Therefore, this essay will discuss Mavis given health condition. Mavis is 60 years old retired Nurse who had undergone a laparotomy for an acute bowel obstruction. According to the case study, Mavis first day post-op and her recovery has been uneventful. It is stated that Mavis vital signs have all been within normal limits. However, that morning, Mavis vital signs have somewhat altered with her heart rate has increased to 92bpm, her blood pressure has decreased to 105/70, temperature is 38. 0 C. Even though she looked a little pale, she did not pass urine since midnight she had an IV infusion insitu.
Even though Mavis seemed fine this morning, she told the nurses that she wanted to go home as she is due to start work soon. Mavis became frustrated with the nurses and spoke quite aggressively in a loud voice. The nurses were very busy with other patients this morning and as such, Mavis was left for approximately 45 minutes since she was last seen. Her gown is open (back to front), she removed her dressing from the wound site and was smearing faeces across her abdomen and surgical wound. Further, Mavis pulled out her IV cannula and was bleeding at the insertion site.
Mavis refused to return to her oom and also the need to be washed. She told the student nurse and the RN preceptor to go away, to leave her alone and not to touch her since she wanted to get home. According to this case study, Mavis was left in the visitor’s room for approximately 45 minutes because the Nurses were very busy without patients and in patients following surgeries this morning. As stated in Nursing and Midwifery council (2006) (Code of ethics for nurses in Australia) that “Nurses are accountable for the decisions they make as well as should value the quality of nursing care for all people”.
When it comes to dealing with patients, they have the right to make their own decision (Beauchamp and Childress 2012). In this given case study, Mavis had to right to make her informed decision about the type of treatment she would like to receive as a result of her condition. However, nurse’s duty of care is overriding Mavis autonomy, as she seems confused and unable to make own decision. As indicated in the case study, the nursing staff told Mavis that they needed to attend to her hygiene needs, she refuses to return to her room and told the nursing staff that “I don’t want to wash”.
Mavis has the right to make her own decision and refuse to be washed. It is the student nurse therefore to explain to Mavis what was transpiring as she is lacking capacity to make informed decisions for herself. Mavis lack of capacity to make decision was demonstrated by her removing the dressing from her wound site, and smearing faeces across her abdomen and unto her surgical wound. Therefore, Mavis was unable to give valid consent to the nursing staff to attend to her.
Valid consent is said to be given when a patient has the capacity to make decision and consents voluntarily to be attended to whilst mplied consent is when a patient could not make right decision in respect of their treatment and daily activities performed by them. In this case study, Mavis could not make a right decision as seemed confused by her refusal (Johnstone, 2011). Deontology can be defined as duty of care for patients with the principle that “Right is right and wrong is wrong”. Duty of care and obligations are very important for Nurses in the profession.
The student nurse and the RN preceptor went to touch Mavis to try to encourage her back to her room which is duty of care evidence wanting to wash her. Negligence is when a health staff member fails in their duty to provide care and safety to the patients resulting in foreseeable harm and injuries to the patients (Jerjes, Mahil & Upile 2011). The RN preceptor seemed to have breach her duty of care when Mavis was left attended in her room even when she told the nurses that she wanted to go home as such Mavis pulling out her IV cannula and bleeding at the insertion site.
Mavis at this stage is being cared for the student nurse and the RN preceptor to ensure her safety. Ethical principle of beneficence involves the potential to a patient and the society, n order to maximise safety and reduce harm (Huang and Liao, 2013). Beneficence is the duty to do good for clients and to follow anything that is in the best interest of the patients. In application the principle requires provision of benefits, to balance benefits and harms (Jacobson, and Silva, 2010). The staff tried to encourage Mavis back to her room but she yells, “leave me alone and go away, don’t touch me, I need to get home or I will be late for work”.
The staff action was to minimise risk of harm to Mavis. The principle requires health professionals to consider any risk of harm over benefit of any treatment Johnstone, 2009). From this case study, the RN preceptor complied with the ethical obligation/principle when she show concern on Mavis risk issues as she became quite aggressive by telling the nurse to go away and removal of her dressing and IV cannula. The situation was under the control of the RN preceptor and scope of practice (Nursing and Midwifery Council 2006).
