Questions:
Assessment Item No.2 (Problem Solving Task) CRA 2018, Semester 2
| Knowledge and understanding: Identification and usage of relevant legal and ethical principles and statements from the Codes in relation to the scenario | |||||
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Excellent | Very Good | Good | Average | Inadequate |
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Demonstrate knowledge of the relevant ethical principles, elements from the ICN Code of Ethics and principles from the Code of Conduct for Nurses |
Your paper correctly identified and described all the relevant ethical principles, elements from the ICN Code of Ethics and principles from the Code of Conduct for Nurses relating to the scenario. |
Your paper correctly identified and described nearly all the relevant ethical principles, elements from the ICN Code of Ethics and principles from the Code of Conduct for Nurses relating to the scenario, with only a few issues missing or not discussed in sufficient detail. |
Your paper correctly identified and described several relevant ethical principles, elements from the ICN Code of Ethics and principles from the Code of Conduct for Nurses relating to the scenario but some significant issues were missing, unclear or not discussed in sufficient detail. |
Your paper identified and described some relevant ethical principles, elements from the ICN Code of Ethics and principles from the Code of Conduct for Nurses, relating to the scenario but some significant issues were missing, unclear or not discussed in sufficient detail. |
There was limited coverage of the relevant ethical principles, elements from the ICN Code of Ethics and principles from the Code of Conduct for Nurses relating to the scenario. Some essential issues were not addressed.
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| Demonstrate knowledge of the relevant legal principles | Your paper correctly identified and described all the relevant legal principles relating to the scenario. | Your paper correctly identified and described nearly all the relevant legal principles pertaining to the scenario, with only a few issues missing or not discussed in sufficient detail. | Your paper correctly identified and described several relevant legal principles relating to the scenario but some significant issues were missing, unclear or not discussed in sufficient detail. | Your paper identified and described some of the relevant legal principles, but some significant issues were missing, unclear or not discussed in sufficient detail. | There was limited coverage of the relevant legal principles related to the scenario. Some essential issues were not addressed.
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| Critical thinking: Analysis, Reasoning and Application of relevant principles within the context of the scenario | |||||
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Arguing your position by application of the ethical principles, elements from the ICN Code of Ethics and principles from the Code of Conduct for Nurses |
Your paper comprehensively argued your position by clearly demonstrating how the ethical principles, elements from the ICN Code of Ethics and principles from the Code of Conduct for Nurses identified were relevant to those in the scenario. This included recognising or acknowledging different perspectives on an issue where relevant. |
Your paper argued your position by demonstrating how nearly all the ethical principles, elements from the ICN Code of Ethics and principles from the Code of Conduct for Nurses identified were relevant to those in the scenario. This included recognising or acknowledging some different perspectives on an issue where relevant. |
Your paper argued your position by demonstrating how some of the ethical principles, elements from the ICN Code of Ethics and principles from the Code of Conduct for Nurses identified were relevant to those in the scenario. |
Your paper made some limited attempt to argue your position by demonstrating how a limited number of the ethical principles, elements from the ICN Code of Ethics and principles from the Code of Conduct for Nurses identified were relevant to those in the scenario. |
Your paper did not successfully argue your position and did not demonstrate how the ethical principles, elements from the ICN Code of Ethics and principles from the Code of Conduct for Nurses identified were relevant to those in the scenario. |
| Arguing your position by application of the legal principles | Your paper comprehensively argued your position by clearly demonstrating how the legal principles identified were relevant to those in the scenario. Correct conclusions regarding the legal position were drawn. | Your paper argued your position by demonstrating how nearly all the legal principles identified were relevant to those in the scenario. Some correct conclusions regarding the legal position were drawn. | Your paper argued your position by demonstrating how some of the legal principles identified were relevant to those in the scenario. Few correct conclusions were drawn regarding the legal position. | Your paper made some limited attempt to argue your position by demonstrating how a limited number of the legal principles identified were relevant to those in the scenario. | Your paper did not successfully argue your position and did not demonstrate how the legal principles identified were relevant to those in the scenario. |
| Supporting your final decision | Your paper used the analysis of ethical and legal principles to support all the appropriate courses of action for a nurse in the scenario. | Your paper used the analysis of ethical and legal principles to support a number of highly appropriate courses of action for a nurse in the scenario. | Your paper used the analysis of ethical and legal principles to support some appropriate courses of action for a nurse in the scenario. | Your paper used the analysis of ethical and legal principles to support a limited number of appropriate courses of action for a nurse in the scenario, but also included some courses of action which were not supported or were inappropriate. | Your paper did not use the analysis of ethical and legal principles to support appropriate courses of action for a nurse in the scenario. You may also have included some courses of action which were inappropriate. |
| Written Communication: Academic Writing/ Professional Presentation | |||||
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Expression |
Logically and succinctly structured the content to create a coherent assignment by: – the use of headings – using formal academic language – consistently adhering to the English conventions of grammar, paragraphing, punctuation, spelling. |
Logically structured the content to create a coherent assignment by: – the use of headings – using formal academic language – mainly adhering to the English conventions of grammar, paragraphing, punctuation, spelling.
