WHAT ARE YOUR RESPONSIBILITIES IN THIS SITUATION AND WHAT SHOULD YOU DO TO STAY WITHIN THE BOUNDARIES OF PROFESSIONAL NURSING PRACTICE

19 Jul WHAT ARE YOUR RESPONSIBILITIES IN THIS SITUATION AND WHAT SHOULD YOU DO TO STAY WITHIN THE BOUNDARIES OF PROFESSIONAL NURSING PRACTICE

You are working as an EEN at Sunnyside Day Respite Centre on a morning shift.

You have had six clients come in for care today one of whom is Mrs Jocelyn Davis.

She is a regular client at the Respite Centre and has been diagnosed with moderate

dementia.

At 1030 hours Mrs Davis becomes agitated and begins to wander around the

Respite Centre. The Registered Nurse in charge of the shift, RN Jolie, tells you to

restrain Mrs Davis in her chair with a lap restraint. You are not certain that Mrs Davis

needs to be restrained and you question RN Jolie’s order. RN Jolie becomes

annoyed at your question and tries to restrain Mrs Davis herself.

Mrs Davis verbally objects to being restrained and attempts to undo the restraint. In

the process her chair tips over, she hits her head on the floor and loses

consciousness. While RN Jolie attends to Mrs Davis you call the ambulance.

After Mrs Davis is taken to hospital RN Jolie tells you to say that Mrs Davis was

found after she had falle n and hit her head if anyone asks you about what happened

to her. RN Jolie also tells you not to say anything about restraining Mrs Davis as you

will both get into trouble. You feel uncomfortable about this but she is your

Registered Nurse so you say nothi ng.

Mrs Davis dies in hospital two days later. The Coroner has been notified by the

hospital and her death is to be investigated by the Coroner’s Court.

When you hear about what is to happen following Mrs Davis’ death you are unsure

and become worried about what you should do now.

1. Discuss the following legal and professional issues in relation to this Case

Study:

• Consent, restraint, assault and battery

• Duty of care, negligence and vicarious liability

• Scope of practice (the legal and professional boundaries imposed upon

you as a nurse)

• Advocacy (the nurse’s role as an advocate for the client)

• Documentation

• Open disclosure

• The Coroner

2. Discuss the following ethical and professional issues in relation to this Case

Study:

• How would you respond to RN Jolie when she tells you to lie about

what happened to Mrs Davis

• What are your responsibilities in this situation and what should you do

to stay within the boundaries of professional nursing practice

I n this section, you need to choose an ethical decision -making model and

discuss how you would use it to help you to make a decision about how to

respond to the RNs request to lie, and to outline what your professional

responsibilities would be in this situ ation.

There are a number of different decision -making models (see Topic 7 of your

online resource “Models for Decision Making”), but the DECIDE model is

recommended for novice nurses (and therefore student nurses), according to

Allen, Chapman, Francis and O’Connor (2008). However, all decision-making

models serve the same purpose: to provide a process through which a person

can examine, and reflect on, all the aspects of an ethical dilemma, so that

they can make a decision.