You are working as an EEN at Sunnyside Day Respite Centre on a morning shift. You have had six clients come in for care today one of whom is Mrs Jocelyn Davis. She is a regular client at the Respite Centre and has been diagnosed with moderate dementia.
At 1030 hours Mrs Davis becomes agitated and begins to wander around the Respite Centre. The Registered Nurse in charge of the shift, RN Jolie, tells you to restrain Mrs Davis in her chair with a lap restraint. You are not certain that Mrs Davis needs to be restrained and you question RN Jolie’s order. RN Jolie becomes annoyed at your question and tries to restrain Mrs Davis herself.
Mrs Davis verbally objects to being restrained and attempts to undo the restraint. In the process her chair tips over, she hits her head on the floor and loses consciousness. While RN Jolie attends to Mrs Davis you call the ambulance.
After Mrs Davis is taken to hospital RN Jolie tells you to say that Mrs Davis was found after she had fallen and hit her head if anyone asks you about what happened to her. RN Jolie also tells you not to say anything about restraining Mrs Davis as you will both get into trouble. You know that this isn’t true but she is your Registered Nurse and you reluctantly agree to do this.
Mrs Davis dies in hospital two days later. The Coroner has been notified by the hospital and her death is to be investigated by the Coroner’s Court.
When you hear about what is to happen following Mrs Davis’ death you are unsure and become worried about what you should do now.
a. Discuss the following legal and ethical issues in relation to this Case Study:
a. Consent, restraint, assault and battery
b. Duty of care, negligence and vicarious liability
c. Scope of practice (the legal and professional boundaries imposed upon you as a nurse)
d. Advocacy (the nurse’s role as an advocate for the client)
f. Open disclosure
g. The Coroner
b. Using a moral and ethical decision making model (such as DECIDE) discuss the ethical issues raised in this Case Study:
· How would you respond to RN Jolie when she tells you to lie about what happened to Mrs Davis
· What are your responsibilities in this situation and what should you do to stay within the boundaries of professional nursing practice
Your response should be written in an essay format with the above legal and ethical issues discussed under headings or as a free-flowing essay. These issues don’t need to be discussed in the order listed and can be done in a way that is relevant to the Case Study. For example you may begin your essay discussing the requirements for a valid consent and how Mrs Davis meets these before moving on to say how this would then influence the practice of restraint before going on to the other issues in the Case Study.
This essay should be at least 1,200 words and up to a maximum of 2,000 words. You need to support your work with references from appropriate sources including your text books, journal articles and appropriate websites. Please reference your essay using the APA (American Psychological Association) system of referencing for both ‘in text’ references and as a references list.
Your essay is not to be based on unsupported personal opinion.
Discuss the legal concepts of consent, assault and battery
Apply the principles of restraint including the criteria for legal restraint and the consequences for the illegal restraint of a person
Explain the concepts of negligence, duty of care and vicarious liability as they apply to this Case Study
Demonstrate how to support client dignity, rights and interests by acting as an advocate for the patient and family in line with the EEN scope of practice
Discuss correct legal documentation in nursing and what documents should be completed for this Case Study
Apply open disclosure to this situation in relation to your role as an EEN and the roles of other health care workers
Apply ethical principles to nursing practice and interactions with patients, relatives and other health care staff
Identify, document and report any ethical issues that may arise in nursing practice
Develop and implement strategies to resolve ethical issues with this Case Study using a moral and ethical decision making model
Apply the Code of Ethics and Code of Professional Conduct as well as the Enrolled Nurse Competency Standards to this Case Study