Dyllan Jones is a 16-year-old male who has been admitted to Horizon Hospital and Health Services with hyperglycaemia. He has a history of non-compliance of the management and care of his Type 1 Diabetes. Dyllan resides with parental grandmother, Mary Young, while the remainder of his family reside in Yuendumu near Alice Springs (City of Horizon 2020). Using the Dylan Jone’s scenario, the paper will discuss about the role of registered nurse in relation to consent and mandatory reporting. Throughout the discussion, reference will be made to the NMBA Registered Nurse Standards for Practice (2016) and other legislations that supports legal and moral responsibilities for mandatory reporting for infants and young people.
Informed consent is the process of achieving a person’s voluntary agreement to health care after awareness about benefits and risk involved in the process. According to the nursing code of conduct, it is important to support the right to informed consent by giving access to all information, giving the person adequate time to ask questions and act according to relevant norms (NMBA, 2018). Prior to any medical treatment, achieving voluntary consent for medical treatment from patient or their family members is a legal responsibility too. The Consent to Medical Treatment and Palliative Care Act 1995 mandates the need to take consent before implementing any treatment for children. This is part of policy to protect safety of children and young people. This is in compliance with the Children and Young People (Safety) Act 2-17 which states the need to protect children and young people from any harm and to provide for children in care (legislation.sa.gov.au, 2017). In case of a person aged 16 years, the Consent to Medical Treatment and Palliative Care Act 1995 informs that persons over or of 16 years can decide themselves about undergoing or not undergoing any treatment. Registered nurses plays a crucial role in the consent process as they are held accountable for the safety and advocacy for patient. To successfully complete the informed consent process, RNs must engage in therapeutic and professional relationship with patient. The NMBA standard 2 for registered nurse practice suggests the need to advocate on behalf of people in way that they respect people’s autonomy and legal capacity (NMBA, 2017). While seeking to achieve consent from Dylan, similar approach needs to be taken so that no ethical conflict takes place after treatment. Legal guardians of children have the capacity to engage in similar decisions (Katz, Webb & Committee on Bioethics, 2016).
Dylan was admitted to the hospital because of diabetic ketoacidosis and his condition deteriorated because of diabetic ketoacidosis. Dylan has expressed poor coping with the disease. Hence, lack of education and skills on self-management is regarded as the cause behind his current health stats. Dylan leaves with his grandmother who is an aboriginal women. Thus, any form of education can be initiated considering the cultural background of the patient. As Dylan is 16 years old, he is legally bound to take his own decisions on treatment (legislation.sa.gov.au, 2017). However, he may not be mentally capable to understand the pros and cons associated with medical treatment and its consequences. Thus, under such circumstances, it is important for nurses consider including his legal guardian in decision making process. Brothers et al. (2014) argues too that it is a legal authorization to ensure that guardians are involved in informed consent process, but the duty to inform the child must be respected too.
Nurses are in a good position to contribute to child protection efforts. Legal and practical guidelines states mandatory reporting as an important criteria to prevent overlooked events and promote safety of the child. It is a legal requirement for all health care professionals to report about any incidence of physical or sexual abuse to child protection authorities (Einboden, Rudge & Varcoe, 2019). The Children and Young People Safety Act 2017 and the Children’s Protection Act 1993 mentions the need to make a mandatory notification compulsory (legislation.sa.gov.au, 2017). The nursing code of conduct also states that nurse must abide by mandatory reporting legislation, the purpose of which is to protect groups from any risk of child abuse and neglect. Thus, a nurse have a professional duty to remain alert and protect vulnerable groups from any harm. In the context of Dylan, there is a possibility that exposure to any violence or neglect might be the cause behind his non-compliance to treatment. Thus, nurse must be skilled enough to assess and identify symptoms of abuse. This will help them to protect the interest of the child in a timely manner (Australian Government, 2020). However, if any nurse decides to avoid reporting about any such incidents, they may face legal consequences to as it will be a breach of their registration requirements (NMBA, 2018). Thus, while assessing patient, nurses must be vigilant about any risk of abuse too so that mandatory reporting criteria can be fulfilled.
To conclude, the review of legal and ethical systems on consent and mandatory reporting in pediatric practice revealed that nurse have crucial duty to complete consent process according to legal standards and respect the need to protect children with mandatory reporting process. The review of professional standards of practice and code of conduct for registered nurse also states that nurses need certain skills like advocacy and therapeutic relationship to share information about treatment during informed consent process. The significance of respecting cultural values of the child and their family was clear from the analysis too.
References
Australian Government (2020). Mandatory reporting of child abuse and neglect. Retrieved from: https://aifs.gov.au/cfca/publications/mandatory-reporting-child-abuse-and-neglect
Brothers, K. B., Lynch, J. A., Aufox, S. A., Connolly, J. J., Gelb, B. D., Holm, I. A., … & Antommaria, A. H. (2014, November). Practical guidance on informed consent for pediatric participants in a biorepository. In Mayo Clinic Proceedings (Vol. 89, No. 11, pp. 1471-1480). Elsevier.
Einboden, R., Rudge, T., & Varcoe, C. (2019). Beyond and around mandatory reporting in nursing practice: Interrupting a series of deferrals. Nursing inquiry, 26(2), e12285.
Katz, A. L., Webb, S. A., & Committee on Bioethics. (2016). Informed consent in decision-making in pediatric practice. Pediatrics, 138(2).
legislation.sa.gov.au (2017). South Australia Children and Young People (Safety) Act 2017. Retrieved from: https://www.legislation.sa.gov.au/LZ/C/A/CHILDREN%20AND%20YOUNG%20PEOPLE%20(SAFETY)%20ACT%202017/CURRENT/2017.25.AUTH.PDF
NMBA (2017). Registered nurse standards for practice. Retrieved from: https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx
NMBA (2018). Code of conduct for nurses. Retrieved from: https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards.aspx
