Professional Issues in Nursing

Our text defines a tort as “a civil wrong” and negligence as “a tort, a civil or personal wrong” (Pozgar, 2012). Negligence as it is related to healthcare is an unintentional commission or omission of an act that a reasonably prudent person or organization would or would not do under normal circumstances. Not following a recognized standard of care could be considered negligence. The case I have chosen to study is one from the Circuit Court of Baltimore City Maryland and is that of Enso Martinez a minor by and through his parent (Rebecca Fielding) vs The Johns Hopkins Hospital in Baltimore Maryland July 2013. I would describe this as a landmark, “David vs Goliath” case

As a nurse it has happened to be an essential need to be conscious of the legal aspects associated with caring and serving people in the health industry today. Unfortunately, only fewer people want to get into the health care field fearing the legal aspects and the predictable law suits. The Tort Law is one of the legal aspects of the law that most nurses is more familiar with. This is the law that involved misconduct and negligence cases, which many nurses take the time to study in depth. This is one of the most universal and well-known laws, something that nurses and doctors must be familiar with, to maintain their care resourcefully.

Ethical issues have always affected the role of the professional nurse. Efforts to enact this standard may cause conflict in health care settings in which the traditional roles of the nurse are delineated within a bureaucratic structure. Nurses have more direct contact with patients than one can even imagine, which plays a huge role in protecting the patients’ rights, and creating ethical issues for the nurses caring for the various patients they are assigned to. In this paper I will discuss some of the ethical and legal issues that nurses are faced with each and every day.

A health care provider must understand many aspects of statutory duty. Duty is “a legal obligation imposed on one to conform to a recognized standard of care to safe guard the rights of others”. The standard of care is usually related to medical malpractice cases. Standard of care is defined as “the caution and prudence that a reasonable person would exercise under the circumstances or by appropriate authority for such situations”. This is mainly of importance because all physicians are expected to perform within the guidelines of this duty, and this standard or care changes depending on the circumstances. “Once the duty has been established, the plaintiff must show that it was breached by presenting evidence of the facts of the case and testimony from expert witnesses regarding whether the standard was met”(Showalter, 2014 p 139). Negligence results in the failure to meet this standard of care, and the jury usually decides if the defendant is guilty of committing a negligent act. Causation is an aspect of negligence. The defendant could be held liable for negligence if the act was considered to be foreseeable, and if the injury occurred from a breach of duty.

A professional is characterized by or conforming to the technical or ethical standards of a profession (2) : exhibiting a courteous, conscientious, and generally businesslike manner in the workplace. Being professional should be a subconscious effort in the fact that it should always be applied. When employees are professional it helps the system run more efficiently and safely. A person must me a certain criteria when being evaluated on professionalism, a person is judged based on the clients; Attitude, Values, Communication techniques, and approachability. Clients who display a committed, dependable attitude will benefit more from work exerted, and overall be rewarded with incentives. Although professionalism may be in the eye of the

According to American Nurses Association (ANA), (2010) “the nurse promotes, advocates for and strives to protect the heath, safety and right of the patient” (p. 6). Nursing responsibilities should be acted at the highest standard and must be based on legal and ethical obligations.

Primarily, one must understand what an unsafe patient assignment is and comprehend the dangers of accepting an unsafe patient assignment. According to Keller, an unsafe patient assignment “can include patients requiring any interventions or technology that you have not been adequately trained on, patients outside the normal patient’s population of your floor, patients with higher level of acuity than is appropriate for your floor, to many patients assigned to you, and many others” (Keller, 2014, p. 18). An

Many people do not ponder on the possibility of some form of malpractice or misdiagnosis occurring during their time as patient. They put their trust solely in the healthcare provider. More importantly nurses hardly ever consider being the one that causes harm or the one whom neglects a patient, let alone misdiagnose a patient. When entering the nursing field one needs to look at all options that will help protect them from sustaining any loss. Many nurses in today’s time are purchasing profession liability insurance or more commonly known as professional indemnity. Professional indemnity helps pay for expenses that occur during malpractice, negligence, and misdiagnosis lawsuits.

At a practice level, the importance and guidance of the Code of Conduct, Code of Ethics and NPA are demonstrated on a daily basis with regard to the issues of documentation, informed consent and open disclosure, and confidentiality. With respect to documentation, nurses must be able to document patient assessments and responses in an accurate, comprehensive and confidential manner and record all observations objectively. Informed consent and open disclosure are also major legal issues nurses face daily. It refers to the communication between the patient and health professional that results in the patient's agreement to undergo a specific procedure and requires that the patient has thoroughly understood the procedure, implications and risks prior to giving written consent.

Ethical issues in nursing will always be an ongoing learning process. Nurses are taught in nursing school what should be done and how. Scenarios are given on tests with one right answer. However, there are situations that nurses may encounter that may have multiple answers and it is hard to choose one. “Ethical directives are not always clearly evident and people sometimes disagree about what is right and wrong” (Butts & Rich, 2016). When an ethical decision is made by a nurse, there must be a logical justification and not just emotions.

Nightingale said, “The very first requirement in a hospital is that it should do the sick no harm”. The history of nursing initially begins with Florence Nightingale. Before her era nurses had a tarnished reputation (Glasper, 2017). They were poorly educated and incompetent people. Nurses such as Mrs. Bedford Fenwick wanted to change the image of nursing. They did this by leading a campaign for professionalism. Which led to the culminated Nurse Bill receiving is royal assent in December 1919 (Glasper, 2017). July 27, 1921 was the official opening of the nursing register, there are currently 688,927 nurses registered with the Nursing Midwifery Council (NMC) (Glasper, 2017). The NMC code has four themes of professionalism, “Prioritizing

“The definition of a health professional is a person who works to protect and improve people’s health by the diagnosis and treatment of illness to bring about a complete recovery from mental, physical and social perspectives, either directly or indirectly (Kurban, 2010, pg. 760).” Nurses in the community today have acquired an increasing responsibility to intervene with medical decisions. In the past, there were clear differences between nurses and doctors. It was more common for a nurse to be supervised directly under the physician. They are not just performing Doctor’s orders anymore. The nurse role in patient care has been widely expanded. Allegations against someone can be one of the most stressful moments of their careers. Negligence

Professional relationships with patients and the developments in standard of care have made law paramount to the study and practice of nursing. Law helps keep up to date nursing practice in every stage of patient care making it important for nurses to understand the ethical and legal implications of law in their nursing profession (Griffith and Tengrah, 2011).

When working in the health care setting, I believe that it is the responsibility of everyone to dress in a manner that conveys confidence and professionalism to the patients. Today, when it comes to appropriate attire and policies on dress and appearance, organizations now must consider body modifications (piercings and tattoos), jewelry with religious symbols, and styles of cultural dress. As a nurse in my hospital, we wear seal blue scrubs that differentiate us from the other employees. In my profession, it is important to come to work with a clean, neat, and unwrinkled scrubs or uniforms. We only use white or black color type of shoes. We can only wear white shirt or long sleeves underneath our scrubs. Our lab coat should be white, clean,

This concept is taken from module 1 of block 6 entitled “Ethical Issues in Nursing Practice”.