Assessment details

Assessment 1 – Case study

Date: 24 August 2019

Length: 2,000 – 2200 words

Assignment type – Essay

Students are provided with four practice-based case studies involving legal and ethical issues.

They must complete each case study. (Apportion your word count roughly equally to each

scenario) Students are to:

· Identify ethical implications of each case study.

·Identify and link relevant NMBA Codes or other documentation to the case study.

· Critically discuss ethical principles relevant to the case study.

· Identify any conflicts between different ethical principles and/or conflicts between ethical

principles and legal requirements

· Identify a course of action and provide a rationale for their decision by reference to the

National Decision Making Framework.

You are not required to refer to legislation or case law.

Please adhere to the standards for academic essay writing outlined in the Course. Headings and subheadings are not required but may be included.

Case studies

You are in your first year of nursing practice and are employed at the ‘Good Health Hospital’. The Nursing Sister in charge of your ward is Anne. There are two other nurses on your ward, Mark and Betty. You care for four patients, as detailed below.

Case study one –

Sam is a 75 year old man. He has been widowed for many years. He was first

admitted four weeks ago for recurrent severe headaches. When first admitted, he told you that he has lost contact with his son and hasn’t spoken to him for many years. He says that he has had a happy life working on fishing boats. He said ‘if anything happens to me, where I can’t speak or move or anything like that, well I don’t want to be here anymore. I would hate to be one of those patients kept alive on machines.’ You suggest that Sam complete an Advanced Statement, but he fails to do so. After Sam has been in hospital for three weeks, he suddenly suffers a severe stroke. His doctors have since advised that he will not recover. He cannot speak, cannot move at all and cannot eat. After Sam has been admitted for four weeks, a man arrives, who says that he is Sam’s son. He says that does not accept that Sam cannot be cured, and insists that everything be done to keep his father alive. Moreover, he says that Sam is a devout Catholic and his religious beliefs require that all be done to keep him alive.

Case study two –Sally

: You are present in the ward one day when Mark arrives for work. You

immediately notice that he smells of alcohol and is dishevelled. You ask him whether he has been drinking. He winks in response but says nothing else. Mark goes to Sally’s bed and draws the curtains. You hear him tell Sally that he needs to do an internal examination. You think that this comment is odd, as Sally is in hospital for a sinus operation. When Mark later leaves the ward, you go to speak to Sally. You ask her what Mark did. She responds ‘It doesn’t matter he is my favourite nurse. He makes sure I get all of the pain relief I need, whether the doctor has ordered it or not’. You go to Anne’s office to tell her what you have just seen. You only get to tell her that Mark smelled of alcohol when she interrupts you and says ‘I don’t want to hear stories. What happens on this ward stays on this ward. You better learn that if you are going to keep your position here’.

Case study three- Mia

Mia is an insulin dependent diabetic, who is in hospital for surgery on her

toes. She suffers with heart issues as a result of her diabetes. Mia is intellectually disabled. Today Mia is being cared for Betty. Towards the end of the shift, Betty comes to you and says ‘I have just realised that I forgot to give Betty her insulin dose four hours ago. I’m going to fill out her chart and pretend that I did it anyway. Please don’t say anything to anyone. I’ll just give her a double dose of insulin next time.’ A few minutes later, Mia’s parents come in to the ward. They ask you how Mia is going, and whether there are any concerns. You are unsure what to do. You go to Anne’s office. Before you can even go in, Anne says ‘oh, it’s the troublemaker again. I don’t want to hear anything from you. I’m writing up a report as to whether you should keep your position or not. Don’t give me anything to get upset about.’

Case study four- Helen

: Helen is 52 years of age. She has been diagnosed with a terminal illness.

Her specialist has said that there is nothing which can be done to help. You are aware, however, of a hospital in New South Wales where treatment is provided for Helen’s condition and where some success has been achieved. Helen is unaware of her situation, as her family have requested that she not be told. Her husband explains that Helen would ‘just give up’ if she were told. He says that she has suffered from depression in the past. One day when you are nursing Helen, she comments that she is willing to try anything to try to get better. She says she is uncertain as to her diagnosis and prognosis, and asks you to explain it to her. She says that she has always had a poor relationship with her husband. She says ‘he is only with me because he wants my money. He would love it if something happened to me.’ You suggest she speak to a counsellor. She says ‘no, you are the only person I feel I can confide in.

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