Integrity in Practice Ethics and Legal Considerations Sample
Healthcare professionals operate under strict legal and ethical guidelines due to the complexities surrounding quality healthcare services delivery. Different healthcare settings require healthcare professionals to apply legal and professional guidelines stipulated by international, regional, and national organizations. For instance, nurses, physicians, and social workers in healthcare settings should embrace ethical values such as accountability, integrity, responsibility, respect, and impartiality.
Inevitably, failure to embrace these principles attracts legal actions by organizations, patients, and relatives, leading to a tarnished reputation, financial losses in the forms of compensations, job uncertainties, and altered confidence. Although balancing between professional, ethical, and legal requirements is a daunting endeavor for a healthcare professional, maintaining meaningful professions, developing relationships with patients, and fulfilling quality healthcare objectives is the only viable way of maintaining meaningful professions. To that end, this discussion examines ethical and legal issues surrounding failure to adhere to physician orders, thereby resulting in negligence in practice lawsuit.
Nurse Case Study: Failure to Follow Physician Orders
According to this case study by the Nurse Service Organization (NSO), the family of a 23-year-old patient sued the attending physician on allegations of negligence and failure to follow the physician’s prescription when administering medication to the patients. The family demanded $3000000 in damage based on the belief that the ICU nurse’s alleged failure to administer medication and follow the physician order properly led to the patient’s death. According to the NSO, the patients showed no significant prior medical history upon arriving at the emergency room. However, lab tests and an abnormal CT scan of her chest confirmed pneumonia, elevated white blood count, abnormal liver function tests, and abnormal coagulation profile.
The prevailing concerns confirmed by the lab test and CT scan prompted healthcare professionals to transfer the patient to the intensive care unit (ICU), where she was treated with oxygen and antibiotic therapies. Between 7:30 am and 4:30 pm, the patients portrayed fluctuating blood pressure and heartbeat per minute. Although the attending nurse recorded these dynamics, she failed to notify the physician of the patterns regarding heart rate. The physician ordered a pulmonary consultation for possible bronchoscopy, which prompted the attending nurse to transfer the patient to the telemetry unit. The nurse’s record failed to provide the exact time of transfer.
The conditions in telemetry units compromised the patient’s recovery process because the patient did not arrive with a monitor and the unit was in an overflow situation. By 10:00 pm, the patient suffered a cardiac arrest that claimed her life. As the pursuit of legal investigation unfolded, the investigators revealed that the attending nurse faced challenges when expressing herself because English was not her primary language. However, she firmly defended herself in the account that she followed all guidelines provided by the physician and recorded every development regarding the patient’s conditions. Arguably, this case study raises the question of negligence, poor record-keeping, lack of nurse-physician collaboration, and the potential consequences of failing to execute the mandate effectively.
Potential Risk-mitigation Techniques to Prevent the Situation
The hospital could have embraced various strategies to prevent the situation and avoid lawsuits. Some of the viable interventions that would have saved the situations include frequent supervisions to document vital signs and symptoms, embracing timely documentation to indicate trends and communicate them to the on-call physician, providing monitor to the telemetry unit, and closely supervising the attending nurse to evaluate whether she is competent enough to deliver quality healthcare services to the patient.
Also, the hospital could have provided all ICU nurses with relevant training and enhance their competencies to deal with such situations. In this sense, proper training is essential in boosting professional confidence, eliminate doubts when completing tasks, and enhance ethical and legal operations.
Nurse’s Actions to Improve the Outcome
Undoubtedly, the attending nurse failed to live up to the case study’s professional, ethical, and legal expectations. One of her failures was the inability to record patient’s data regarding fluctuating symptoms. Secondly, she failed to collaborate with the physician in administering medication to the patient. Thirdly, she could not factor potential consequences of medication errors on the patient’s health and the hospital’s reputation.
As a result, the first action of improving the situational outcomes to embrace proper record-keeping and communication with other practitioners. According to Mutshatshi et al. (2018), the good nursing practice requires practitioners to embrace comprehensive, timely, and accurate record-keeping. In the context of poor record-keeping, attending nurses or other practitioners face legal claims and undermine the objective of quality healthcare services.
Another action is promoting collaboration between the nurse and physician to administer medication to the patient properly. According to Salar et al. (2020), physician-nurse communication and collaboration are the most profound indicators of high-quality patient care. If the attending nurse collaborated with the physician, they could have made informed decisions and eliminate any operational doubts.
