The Patient Who Fell Through The Cracks

In the Code of Ethics for Nurses provision 4 states “The nurse has authority, accountability, and responsibility for nursing practice; makes decisions; and takes action consistent with the obligation to promote health and to provide optimal care.” This was not done, there was no regard for human life. The patients in the hospital were treated as a burden. A meeting was held where the doctors agreed that

“Be the one who nurtures and builds. Be the one who has an understanding and forgiving heart one who looks for the best in people. Leave people better than you found them.” Nursing is more than just doing assessments and giving medications; it is going beyond that to know what is right or wrong, what can and cannot be done, and what is considered harming the patients rather than doing them good. In nursing, there is a fine line between what is considered to be negligence and beneficence. According to Marquis (2017), “Ethics is the systemic study of what a person’s conduct and actions should be with regard to self, others human beings, and the environment (pg. 83), on the other hand, it does not necessarily mean that their

Maria Niceforo, a 75-year-old woman receiving in-home nursing care, had died of infection due to numerous pressure wounds (Le May, 2016). She was admitted to the hospital presenting with a bleeding pressure wound across her back and legs that had penetrated through the bone (Le May, 2016). It was also observed that the wounds were soiled with urine and dried faeces (Le May, 2016). She was receiving in-home support from registered nurses, who according to her son, were not consistent nor reliable in their care of Mrs. Niceforo (Le May, 2016). Another contributing factor to her death was inadequate communication and documentation of her treatment (Menagh, 2016). For example, one of the nurses had reported not providing treatment to Mrs. Niceforo's bottom as she was not aware of it (Menagh, 2016). I was quite

The negligence of this incident had a negative impact on the patient’s family members. Approximately 25% of cases involving medical negligence involve poor nursing care. Another negative aspect was patient’s family follow up was poor resulting in lack of importance highlighted on the pressure wounds. Ashley (2003) states nurses can be sued for malpractice, this means he or she is being sued for “negligence”. Furthermore, the nursing health professionals can lose its credibility among a community as they failed to provide a holistic care for the patient. However, a positive outcome was nurses were able to reflect among this evidence based practice to assist in better quality in patient

The two provisions from the Nursing Code of Ethics that were violated are Provision 2 and 3. Provision 2 states “the nurse’s primary commitment is to the patient, whether an individual, family, group, community, or population” (Brown, Lachman & Swanson, 2015). Provision 2 focuses on “the nurse’s obligation to assure the primacy of the patient’s interests regardless of conflicts that arise between clinicians or patient and family”(Brown, Lachman & Swanson, 2015). Provision 2 was violated because the nurses

Healthcare professionals have an ethical obligation to respect patient’s wishes. Consequently, many legal and ethical dilemmas arise in healthcare in response to clinical decisions related to the needs, beliefs, and preferences of patients and families. Other dilemmas result over concerns about the integrity, competence, or actions of other healthcare professionals. Preserving human dignity, relieving suffering, equality, integrity, and accountability are essential nursing values (Kangasniemi, Pakkanen, & Korhonen, 2015). Nurse leaders have an

The American Nurses Association (ANA) Code of Ethics provides many professional traits that can be incorporated to an interdisciplinary team of healthcare professionals such as compassion and respect, advocacy, accountability for nursing practice and participation in advancement of the nursing career (Cherry, 2011). Compassion is a very important aspect of the nursing profession. It would be very difficult to be a nurse without being compassionate. Nurses demonstrate compassion and respect daily in their work by actively listening to patients’ and family members’ problems and concerns and by empathy when appropriate. Advocacy is a nursing trait constantly used by the entire interdisciplinary team. Nurses advocate for patients’ right of autonomy for decision making in regards to their care, treatments and procedures. Also, nurses are in the best position to serve as a bridge between the patient and the interdisciplinary team. Accountability is so essential in the nursing profession. Nurses are accountable for their own nursing practices and for our patients.

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.

