Description of the Case Study
Discuss about the Ethical Issues: Case Study Of Jack And Sophie.
In the nursing profession, there are various ethical constraints that can represent itself and can have a significant impact on the care delivery and the safety and wellbeing of the patient. Hence there is a multitude of different ethical standards and practice protocols that have been incorporated with an emphasis on the different ethical principles to optimize the use of the ethical practice in nursing care (Runciman, Merry & Walton, 2017). This essay discusses a case scenario with ethical issues that arose from the care practice by paramedics and health care professionals taking the assistance of case study of Jack and Sophie. The essay attempts to analyze the ethical issues with respect to the professional code of ethics or conduct, principles of health care ethics, human dignity and human rights along with future recommendations based on the analysis of ethical issues.
The case study chosen for the assignment focuses on the case of two paramedics, Jack and Sophie who had been called to a home at 10 pm and on arrival to the house they heard shouting coming out from the house. The issue that was reported to the paramedics had been that Milly the child of the house had sustained a fall, the paramedics found the subject on the floor crying and clutching her arm. Upon examination, the paramedics discovered that Milly, the child could have a humerus fracture and they informed the mother, Sandra that the child will need to be transported to the hospital at the earliest. However, soon they encountered the partner emerging from inside the house being completely intoxicated, verbally abusing and restricting the child from being taken away to the hospital. However the paramedics still removed the child from the house and while taking her to the hospital they noticed evidence of physical abuse on the child and reported to Beth, the triage nurse in the healthcare facility. Later the agency nurse while prescribing the medication to the child performs narcotic abuse with the prescribed medication and offers the triage nurse to take half of the narcotic.
There are various ethical issues that have been represented in the healthcare of the cases study. First and foremost, the paramedics have threatened the family by calling the police when the intoxicated partner had refused to let the child be taken away to the hospital. Although, it has to be mentioned in this context that the paramedics had taken that step to ensure that the child can get the health care that she needed yet the paramedics must have taken a compassionate and empathetic approach to the scenario rather than threatening the family with the police case (Competency Standards for Paramedics, 2018). Another very important ethical issue that can be mentioned in this context is that the child Milly had clear signs of burn marks on her leg and abdomen which was discovered by the paramedic Sophie which she reported to the triage nurse, Beth. However, Beth did not confront with the mother of the child regarding the physical abuse of her two-year-old daughter and stated that she would report the issue to the doctor. This can be loosely considered as a breach of confidentiality as the nurse did not conform with the mother before disclosing the information to the other parties. Lastly, the most important ethical issue present in the case study which is also a great violation of the professional code of conduct and ethics is the narcotic abuse intended by the agency nurse. It has to be mentioned in this context that mis-utilization of hospital resources by the staff is a huge violation of the professional code of conduct for the nursing professionals. Along with that, it has to be mentioned that the agency nurse was not mindful of the pain that the patient had been under and instead of administering the medication at the earliest, she engaged in narcotic abuse with the triage nurse. This can be considered an extreme violation of human dignity as well as breach of professional ethics (NMBA Code of ethics, 2018).
Analysis of Ethical Issues
Considering the professional code of conduct for the paramedics practicing in Australia, it has to be mentioned that the paramedics are expected to integrate optimal respect and compassion with the patients and their families and exhibit empathy and resilience when faced with challenges such as noncompliance (Competency Standards for Paramedics, 2018). In this case, as well, the first ethical issue is a violation of this professional code of conduct. When Sandra’s partner in his intoxicated state has expressed his reluctance to let the paramedics take Milly away from the house and to the nearest hospital, according to the professional code of conduct, the paramedics should have tried to calmly and compassionately communicated with both parents and made them understand the need for the child to be taken to the healthcare facility as soon as possible. Instead, the paramedics resorted to threatening Sandra, mother of Milly, to call the police and take legal action against them if they are not allowed to take the child away from the house. According to the element of respect under the code of conduct for paramedics, the paramedics must ensure that their “their actions and treatment demonstrates respect for the client as a person and that care is provided at the highest professional standard”; this was violated by the threatening and disrespectful approach taken by the paramedics (Paramedics Australia, 2018).