Finally, the nurse could have factored in the potential consequences of medication errors by reviewing prescription orders provided by the physician. Ahmadieh et al. (2020) argue that medication errors are among the leading causes of death in hospital settings despite nurses having the responsibility to avoid such errors. The nurse could avoid medication errors by consulting the physician, being aware of legal provisions surrounding medical errors, and consistently engaging the physician during the exercise.
Nurses and other healthcare professionals operate under pressure to observe legal, professional, and ethical practices. The case study regarding negligence provides insights into the essentiality of observing professional expectations when delivering care to patients. Some of the fundamental actions that enable nurses and other professionals to observe legal and ethical considerations include personal awareness, collaboration and teamwork, proper and accurate record-keeping, and individual understanding regarding the consequences of unethical clinical practices.
- Ahmadieh, H., Majzoub, G., Abou Radi, F., & Abou Baraki, A. (2020). Inter-professional physician-nurse collaboration in Lebanon. International Journal of Health Governance, 25(1), 34-45. https://doi.org/10.1108/ijhg-05-2019-0036
- Mutshatshi, T., Mothiba, T., Mamogobo, P., & Mbombi, M. (2018). Record-keeping: Challenges experienced by nurses in selected public hospitals. Curationis, 41(1), 1-6. https://doi.org/10.4102/curationis.v41i1.1931
- Nurses Service Organization (2021). Nurse Case Study: Failure to follow physician orders. NSO. Retrieved 10 July 2021, from https://www.nso.com/Learning/Artifacts/Legal-Cases/Nurse-Case-Study-Failure-to-follow-Physician-orders.
- Salar, A., Kiani, F., & Rezaee, N. (2020). Preventing the medication errors in hospitals: A qualitative study. International Journal of Africa Nursing Sciences, 13, 1-5. https://doi.org/10.1016/j.ijans.2020.100235
Sample Paper 2: Intergrity
Integrity is defined as the ability of an individual to behave in an ethically acceptable manner without deviating from what is right (Choi et al., 2020). Honesty, accountability, and responsibility are the building blocks of integrity. Integrity defines the behaviors and decisions undertaken by an individual either at a personal or organizational level hence reflecting the relationship with others. An individual who upholds a high level of integrity gains trust from many, fosters good relationships with others, and will always be an example to others who will emulate his/her behaviors (Erkutlu & Chafra, 2019). It is a value required of any leader in any organization.
Integrity can be fostered in several ways as follows. First, a leader must behave acceptably so that others can emulate the same behaviors and foster integrity (Erkutlu & Chafra, 2019). It is therefore unacceptable for any leader to mispresent a situation as this can negatively impact how others will behave. A good leader must be a good example to his/her followers.
Secondly, giving constant education about acceptable values and behaviors is essential in fostering integrity. Education should include a code of ethics, professional expectations, and social policies (Choi et al., 2020). Educating employees about integrity strengthen their knowledge about the matter and influence how they behave.
Additionally, leaders must advocate for transparency and create required structures that support transparency. Leaders must be observant of how they interact, handle difficult situations, and create policies as these will influence how employees judge them. In enhancing transparency, for example, a manager should not sign an evaluation that has not been signed by an employee during an annual performance evaluation.
Decision-making should be systematic and ethically acceptable by engaging all parties involved. This will enhance the integrity and ease conflict resolution (Ridge, 2015). The ultimate benefit is upholding principles, encouraging support, and improve teamwork that is all necessary to foster integrity.
Finally, promoting accountability fosters integrity. Accountability should be emphasized in all steps to ensure credible results are met (Ridge, 2015). The process of attaining the results must be authentic and ethically acceptable to ensure that integrity is upheld. It is therefore required of a leader to understand the whole process used by a manager to attain specific results without only looking at the outcomes.
- Choi, Y., Yoon, D. J., & Kim, D. (2020). Leader behavioral integrity and employee in-role performance: The roles of coworker support and job autonomy. International Journal of Environmental Research and Public Health, 17(12), 4303. https://doi.org/10.3390/ijerph17124303
- Erkutlu, H., & Chafra, J. (2019). Leader’s integrity and employee silence in healthcare organizations. Leadership in Health Services (Bradford, England), 32(3), 419–434. https://doi.org/10.1108/LHS-03-2018-0021
- Ridge, R. A. (2015). Putting the I in integrity. Nursing Management, 46(4), 52–54. https://doi.org/10.1097/01.NUMA.0000462381.26593.91