Question

CRITICAL THINKING EXERCISE Ms. Anna vanDahm, one of the wealthiest and most influential people in town, was placed in the hospital's intensive care unit (ICU) after undergoing kidney replacement surgery. Because of the inability to deliver high-quality care as a result of financial constraints and a high turnover rate related to nurse discontentment with the dictatorial leadership styles of ICU nurse managers, the ICU was regularly short of qualified staff nurses. As a solution to this problem of short staffing, nurses from other units with lower levels of client acuity were routinely floated to the ICU, often without regard to whether they were cross-trained to take on ICU responsibilities. Abigail Friendly, an RN without prior training or experience in caring for ICU clients, was floated to the ICU, where she was assigned to provide care for Ms. vanDahm, who had responded very poorly to her surgery and was put on a life-support system by a physician just before Nurse Friendly's arrival. While Nurse Friendly was caring for her, Ms. vanDahm communicated, in the presence of her oldest son, that she did not want to be resuscitated in the event of cardiopulmonary arrest. When her shift ended a few minutes later, Nurse Friendly, exhausted and overwhelmed by what she had just experienced, left for home. Shortly thereafter, Ms. vanDahm sustained a cardiopulmonary arrest; however, in the absence of proper documentation and notification, she was resuscitated. Subsequently, the son, angry that his mother's request had not been followed, consulted an attorney, who promptly contacted the hospital's CEO. The next day, Nurse Friendly, who had always received highly positive performance evaluations over the 5 years she was employed by the facility and also was subject to protection under the provisions of an antidiscrimination statute, was told by the manager of her unit that she was being fired effective immediately.

1.Nurse manager of the ICU

a.On what grounds could the nurse manager be found legally liable?

b.What actions should have been taken by the nurse manager to prevent legal liability in this type of situation?

c.What ethical dilemma(s) did the nurse manager face in this situation?

d.What factors should have been considered by the nurse manager in dealing with the ethical dilemma(s) encountered in this situation?

2.Hospital

a.On what grounds could the hospital be found legally liable?

b.What actions should have been taken by the hospital to prevent legal liability in this type of situation?

Answer 1

1, a, Negligence act causes harm to the patient. legal liability occurs when failure to act and do the right work for the patient due to nurse carelessness, recklessness, and attitude of nurses cause medical negligence. in this case, she fails to disclose the information in the patient record, and physicians cause legal liability.
b, Nurse legal and professional responsibility against negligence act. unintentional act failure to fulfill the standards in clinical practice causes a malpractice lawsuit. when failure to follow standards of care and responsibility and failure to communicate information and failure to keep the patient record update and failure to act as a client advocate cause malpractice lawsuit. maintain competence in the profession with adequate knowledge, skills, decision making, and problem-solving power by continuous education and training, follow hospital policy, and procure to avoid legal liability.
c, In ethical decisions nurse, may face ethical dilemmas. Ethical dilemmas raise in this situation for the patient failure to fulfill the beneficence and nonmaleficence.
d, the Nursing practice should include nurse advocacy by respecting patient and eliminating harm and ensuring patient safety and providing quality and effective patient care. beneficent and maleficence ethical concern as a primary factor should be included in this case to do good for the patient and avoiding harm for the patient with ethical act, it can deal with ethical issues encountered in this situation.