Case Study: Mr Murray is a 65 year old Aboriginal man who is presently staying with his wife in a regional city with extended family members. Whilst visiting with his extended family members, Mrs Murray noticed that her husband had very reddened swollen painful areas on his legs. The family that he was staying with immediately drove Mr Murray to a 24 hour bulk billed clinic to see a general practitioner, as the local Aboriginal Medical service was closed. The GP treated his ulcerated legs at the 24 hour clinic and referred Mr Murray to have frequent visits from a community nurse - to the home where he was currently visiting - for continual evaluation and treatment for his stasis ulcers on his legs.
When RN Allison, the community health nurse, visited the home, where Mr and Mrs Murray were staying with family, she found large oozing sticky areas of raw tissue on Mr Murray’s legs. RN Allison cleaned and dressed the ulcers and continued to visit the Murrays at their temporary home several times per week.
At one of RN Allison’s last visits to see Mr Murray, she decided to bring up the fact that both of the Murrays were obese and she did so, not only in a very judgmental manner, but gave little indication of respect to the Murrays or too culturally safe care . She gave them both a list of foods and drinks they should be having so as to start a weight loss reduction program. Neither Mr nor Mrs Murray seemed interested in learning about RN Allison’s specifications of foods to eat and drink to improve their health. After this last visit, both Mr and Mrs Murray went home to where they permanently lived 45 minutes from the regional city.
Several months passed by and Mr Murray’s ulcers again began to deteriorate. Mr Murray was able to have his son drive him to the major city hospital, where he was admitted as an inpatient, treated and then returned home. Mr Murray was not offered a referral to an Aboriginal Health worker nor was he connected to a National Aboriginal Community Controlled Health Service. A follow up letter from the city hospital physician was sent to Mr Murray’s home address requesting another appointment to check on his legs. Mr Murray did not understand the importance or the need for the appointment. 7 | Page NURBN 1001 – SUMMER PROGRAM 2019/20 – ASSESSMENT TASK 2. When Mr. Murray’s condition deteriorated for the second time, his son, again drove him to the city hospital. Mr Murray was again hospitalised. Feeling alone, marginalised and vulnerable, Mr Murray signed himself out of the hospital and went to stay with his family in the city where he had stayed before.
Angered by Mr Murray’s actions, his treating physician, who had treated him twice before, refused to continue to treat him. RN Allison, had been made aware of Mr Murray’s recent admission, she was also well aware, that as per policy, she could not complete a community visit, without that doctors referral,
RN Allison, contemplated, not having a referral, however, decided that she would visit the Murrays regardless of not having a referral. RN Allison explained the situation to the Murray’s, that she did not exactly have the permission to visit their home in her role as a community RN due to not having the required Doctors referral. However, RN Allison taught Mrs Murray how to wash her husband’s legs and to apply the medicine. Mr Murray was satisfied with this and said he did not intend to seek medical help for his condition in the future.
A year later, RN Allison received a phone call from Mrs Murray at the Community Health Centre where she worked, saying her husband was awfully sick and could not get out of bed. RN Allison was able to make a onetime evaluation visit in her capacity as a home community nurse.
RN Allison found Mr Murray’s leg ulcers in extremely poor condition, infected and infested with larvae. She urged Mr Murray to be hospitalized to which he agreed and was transported by the local ambulance to hospital. Because of the extreme condition of his legs a bilateral leg amputation was performed
Critically identify and discuss the relevant legal and ethical considerations in relation to the case study.
Focus on the following areas:
• Culturally sensitive care;
• The Australian Charter of Health Care Rights;
• Consent, confidentiality and privacy;
• Patient right of refusal to treatment;
• Duty of care;
• Elements required for an action of medical negligence;
• The four (4) main bioethical principles, according to Beauchamp and Childress, Atkins et al (2017) and how each of these apply to this case study.
1.Explore the ethical, legal and professional frameworks that underpin the professional nursing in Australia.
2.Discuss the application of these frameworks in relation to scope of practice and professional nursing practice.
3.Identify the legal and ethical roles and responsibilities of professional nurses, including responses to critical incidents and vulnerable populations.
4.Critically analyse and demonstrate an understanding of legal and ethical issues for health care.
5.Explain the scope of practice and professional regulation of nursing.
6.Investigate methods of managing information effectively from a legal perspective, in maintaining freedom of information and consumer rights as a health professional.
7.analyse the outcomes of the application of professional frameworks for the nurse and individuals, groups, communities and populations.
8.Differentiate between legal and ethical issues and apply principles of law and ethics that influence nursing practice.
9.Demonstrate knowledge of common law and statute law pertinent to health professional practice.
10.Demonstrate knowledge of the requirements for professional regulation and nursing registration.