NURS2004 Assessment 2 – Decision Making Case Study Guidelines

The purpose of this assessment is to identify the principles of professional  nursing practice, outline the ethical and legal frameworks for professional  practice and apply them to a complex scenario to establish an ethically and  legally sound decision.  

The professional practice framework provides direction for nurses on their  responsibilities. Standard 1.4 and 1.5 of the Registered Nurse Standards for  Practice instructs nurses to consider ethics, law and professional frameworks when  making decisions and providing care (Nursing and Midwifery Board of Australia,  2016). This guidance is supported by the Code of Conduct for Nurses principle 1.2  which describes the expectations for nurses to maintain professional conduct by  practicing ethically and lawfully (Nursing and Midwifery Board of Australia, 2016).  Elements of ethical behaviour for nurses are explained in the ICN Code of Ethics for  Nurses to ensure patients receive ethical care (International Council of Nurses,  2012).  

Discuss your ethical, legal, and professional considerations as a Registered  Nurse related to the case study provided using the framework below and  decide the best course of action to resolve this situation.  

WORD COUNT 2000 words +/- 10% MINIMUM 10 REFERENCES  

Faculty of Health Sciences  

Inquiry for Professional Practice  

Assessment 2 – Decision Making Case Study Guidelines  

CASE STUDY  

I I am the Recovery Room Nurse Joan handing over the care of Kevin Murphy to you,  registered nurse on the Intensive Care Unit. Kevin’s MRN is J926703, and his date of birth is  8/10/1948.  

S Kevin was admitted for a cholecystectomy, due to ongoing pain and discomfort from  gallstones, this morning. The procedure was aborted in the operating room when he  developed cardiac changes following the anaesthetic. He was returned to the recovery  room with the diagnosis of possible myocardial infarction. Kevin went on to go into  ventricular tachycardia/ventricular failure (VT/VF) and needed defibrillation x3,  cardiopulmonary resuscitation (CPR), intubation, lidocaine and vasopressors to maintain his  blood pressure (BP)  

O Temperature 36.1 degrees Celsius. Pulse 130 bpm, sinus tachycardia. Respiratory  rate 20 breaths/min ventilated with 100% oxygen, o2Sa 92%. BP 76/40 mmHg, maintained  with IV dopamine, 26 mcg/kg, and IV dobutamine, 8 mcg/kg. Kevin is occasionally  responding to verbal commands, responding to pain. Kevin is being kept alive by the  ventilator and medications.  

B Kevin has a history of previous myocardial infarction (MI) and cancer of the prostate.  Kevin was a builder for 45 years, with his own business and is now officially retired. His only  son took over the business and Kevin continues to help him out on a part time basis. Kevin’s  wife died last year. Kevin’s son is his next of kin. Following the code, the cardiologist, Dr  

Levitt, attended and recognised Kevin. He stated to the nursing and medical staff, “I know  him from his last hospitalisation. I think he has an Advance Health Directive (AHD).” We  have not been able to contact Kevin’s son as yet. However, on review of the notes, we have  found a “Not for Resuscitation (NFR)” formed signed by a doctor and Kevin from his last  admission.  

A So the plan is for Kevin to be moved to the ICU. The medical team will continue to  try and contact Kevin’s son. Kevin will be reviewed as soon as you return to the ICU with  him to decide whether to continue with conservative management, ventilation and  medication, until the AHD can be located or whether treatment should be slowly  withdrawn.  

R I will contact the doctors now to let them know you are transferring Kevin now. You  should let your unit manager know what is happening.  

WORD COUNT 2000 words +/- 10% MINIMUM 10 REFERENCES  

Faculty of Health Sciences  

Inquiry for Professional Practice  

Assessment 2 – Decision Making Case Study Guidelines  

FRAMEWORK  

1. INTRODUCTION  

- clearly describe the purpose of the paper  

- introduce structure of essay  

- DO NOT summarise the case study  

- separate and identify the main medical, social, legal and ethical issues relevant to  this case study  

3. CONSENT  

Use this section to  

- describe and apply the legal issue of consent.  

- describe and apply the legal issue of civil battery.  

- consider how an emergency situation impacts the consent process legally.  - does the patient have decision-making capacity?  

- ensure any relevant legislation, case law or WA Health Policy is included.  

4. LEGAL ISSUES  

Use this section to  

- consider the other legal issues raised by this situation.  

- describe and apply the legal issue of negligence.  

- describe and apply the legal issue of professional misconduct.  - describe and apply the legal issue of Advance Health Directives.  - ensure any relevant legislation and case law is included.  

5. ETHICAL ISSUES  

- describe and apply the 4 fundamental ethical principles - Beneficence, Non maleficence, Autonomy, Justice  

- identify 2 sets of conflicts between the ethical principles  

6. PROFESSIONAL ISSUES  

- what are the professional issues raised by this situation?  

- describe and apply the professional issue of documentation.  

- describe and apply the professional issue of person-centred practice.  - use specific elements of the professional framework to demonstrate the  professional expectations for these issues.  

- Professional framework includes the Code of Conduct for Nurses, ICN Code of  Ethics, RN Standards for Practice, NSQHS Standards  

7. CONCLUSION  

- what is the best course of action to resolve this situation?  

- clearly state what action the nurse should take  

- justify the proposed course of action using law, ethics, and professional standards 

WORD COUNT 2000 words +/- 10% MINIMUM 10 REFERENCES  

Faculty of Health Sciences  

Inquiry for Professional Practice  

Assessment 2 – Decision Making Case Study Guidelines  

References  

International Council of Nurses. (2012). ICN code of ethics for nurses.  https://www.icn.ch/sites/default/files/inline 

files/2012_ICN_Codeofethicsfornurses_%20eng.pdf  

Nursing and Midwifery Board of Australia. (2018). Code of conduct for nurses.  https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines 

Statements/Professional-standards.aspx  

Nursing and Midwifery Board of Australia. (2016). Registered nurse standards for practice. https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines Statements/Professional-standards/registered-nurse-standards-for practice.aspx