental legal aspects of each case study, and the legal responsibility of the nurse in the work setting. The ANA code of Ethics must be followed in practice and is an especially useful tool when there are difficult legal and ethical issues that arise in nursing practice. In the example of the malpractice case for negligence, as a witness to questionable practice, it is the nurse’s primary responsibility to protect the safety of the patient. Although the nurse was correct in reporting the episode to administration, she also had a duty to counsel the nurse about the inappropriate standard of care. The ANA is clear that when a nurse is aware of questionable practice the person must be confronted with the concern ("Code Of Ethics for Nurses With Interpretive Statements", 2010). Furthermore, if the nurse was asked at if she had witnessed additional acts of negligence, it would be her legal duty...
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...Ethical and Legal Issues in Nursing NUR/391 Ethical and Legal Issues in Nursing As nurses, it is our duty to advocate for our patients. At times, we are faced with personal and professional challenges that impact how and when we chose to advocate. It is imperative we have a healthy awareness of these potential challenges. Improvements in health care technology have provided patients with an array of treatment options as well as assumed or possible increased chance of survival. As a result, nurses are met with a rise in ethical decision making. This paper will discuss the legal, ethical, social, and personal factors that can impact our decision making process, with the focus on two specific case studies. American Nurses Association Code of Nursing Ethics Role in Practice The American Nursing Association (ANA) has created a set of ethical standards for the profession of nursing to abide by, which is entitled the ANA Nursing Code of Ethics. The ANA Code of Ethics states that collaboration is central to the care nurses deliver and to their ethical commitment to the patient (Garity, 2005). In the end-of-life case study, the nurse (she) has an unwritten obligation to the patient; the family appears to be in conflict with how to proceed with the patient's medical treatment. The medical team has an obligation to give the family all of their options and possible outcomes. If the family remains in conflict, it would then be appropriate for her to refer the family to the...
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...1. Identify and explain the four elements of proof necessary for a plaintiff to prove a negligence case. To begin with, when people think of professional liability in healthcare, they usually think of medical practice, a form of negligence. Negligence by definition is known as one of the most common type of malpractice that exists in the healthcare industry. However, in order for a negligence case to be proven, four elements are necessary: Duty of Care, Breach of that duty, Injury and Causation, (J. W. Showalter, 2007). The first element, duty of care, requires all persons to conduct themselves as a reasonably prudent person would do similar circumstances. Generally, duty of care is a legal notion that states that people owe anyone around them or anyone who could be around them a duty to no to place them in situations of undue risk of harm. For example, physicians have a duty to protect patients from foreseeable dangers that could lead to any injury. In case of a surgery, they have a duty to make sure all equipment are in good condition, so it does not lead to injury while the procedure is done. They also have a duty to take preventive measures which create a safer environment. The second element, breach of that duty, requires expert testimony, which normally comes from the defendant’s fellow practitioners because they know the standards of practice best. For example, a specialist may testify about the standards for general practitioners if she is knowledgeable about...
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