A nurse is given an opportunity to help patients, either if its by helping them through a very serious sickness or just helping a patient get to the bathroom on time, or a time when happiness is overfilling the room and a child is being born. Registered nurses provide a wide variety of patient care services (Mitchell, p.12). A Nurse must always know where to begin and where to stop, as any other career in the health field there is always something that cannot be done by everyone but only the certified person, a nurse must always remain inside her scope of practice to prevent any misunderstandings. A nurse must also follow a code of ethics , the code of ethics of the American Association of Medical Assistants states that a nurse should at all times render service with full respect and dignity of humanity, respect confidential information obtained by a patients file, uphold the honor and high principles the profession and accept its discipline, and last but not least always want to improve her services to better serve the health and well being of the community. (Mitchell, p.65).

I learned that as a nurse it is my duty to always consider my own well being, along with my patient’s. I must keep a high moral character both in the workplace and in my personal life. I must continue to educate myself and keep myself up to date with all the latest nursing practices and research. I must subject myself to peer review and evaluation. I must never let my personal feelings about a patient’s lifestyle affect my care for them. When met with a tough choice that places me in an ethical crisis I must keep a good head on my shoulders and always have my patient’s best interests in mind. If I feel that a situation at work is in direct conflict with my personal values or my oath to be an ethical nurse I must go through the proper channels to work through the problem.

At the time of the incident, I felt very inadequate. I felt that I was not a good advocate for Ms Lisa, nor did the AMU nurse fulfil the clause of the NMC (2015)’s Code of Conduct and act in patient’s best interests (NMC (2015)). For me, the hardest part was not able to help Ms Lisa. However, I felt that I did help Ms Lisa, only in a small way but could

Nurses are constantly challenged by changes which occur in their practice environment and are under the influence of internal or external factors. Due to the increased complexity of the health system, nowadays nurses are faced with ethical and legal decisions and often come across dilemmas regarding patient care. From this perspective a good question to be raised would be whether or not nurses have the necessary background, knowledge and skills to make appropriate legal and ethical decisions. Even though most nursing programs cover the ethical and moral issues in health care, it is questionable if new nurses have the depth of knowledge and understanding of these issues and apply them in their practice

Practicing beneficence involves a moral obligation to act for the benefit of others by helping them to further their important and legitimate interests, often by preventing or removing possible harms. Nursing is a healthcare profession where beneficence is often displayed. During the entire patient interaction, nurses must advocate for their patients. For instance, if a patient doesn’t have an order for pain medication or their current order isn’t sufficient, nurses must advocate for the patient by contacting the physician. By doing this, nurses are working for the good of the patient that may unable to verbally express their pain and perspective.

Ethical principals are the seed of which nursing flourishes from. Many ethical principals were involved and dishonored in this case such as, justice, autonomy, beneficence, non-maleficence, confidentiality and fidelity (Burkhardt et al., 2014). I believe justice was the main principal involved as the entire ethical predicament was revolved around unjust behavior and treatment of the residents. The residents were treated poorly and given unequal rights as a causation of their illnesses. Autonomy, an essential piece of human rights was also being violated in this ethical dilemma. The residents did not have any choice or independence in their care or how they were being treated. Beneficence and non-maleficence are significant dynamics of this ethical situation, as the health care providers needed to reflect on how they can have the maximum benefit while diminishing possible damage to the residents (Burkhardt et al., 2014). Our actions as nurses should always be beneficent and non maleficent, continuously being kind, compassionate and doing what is in their best interest as well a removing and preventing harm. Confidentiality is a key component of nursing and it was blatantly being violated as the health care

This paper is an analysis of a case study by Karla Lowe-Phelps, titled The Patient Who Fell Through the Cracks. The paper analyzes different ethical topics concerning patient’s right to deny care and how the nurse handles the situation as an advocate for this client. Many studies displays ways and strategies that nurse can implement to help improve care that is given to this 48 year-old man weighing over 380 pounds, and exhibiting stasis ulcers on both legs. The American Nurses Association Code of Ethics along with other professional nursing journals and studies shows a great inside on how nurses should implementation care for clients. Beside the ethical problems, this paper assesses and examines the client’s family as his caregiver, with detailed teaching strategies related to patient’s weight, diet, hygiene, wounds, and most importantly a better look on how the nurse should have acted as a better advocate for this patient.