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Structured the content to create an assignment that had coherent sections by: – mostly using formal academic language – mostly following the English conventions of grammar, paragraphing, punctuation, spelling.
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Partially structured the content into rudimentary paragraphs by: – sometimes using formal academic language – mostly following the English conventions of grammar, paragraphing, punctuation, spelling.
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Made some statements that occasionally related to the topic by: – only using informal language – occasionally using the English conventions of grammar, punctuation, spelling
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| Citation & Referencing | There were no technical mistakes in citation and/or referencing with explicit acknowledgment of all sources throughout the assignment.
A complete reference list was included. |
There were one or two technical mistakes in citation and/or referencing with explicit acknowledgment of most sources throughout the assignment. A complete reference list was included. | There were several technical mistakes in citation and/or referencing with only some sources acknowledged throughout. A reference list was attempted and included. | There were several technical mistakes in citation and referencing with only some sources acknowledged throughout. An incomplete reference list was included or was not included. | There were many technical mistakes in citation and referencing with only occasional referencing and acknowledgments of sources of information
and a reference list was not included. |
Answers:
Identify issue and collect information
There are many issues related to the case that makes it difficult for Komiko and Boris to agree on what course of action should be taken. Firstly, Andre is a minor who cannot make decision on the course of his health. This means that Boris, his caregiver and Komiko, the nurse is expected to make decision on the course of treatment which Andre should receive. The facts at hand is that Komiko and Boris are in conflict as to whether Andre should get additional tests. Komiko’s perspective is that Andre should be tested further so as to ascertain other underlying causes of Andre’s condition. On the other hand, Boris is against the idea of further testing. One of the relevant facts is that Andre presents with limited mobility in his right arm, swelling and an open cut that looks to be a number of days old. It is also evident that Andre child seems very withdrawn and does not engage when asked questions. Komiko also established that Andre have older bruises on Andre’s upper arms and shoulders. It is also clear that Boris seems to mistreat Andre and warns him not to report anything to his mother. Although the treating team recommended that further test be carried out, Boris refused. Kimiko is concerned that Andre’s health will suffer significantly if Boris does not consent to further tests and antibiotics for his son.
Evaluate the issue
From the case, it is apparent that there are a lot of ethical violations from the caregiver’s side and irresponsibility from nurse side. The first violation is that the Komiko is violating E2.1, which expects nurses to carry personal responsibility and accountability. Komiko is not doing this because as a nurse, she knows that Andre need further assessment yet she is giving in to Boris suggestion. Additionally, Komiko is violating E1. 5, which stipulates that every nurse should act as per the standards associated with the profession and augment its image and public confidence (International Council of Nurses 2012). Komiko is violating these expectations. She is not displaying any public confidence because instead of demanding that the child be subjected to more tests, she is asking the caregiver to give her opinion and hence she violates P 2.2.b, which expects nurse to advocate on behalf of the person where necessary, and recognise when substitute decision-makers are needed. That is why E1. 5 further expects nurse to determine and implement acceptable standards of clinical nursing practice, management, research and education. The nurse presented in the case is not doing this. Instead of carrying out the test, she is asking the caregiver whether the test should be conducted. This is wrong because caregiver does not know anything about the clinical nurse practice. Caregiver is bound to give her subjective opinions that may not favor client (Chang & Daly, 2015). And this is exactly what happened. When the nurse asked caregiver whether the suggested tests should be carried, caregiver confidently declined. In the end, the child may end up suffering simply because of nurse’s irresponsibility and caregiver’s selfishness (McGrath & Phillips, 2008).
Actions
The first action is that Andre should be subjected to recommended tests. Boris should not stop the treating team from carrying out recommended test. This action is ethically supported by the principle of beneficence (Crisp, Taylor, Douglas & Rebeiro, 2012). Beneficence principle affirms the obligation to provide any and all types of treatment that may be considered medically beneficial to the patient, in accordance with reasonable medical judgment (Burkhardt & Nathaniel, 2013). In most cases, the parents are those who naturally have parental authority to decide (Johnstone, 2011). Komiko shouldn’t have sought the opinion of Boris. Caregivers do not have technical skills to determine whether tests are necessary or not (Atkins, Britton & De, 2011). According to the ethical principles prevailing in Australia, in pediatrics it is the best interests of the child that must be considered. That is, the plan of care that best promotes the best interests of the child is the most ethically appropriate choice. This best interest of the child should be appreciated by assessing the proportion of benefits to the consequences associated with each choice.
