Ethical and Legal Issues in Nursing

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Criminal Prosecution for Nursing Practice    

Read the following case study and submit a 1- to 2-page essay in a Microsoft Word document using APA 6th edition in response to the questions. Similarity must be 25% or below.  

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Solution

Ethical and Legal Issues in Nursing

Introduction

            Criminal prosecution for nursing practice introduces liability and responsibility for errors in clinical settings. At the core, cases of liability and negligence narrow down to adherence to standards of care as required under the specific circumstances (Huynh, Wong, Correa-West, Terry, & McCarthy, 2017). The Colorado Board of Nursing case highlights the incorporation of criminal prosecution for actions and decisions taken in practice. Liability and responsibility in practice intend to deter instances of negligence and malpractice and foster quality and safe care delivery. It is essential to examine the case and determine the perspectives of the courts, legal implications of unintentional errors in other practices, state law violations, and best responses to the legal threat to nurses.

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Emotions evoked

            The Colorado Board of Nursing case led to more calls for responsibility and liability of health practitioners in their clinical environments. These emotions were triggered by the loss of life, which most members of the public and media believed the death of the child was because of negligence by the nurses. The legal system of the state also believed that the changes made to the physician instructions without consultation have to punish as they put the child at risk. The calls for responsibility mirror the society’s belief that someone has to be held accountable for fatalities that result from errors. The emotions by state systems, the public as well as the media underline the need to minimize the risk of errors in the clinical settings, as most stakeholders relate the errors to negligence and can initiate criminal proceedings.

Court’s decisions

            The courts need to account for the nurse’s effort to avoid inflicting unnecessary pain on the baby. In this case, the courts should consider what the standards of practice in such a case are and whether the nurses acted as a reasonably prudent and careful person would act in such circumstances. Standards of care set by institutions and licensing bodies ascertain that no unnecessary harm occurs to the patient, and the duty of care is not breached by the processes nurses use (Huynh et al., 2017). Shifting to IV administration was a standard measure as it ensured that no unnecessary harm occurred to the child. Hence, the act should point out that the outcomes were because of unintended errors. However, since the burden of proof rests on the prosecution, they have to show that the nurses, in taking part in the treatment of the child, failed to act as prudent and careful nurses would have in such circumstances.

Occupations with consequences of unintentional errors

            Physicians also have a huge responsibility as well as liability in their line of work. Similar to nurses, slight unintended errors can lead to a fatality. However, for physicians there is no criminal liability for injury. It does no matter how serious or even reckless the error is the doctor will escape criminal liability if the patient survives, even if he is terribly disabled. The legal implications for unintentional errors related to the physician can result in criminal prosecution via courts, in the case of a death and could result in jail time as well as fines and settlements. The burden of proof lies on the prosecution to show the acts of the doctor were negligent, or surmount to malpractice.

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How Nursing Practice should respond

            The best response to the new legal threat should be through the establishment of institutional policies and frameworks that minimize the risk of unintended errors. First, necessitating documentation and counterchecking via the five rights of medication administration will reduce the risk of medication errors (Treiber, & Jones, 2018). Secondly, instituting double-check procedures such as having a medication administration record (MAR) or the treatment administration record will ensure medications are administered per the physician’s order. Further, nursing education should focus on ensuring nurses understand negligence issues and how to proactively initiate safe and high quality processes of care. The issues include standards of care, documentation, patient advocacy, and the need to assess, monitor, and communicate in a manner that accounts for the needs of the patient (Papinaho, Häggman‐Laitila, Liedenpohja, & Kangasniemi, 2019). Incorporating these issues in continuous nursing education will ensure safe and high-quality nursing practice.

Sections violated

            The nurses violated the Colorado State Nurses Act 12-255-120 (1) c, which calls for discipline if a nurse acts in a way inconsistent with the health or safety of persons under his or her care. Per 12-255-120 (1) f, the nurses are also liable if they fail to practice per generally accepted standards of care. From the two sections, the nurses can be held accountable for the unintended error that led to the fatal death of the child.

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Ethical and Legal Issues in Nursing
Ethical and Legal Issues in Nursing

Conclusion

            In the case, the fact that the nurses were indicted for criminally negligent homicide underlines the need for safe and high-quality nursing practice. While the outcomes are because of an unintended error, the case highlights the need to act in a manner consistent with practice and standards of care. Cases of negligence have now been associated with criminal prosecutions besides settlements and fines, necessitating nursing education, and leadership to take an active role in creating awareness and educating nurses on safe and quality practice.

References

Huynh, C., Wong, I. C., Correa-West, J., Terry, D., & McCarthy, S. (2017). Pediatric patient safety and the need for aviation black box thinking to learn from and prevent medication errors. Pediatric Drugs, 19(2), 99-105.

Treiber, L. A., & Jones, J. H. (2018). After the medication error: Recent nursing graduates’ reflections on adequacy of education. Journal of Nursing Education57(5), 275-280.

Papinaho, O., Häggman‐Laitila, A., Liedenpohja, A. M., & Kangasniemi, M. (2019). Integrative review of studies about nurses who have been disciplined by their professional regulatory bodies. Journal of Nursing Management27(8), 1588-1603.

Criminal Prosecution for Nursing Practice    

Read the following case study and submit a 1- to 2-page essay in a Microsoft Word document using APA 6th edition in response to the questions. Similarity must be 25% or below.  

  Case Study:    Until recently, the risk of criminal prosecution for nursing practice was nonexistent unless nursing action rose to the level of criminal intent, such as the case of euthanasia leading to murder charges. However, in April 1997, three nurses at the Centura St. Anthony Hospital, outside of Denver, were indicted by a Colorado grand jury for criminally negligent homicide in the death of a newborn. Public records show that one nurse was assigned to care for the baby. A second nurse offered to assist her colleague in caring for the baby. A third nurse was a nurse practitioner in the hospital nursery. Because the baby was at risk for congenital syphilis, the physician ordered that the nurses give 150,000 units of intramuscular penicillin, which would have required five separate injections.

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Ethical and Legal Issues in Nursing
Ethical and Legal Issues in Nursing

In relation to other problems the same day, the baby was subjected to a lumbar puncture, which required six painful attempts. To avoid inflicting further pain, nurse two asked the nurse practitioner whether there was another route available for the administration of the penicillin. Nurse two and the nurse practitioner searched recognized pharmacology references and determined that intravenous administration would be acceptable. The nurse practitioner had the authority to change the route and directed nurse two to administer the medication intravenously rather than intramuscularly. Unrecognized by the nurses, the pharmacy erroneously delivered the medication, prepared and ready to administer, in a dose ten times greater than was ordered—1.5 million units. As nurse two was administering the medication intravenously, the baby died. The Colorado Board of Nursing initiated disciplinary proceedings against nurse two and the nurse practitioner, but not against nurse one. The grand jury indicted all three nurses on charges of criminally negligent homicide but did not indict the pharmacist (Calfee & Plum, 1997).   

 Respond to the following:    

  1. Identify what emotions are evoked as you consider the Colorado Board of Nursing case stated above?  
  2. Should the courts take into consideration the fact that the nurses\’ error occurred because they wanted to avoid causing the baby unnecessary pain? Discuss your thinking.  
  3. Can you think of other occupations in which the consequences of unintentional errors have greater legal implications? Discuss your answer.  
  4. How should the nursing profession respond to this frightening new legal threat?  
  5. Which sections of the State Nurse Practice Act did the nurses violate?

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