Ethical Principles in Nursing and Medication Error: A Case Study

All healthcare personnel must have ethical beliefs. Nurses must strike a balance when providing patient care since they are advocates for their patients. Autonomy, beneficence, justice, as well as non-maleficence, is the four major concepts of ethics (Keatings & Adams, 2019). According to the ethical principle of non-maleficence, RN Andrea can be accounted for this condition. The concept of nonmaleficence dictates that every clinical activity is balanced against all merits, dangers, and repercussions, with no therapy being deemed the optimal therapy on the event. It also refers to executing activities that are suitable for a person's degree of competence as well as experience within medical training. In other words, it can be stated the main concept of nonmaleficence means not harming a patient (Bradlry, 2017). Therefore, while caring for a patient the nurse needs to adhere to this principle to improve patient safety. These activities can include proper administration of medication, routine observation and reporting to the managers. According to the code of ethics (CNA, 2017), an RN must provide a safe quality of care to the patient also conduct necessary tasks to promote the health of a patient.

According to the concepts discussed in the above section, it can be stated that RN Andrea fails to adhere to these principles. She was supposed to offer the best quality of care to promote the safety of the patient. Although the issue of medication errors is not uncommon; in most cases it is unintentional. The nurse can be considered as a primary caregiver of a patient. Therefore, it is their sole duty to provide medication in the correct way to the patient. Throughout the nursing course, students are taught the 'five rights' or the 'five R's' of administration of a drug, which is a guideline to therapeutic drug administration, ensuring patient safety. Such 'rights' arose during a period in health when the standard would be that a supplier's mistake was solely his or her fault (Haddad & Geiger, 2018). Nurses must understand that they are responsible for any pharmaceutical mistakes they make, even though the prescriptions were recommended by others (Tshiamo et al. 2015). Therefore, considering all of this evidence and the ethical principle of nonmaleficence RN Andrea can be accountable for this situation.

However, considering this situation RN Andrea may not be fully accountable. RN Andrea shows the indication of nursing burnout. This is a prevalent condition, as it can increase the chance of mental and emotional stress over the nursing function. Burnout professional has two times more chance to make medication errors (White, 2018). Also, RN Andrea already filled his resignation and still working due to the request from the nursing manager. Hence, RN Andrea may not be fully accountable for this situation.

The Case Study

While asked, Andrea needs to accept her mistake during care, as it is the sole responsibility of the nurse to provide safe medication. However, she must tell the issue of overwork and how it had affected her mentally, possibly leading to this condition.

Here the coroner needs to understand the issues with burnout and how it might lead to medication errors. Also, the coroner needs to consider the moral duty of a nurse and how overwork might affect it.

As Mrs. Smith died from a drug overdose, it is important to investigate the case, exact cause of death and factors that leads to this situation. Therefore, calling a coroner is necessary.

As per the coroner report, if the RN is found guilty, necessary legal steps will be taken against Andrea; her licence may get revoked. Also, if the facility is found guilty due to nursing shortages, necessary action can be taken (Keatings & Adams, 2019).

Andrea will be an integral part of this report; her actions will be analyzed thoroughly according to the laws, and according to the published report further action will be taken against Andrea.

Andrea can use scientific evidence, which indicates the presence of burnout can increase the chance of medication error. She must convince that the error was not done by intention rather it happened due to immense work pressure (White, 2018). Also, she must state that she has already filed a resignation before this incident happens and still working because there was no nurse to take care of the patient. This indicates Andrea's good intention to serve the patient. Also, according to the CNA standard, she was not involved in abusive behaviour with other patients nor with other co-workers, this fact indicates her professionalism. Additionally, it is important to consider, overstressed nurses are more prone to failures in judgement, which can lead to medical error, poor patient safety, or fatalities. 

References

Bradley L. (2017). Non-maleficence: perspective of a medical student. The British journal of general practice: the journal of the Royal College of General Practitioners, 67(659), 252. https://doi.org/10.3399/bjgp17X691001

CNA. (2017). Code of Ethics. Canadian Nurses Association (CNA). Retrieved 7 February 2022, from https://hl-prod-ca-oc-download.s3-ca-central-1.amazonaws.com/CNA/2f975e7e-4a40-45ca-863c-5ebf0a138d5e/UploadedImages/documents/Code_of_Ethics_2017_Edition_Secure_Interactive.pdf.

Haddad, L. M., & Geiger, R. A. (2018). Nursing ethical considerations. https://www.ncbi.nlm.nih.gov/books/NBK526054/#:~:text=Nurses%20are%20advocates%20for%20patients,their%20own%20beliefs%20and%20values.

Keatings, M., & Adams, P. (2019). Ethical and Legal Issues in Canadian Nursing E-Book. Elsevier Health Sciences. ISBN: 9781771721905

Tshiamo, W. B., Kgositau, M., Ntsayagae, E., & Sabone, M. B. (2015). The role of nursing education in preventing medication errors in Botswana. International journal of Africa nursing sciences, 3, 18-23. https://doi.org/10.1016/j.ijans.2015.06.001

White, T. (2018). Medical errors may stem more from physician burnout than unsafe health care settings. Stanford Medicine. Retrieved 7 February 2022, from https://med.stanford.edu/news/all-news/2018/07/medical-errors-may-stem-more-from-physician-burnout.html#:~:text=%E2%80%9CWe%20found%20that%20physicians%20with,the%20odds%20of%20medical%20error.%E2%80%9D.

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