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Legal Scholarly Assignment

Jaspinder Gill
Student ID: 820-546-760
Date Submitted: November 4, 2014
NURS217: Legal and Ethical Issues
Instructor: Rosemary Watkins
Humber College ITAL

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On the night of November 24, 2010 around 23:58, 17 years old [The Client] was brought
into the Emergency Department in Ontario. The client was found at a coffee shop with a
decreased level of consciousness, due to alcohol and drug consumption and was also
bleeding from her wrists. Client did not have any identifying information with her and
was not willing to provide her name to staff, despite several attempts to gather this
information. The member (guilty nurse) was working in emergency department as a
triage nurse. Her responsibilities included triaging clients. Member abused the client
physically and was failed to intervene to protect the health and well being of the client
when Nurse C was abusing her. The elements of the situation that lead to the allegation of
conduct were the Member did not get the clients history and was not aware of the
assessments already being done on the client. There were other nurses involved in this
care along the member. Client was initially assigned to the RN A and was being assisted
by RN B. RN A, performed a light sternal rub because the client was not responding to
the voice or touch. Client responded by wincing and moving her shoulders and arms,
which indicated that the client is conscious so the RN A stopped applying the sternal rub.
Client started interacting non-verbal with the staff. At 02:30 RN A went on a break till
then client did not disclose her name to the staff. After 03:00, Nurse C asked the member
to help rousing the client to obtain her name. The Member flicked her on the cheeks and
forehead with her fingers and also rubbed clients sternum and ended in providing painful
stimulus, which was another sternal rub. Nurse C made inappropriate comments and
suggestions in the presence of client, which upsets the client. Member did not advocate
the client at that situation instead where it was needed. Therefore, inappropriate behavior
lead client in stress which elevated the heart rate and she was not able to catch her breath.

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I agree with decision made by the Discipline Committee, as the member (guilty nurse)
committed acts of professional misconduct because she needs to work on taking a
responsibility of taking care of individual. She needs to understand her role as a whole.
Decision made were as follows: Member required to appear before panel to be
reprimanded within three months that this order becomes final, Certificate of registration
was suspended for two months; attend two meetings with nursing expert at own expenses
within six months of date of this order; notify employers about the decision for a period
of 12 months from the date the suspension ends.
In this case, the nurse contravened Clients well being. Clients well-being is
maintained through the therapeutic relationship (CNO; 2009). Firstly, reporting was not
done properly so the nurses did not know whether, the patient is conscious or if there is
need of further assessments to make client conscious. Clients well being got worse when
the triage acted unprofessionally and did the sternal rub again without knowing it has
already been done by RN A and the client is conscious. The main reason why the client
was harmed because there was a lack of communication between nurses taking care of
the client. As stated in the Ethics standard, Clients well - being can only be promoted
when the health care professionals are facilitating the clients health and welfare,
preventing or removing harm (CNO; 2009). Harm could have prevented in this particular
case if the nurses had information about clients condition and made a therapeutic
relationship with the client. Clients well being was totally ignored when inappropriate
suggestions and comments were given by another nurse in the presence of the client and
the triage nurse did not advocate patient. Inappropriate comments and unnecessary sternal
rubs made client to cry and she was so upset that she could not even catch her breath.

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Nurse was failed to maintain the therapeutic relationship through professional intimacy.
Nurse should have shown the empathy towards patients condition (CNO; 2013). Nurse
power should only be used in a caring manner to meet the clients need not to misuse the
power to abuse a client.
One of the strategies that help to have secure health care environment is
collaborative teamwork. Each nurse on the floor should understand their professional
responsibilities to collaborate with other nurses in the interests of good patient care to
make it an effective collaboration. Patient information should be retrieved before taking
care of the patient. Every health care professional have responsibilities to confer with
colleagues within their own profession to provide optimal care in the health care
environment. Nurses should remember their primary commitment to the patient.
Documentation plays a significant role in the care. As stated in CNO: Documentation
Practice standard, nurses are accountable for ensuring their documentation of client care
is accurate, timely and complete (CNO; 2009). It reflects the clients point of view,
recognizes the health care provider and supports constancy of care by acknowledging
other health care professionals to approach the information (Grace, 2009; p.135). It also
establishes the nurses commitment to provide effective and ethical care by showing
accountability for professional practice. Failed to keep records or lack of information
about patients record can lead to outcomes that can harm the patient (Grace, 2009; p;
136).
Secondly, Education plays a significant role to provide a client centered care.
Knowledge is key to provide an optimal care. In order to ensure safe and effective
treatment, health care providers should know to practice with compassion. Respect