Another action is that Komiko should report Boris to the relevant authorities. Boris is trying to interfere with the treatment process. In such instances, Komiko is expected to report to the relevant authorities. This is because the Child Protection Act 1999 (Qld), expect nurses to report reasonable suspicions of child abuse and neglect. What Boris is doing is enough to be classified as child neglect and abuse. The case, for example, reveals that Boris is threatening Andre and this could be just an iceberg of what has been taking place between her and Adre. It is therefore the responsibility of Komiko to report to relevant authorities. Andre’s mother should also be told about the situation.
Lastly, Komiko ought to act as per the ICN codes. According to E2.1, every nurse is expected to carry out individual duty and answerability for nursing practice, and for maintaining aptitude by incessant learning (International Council of Nurses 2012). In addition, E1. 5 expects every nurse to act as per the standards associated with the profession and augment its image and public confidence (International Council of Nurses 2012). In this case, Komiko was expected to inform Boris and Andre of the illness, likely course, treatment options, the possibility of not choosing any treatment, the benefits and risks of each decision, and likely outcomes. , such as length of hospitalization or convalescence, scars and so on. This is because it is within her professionalism to ensure that patient gets the needed treatment plans. However, the case suggest that Komiko is violating these expectations. She is not displaying any public confidence because instead of demanding that the child be subjected to more tests, she is asking the caregiver to give her opinion. Komiko did not do this and hence she violated the ICN code of ethics related to nurses and professionalism. That is why it is important for Komiko to review the ICN codes and know her docket and scope in nursing care.
Implement
The first action to be taken is for the treating team to carry out the recommended test without seeking Boris’ approval. The next action is to administer comprehensive treatment to Andre because it is to the best interest of Andre to get tested and get comprehensive treatment (DeLaune, 2013). If Andre is not tested, some of the underlying conditions may persist and he may continue to suffer.
The second line of action is to report Boris to the relevant authorities. It can be deduced form the case that Andre has been suffering for quite sometime simply because Boris is not responsible and ready to help him. This means that after Andre is treated, Boris should be reported to relevant authorities in order to ensure that Andre is not mistreated again and to ensure that his needs are gathered for on time.
The third line of action is to reoriented Komiko on the ICN code of conduct so that next time she has a client, she knows her scope and docket (Then & Mcdonald, 2014). Through proper reorientation, Komiko will know when to act authoritatively, when to consult colleagues, when to consult caregiver and when to report an issue.
Assess outcomes
If the above-mentioned actions are taken, the outcome would be affirmative. Firstly, by treating Andre and carrying out all recommended tests, Andre will recover and he will be able to walk normally and do all daily chores effectively. Personally, I am a strong supporter of utilitarian principle. All my beliefs are based on this principle. If I were to make decision without the knowledge of the ICN codes and the Child protection laws, I will still ensure that Andre is treated and tested as per the suggestions from the treating team. I believe that the idea of beneficence should be implemented in all health care institutions and those who try to interfere with the implementation be punished accordingl (Forrester & Griffiths, 2010). If Boris is reported to the relevant authorities, Andre’s state of well being will improve because he will not be harassed or threatened anymore. On the other hand, if Komiko is reoriented on the ICN code of conduct, she will be able to assert her responsibility in future without feeling inadequate.
References
Atkins, K., Britton, B., & De, L. S. (2011). Ethics and law for Australian nurses. Cambridge: Cambridge University Press.
Burkhardt, M. A., & Nathaniel, A. K. (2013). Ethics and issues in contemporary nursing. Australia : Delmar
Chang, E., & Daly, J. (2015). Transitions in Nursing – E-Book: Preparing for Professional Practice. Churchill Livingstone Australia
Child Protection Act 1999 (Qld) s. 22 186 (Austl.)
Crisp, J., Taylor, C., Douglas, C., & Rebeiro, G. (2012). Potter & Perry’s Fundamentals of Nursing – AUS Version – E-Book.
Mosby Australia
DeLaune, S. (2013). Fundamentals of nursing. Sydney Cengage Learning Australia
Forrester, K., & Griffiths, D. (2010). Essentials of Law for Health Professionals. Mosby Australia
Hamlin, L., Richardson-Tench, M., & Davies, M. (2011). Perioperative Nursing – E-Book: An Introductory Text. Mosby Australia
International Council of Nurses (2012). ICN Code of Ethics for Nurses (revised 2012), Element 1. Retrieved from: file:///C:/Users/user1/Downloads/2572175_1555621987_INCenglish%20(1).pdf
Johnstone, M.-J. (2011). Bioethics: A Nursing Perspective. Churchill Livingstone Australia
McGrath, P., & Phillips, E. (2008). Western notions of informed consent and indigenous cultures: Australian findings at the interface. Journal of Bioethical Inquiry, 5(1), 21–31. doi:10.1007/s11673-008-9085-6
Then, S.-N., & Mcdonald, F. J. (2014). Ethics, law, and health care: a guide for nurses and midwives. South Yarra : Palgrave Macmillan