Another issue that has been neglected by the nurse is the evidence of physical abuse on the child. According to the code of conduct of nursing practice in Australia, the nurses are required to employ shared decision making and effective communication with the patient and her family members, which was violated by the nurse when she did not confront Milly’s mother with the evidence of physical abuse on the child (Fry, Veatch & Taylor, 2010).
With respect to the nursing care that has been provided to the patient, there have been two particular ethical issues in the case study violating ethical principles, code of conduct and practice standards for the nurses in Australia. According to the code of conduct for the nurses from NMBA, the nurses are responsible and accountable for providing safe, effective and immediate nursing interventions to the patients under any circumstances. Along with that, it has to be mentioned that under the code of ethics for the nurses in Australia, the care needs and demands of the patients are to be prioritized by the nurses under any circumstances (Ulrich et al., 2010). And it is the utmost responsibility for the nurses to safeguard the best interests of the patient over anything else. In this case, the agency nurse violated these professional codes of conducts by engaging in narcotic abuse before administering the morphine to the patient that had been in tremendous pain. Along with that, it has to be mentioned that according to the professional boundaries of the nursing professionals in Australia, the abuse of narcotics while on duty is the breach of professional responsibility and accountability and engaging in mis-utilization of hospital resources are a great violation of the professional ethics and job responsibility legislations as well. Considering the ethical principle, beneficence is the principle that has been breached in this scenario. According to this principle, the care professionals will have to prioritize taking actions with intent to benefit the patient above everything else. By not safely and effectively administering the morphine to Milly immediately and rather engaging in narcotic abuse leaving the patient is pain violates the principle of beneficence (Chadwick & Gallagher, 2016).
Professional Code of Conduct for Paramedics Practicing in Australia
Lastly, considering human dignity, According to the 4th standard of NMBA code of professional conduct, it has to be mentioned that the health care professionals are to maintain the basic dignity of the patients. In this case, while a 2-year-old patient was struggling with immense pain the nursing professional ignored the suffering of the patient and instead of administering the pain medication that can relieve the pain of the patient she engaged in narcotic drug abuse for her own selfish and unethical reasons; hence it is undoubtedly a violation of human dignity and denied her of her right to medicine and care (humanrights.gov.au, 2018).
According to the analysis if the ethical issues that have been discussed above in the essay, there are various areas of improvement. First and foremost, it has to be mentioned that the paramedics were disrespectful and rude to Sandra when they threatened the parents with calling police whereas they should have engaged in compassionate communication explaining to the parents regarding the need for moving the child to the hospital, Hence, there is need for training and skill enhancement for the paramedic for them to develop compassionate professional approach and effective communication (health.qld.gov.au, 2018). There is a need for training for the triage nurses as well as that they can engage in communication and information sharing with the patient family regarding the issues like child abuse or others. Finally, there is a need for diligent monitoring of the safekeeping of medications, especially the narcotics and policies restricting the staff to engage in narcotic abuse while in hospital premises. There should be a vigilance committee monitoring the staff for any possible occurrence of misuse of hospital resources and narcotic abuse with strict consequences to ensure compliance from the staff as well (Monroe & Kenaga, 2011).
Conclusion:
On a concluding note, this essay has been an excellent opportunity to discuss and explore the ethical issues that are prevalent in healthcare scenario. It has to be acknowledged that in care scenarios, ethical conflicts are a very common occurrence. However, there is a need for vigilance and monitoring to ensure there is no harmful impact of the ethical conflict on the safety and welfare of the patients. This case study had three individual ethical violations and each affected the care and safety of the patient concerned. Hence there is a need for policy reform to strengthen the auditory system of the facilities to avoid such violations of ethics reoccurring again.
References:
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