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persons dignity to maintain therapeutic relationship. Professional boundaries should be
maintained when taking care of a individual (Alfaro-Lefevre, 2009;p.121). Health care
professionals plays a vital role in promoting, advocating and protect health, safety,
privacy and rights of patients. Seek professional opinions and delegating tasks
appropriately (Alfaro-Lefevre, 2009;p.121). Aim to provide care, which is beneficial to
others and prevent harm. Health care providers should understand how their actions could
influence patients condition. Keep gaining knowledge and seek out learning experiences.
Organization and learning advancement aides enhance patient consideration and persons
own value and employability (Alfaro-Lefevre, 2009;p.121). Participating in various
events like seminars, case conferences to establish, maintain and improve the health care
environment. It is to assure that the physical environment and states of work are helpful
to give quality health awareness. Get included in expert associations which helps
illuminate nursing qualities, shape arrangements, keep up and enhance the nursing
practice. A program by CNO; named as Quality assurance which can be viewed simply as
comprising all those activities in an organization which help to identify and promote good
practice and prevent poor outcomes (CNO; 2014). It is the prominent and important
mechanism for improving the quality of health and education. This program improves
nursing practice by engaging in practice reflection, and by setting leaning plans and
attaining the goals.
In Conclusion, Critical thinking is the most important factor that determines
healthy work environment. Critical thinking also helps to prioritize to make clinical
decisions. The unique and comprehensive resources provided by the facilities can
improve professional responsibility. A framework between the health care professionals

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will help to create safe and efficient health care environment. Education improves
interpersonal skills such as teamwork, resolving conflict and being an advocate. It helps
developing the knowledge and skills required to deal with everyday nursing practice.
Team communication is important to achieve mutual goals of patient good care.
Teamwork is essential to provide the best care to clients. Utilization of extensive variety
of successful opportunities and interpersonal abilities keep up a helpful environment.
Practice Standard and guidelines given by College of nurses of Ontario plays a role of
supportive guide for all nurses to ensure that they are providing an optimal care. Any
questions regarding care, practice standards; nurses can always refer to a CNO
documents in regards to patients care. Clients well-being can be highly effective by
nurses ability to meet proper expectations in patients interest. Critical thinking,
knowledge, collaborative teamwork plays an essential part in giving beneficial treatment
to the patient.

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References

Alfaro-Lefevre, R. (2009). Critical thinking in Nursing: Beyond Clinical

Judgement. In Critical Thinking and Clinical Judgement (4th ed., p. 121).
Canada: Saunders Elsevier.

College of Nurses of Ontario.Therapeutic Nurse-Client Relationship,

(2013, May). Retrieved November 3, 2014 from
http://www.cno.org/Global/docs/prac/41033_Therapeutic.pdf.

College of Nurses of Ontario. (2014, March 7). Retrieved November

3, 2014, from http://www.cno.org/myqa/\

College Of Nurses Of Ontario: Ethics. (2009, June). Retrieved November 3,

2014, from http://www.cno.org/Global/docs/prac/41034_Ethics.pdf

College Of Nurses Of Ontario: Documentation. (2009, June). Retrieved

November 3, 2014, from
http://www.cno.org/Global/docs/prac/41001_documentation.pdf

J. Grace, P. (2009). Collaborating Relationships-Promoting Patient Good. In

Nursing Ethics and Professional Responsibility (pp. 135-136). United States Of
America: Jones and Bartlett.