The student nurse and the RN preceptor did well to attend to Mavis when the realised that she was missing from her room. It is probable that if Mavis condition is not attended to quickly, it could cause more harm to her by closing the visitor’s room in rder to give her privacy. The nursing staff themselves told Mavis that they wanted to attend to her hygiene needs and inform her they need to give her a wash which she refused. The student nurse and the RN preceptor fulfilled their duty of care. There is no indication that delay in care for Mavis from the time that she was found by the student nurse and the RN preceptor.
In fact the student nurse and the RN preceptor close the visitor’s room to give Mavis her privacy that is professional. There is no suggestion that the student nurse left the RN preceptor alone in the room. Value statement 1 of Code of Ethics in Australia (2008) states that “Nurses value quality care for all people” both the student nurse the RN preceptor were accountable for the care they were giving Mavis. In this case study, Mavis stayed in hospital post-op and her recovery so far has been uneventful. The purpose of her treatment was to benefit her without pains, or any inconvenience.
Mavis was attended to in a timely manner by the staff as soon as she was found in the visitor’s room. However, when the staff became apparent of Mavis’ condition, the preceptor could have called for Doctor whilst assessing Mavis as he was bleeding at the insertion site. The preceptor could have made health decision for her although she has got the mental capacity to do so since her condition required someone with sound mind to help her given that she has refused help from the student nurse and the RN preceptor hence a breach of duty of care.
The nursing staff explained to Mavis that they needed to attend to her hygiene needed and also informed her they needed to give her a wash. Mavis responded by “I don’t want a wash”. She yelled, “Leave me alone and go away, don’t touch me. I need to get home or I will be late for work”. If the student nurse and the RN preceptor went ahead to give her a wash, Mavis would sue them and a charge of battery will be on the card because there was no informed consent would have been given to touch her which is intentional touching of Mavis body (Johnstone, 2011).
It is evident that Mavis did not want to be washed, meaning that there was no permission for the Nurses to wash her. If forced was used to wash Mavis, she might have felt apprehended thereby perpetuating an assault on her. An assault is a tort of trespass. It is an act that results to a physical contact, whether r not possible harm is made (Abbas, 2011). Another issue that is likely to arise is false imprisonment, if forced was used to restrain her, as she was refusing to care and being quite aggressive in a loud voice.
Such a force might be considered as false imprisonment specially if she is confined and restrain against her will whilst violating her rights of freedom of movement (Atkins, de Lacey, and Britton, 2014). Without a doubt washing Mavis was going to be the nurse moral obligations and for Mavis benefit, clinically washing her was going to reduce her risk of infections on the surgical wound, hich she smeared faeces on. Should Mavis’ wound be left unwashed there was going to be a risk of infections as well as bleeding profusely at the insertion site.
If this happen, Mavis and her relatives would have sued the hospital for negligence in a civil law suit. For instance, if Mavis was forced to be washed, she and the relatives could bring an action of assault against the individuals and get compensation from the hospital (Forrester, and Griffiths, 2014). If leaving Mavis for approximately 45 minutes unattended resulted to her dead, there was going to be Coronial inquest into the case or even ossible criminal charges against individual tasked with caring for Mavis which will warrant gaol term.
It was possible both assault and manslaughter charges would have been laid and the consequences that follow. If however Mavis and her relatives brought negligence case against the hospital and its employees, Mavis would have been compensated for financially. This is known as vicarious liability. In this case study if there was any harm done to Mavis by the RN preceptor, the RN would have been personally liable for her actions or inactions unless there is documentation of all the actions performed on Mavis during her time in the hospital.
It is the duty and obligation of every hospital to be responsible for their staff welfare. Conclusion. Conclusively therefore, law is a very important part of health care setting in Australia that safeguards the health professionals in day to day duties. Ethical principle is the core of health care. It is about being able to deliberate the pros and cons of a given situation before making any sound decision especially when one is faced with ethical dilemmas, one has to justify their action or inaction for it is ethical.
In this case study, the student nurse and RN preceptor were in an ethical dilemma between respecting Mavis wishes and ignoring her wish and proceed with washing her. Nursing staff had to work within their scope of work according to the guidelines for health professional in the ANMC (2006). As a nursing staff and in the health care profession, if this happens balancing of the rules and nurse obligations is very important. Legally keeping all documents is significant, as this will provide relevant evidence and proof of actions and inactions taken during the care times of every individual patient.
