Question:
Hai is a 20-year-old male patient who arrives at the Emergency Department of a major Brisbane
hospital. An ambulance transported Hai to the hospital after a bystander saw him jumping from the
balcony of a first floor apartment. The paramedics called to the incident think that Hai has broken his
arm as a result of falling over after he jumped. The circumstances surrounding the incident were not
clear to the bystander, and the paramedics were not able to elicit any information from Hai about how
the incident happened. Hai has remained very quiet since his admission to the hospital.
Registered Nurse Mark Traves works at the Emergency Department of the hospital and is caring for
Hai. Hai has not said much about the incident, but opens up to Mark and tells him more about
himself, and what happened. Hai told Mark that he moved to Brisbane from far north Queensland, to
attend university in Brisbane. Hai’s family all live up north, except his older brother, Tim, who is 24-
years-old and is also studying/living in Brisbane. When Mark questioned Hai about what happened,
he said “I had to jump off the balcony, so I could get away from the intruders in my apartment”.
Mark tried to get more information about this from Hai, but he would not say anything further and
instead shuts the conversation down. Mark established that Hai lives alone.
After this conversation, Mark checks the records relating to Hai’s admission to the hospital. The
paramedics made no mention of intruders at Hai’s apartment, so Mark seeks some further information
about Hai’s medical history and background. Mark finds that Hai was recently undergoing
psychiatric care at the same hospital. After speaking with a psychiatrist, Mark confirms that Hai
experiences psychotic episodes which often result in hallucinations and/or delusions. The psychiatrist
confirms that a diagnosis of delusional disorder was previously made, but that, at the time of
treatment, Hai was not considered a risk to himself or others.
After discovering this information, Mark discusses Hai’s circumstances with a colleague, Dr Chin. Dr
Chin examines Hai and Hai tells her that she better be quick as the intruders are on their way, and that
they are “going to get him”. Dr Chin thinks that the incident leading to Hai’s injuries resulted from a
psychotic episode and that Hai is delusional. Dr Chin says to Mark that Hai should be treated for his
mental illness so that he can then be treated for his physical injuries. Dr Chin asks Mark to take the
steps necessary to treat Hai’s mental health.
Mark returns to follow up with Hai’s care and says that the team want to help him get well. Mark
tells Hai that he imagined the intruders at his apartment; that this is related to his hallucinations and
delusions. Hai becomes agitated and denies the possibility that he imagined the intruders, saying that
he has never experienced hallucinations before. Additionally, Hai tells Mark that he does not want
any kind of antipsychotic medication and wants to be discharged from hospital. Hai is adamant that
he is not delusional. Hai tells Mark that he has medical training that will enable him to take care of
himself (which, in fact, he does not), and that there are no complications or risks associated with his
injuries. Hai tells Mark that he is going to ask his friend to pick him up from the hospital. However,
before that happens, Tim (Hai’s brother) arrives and asks that the health care team provide any
necessary treatment that might help Hai’s psychological wellbeing.
Apply the ethical and legal decision-making framework to this problem so that you can advise
RN Mark Traves of any necessary steps to take that might enable the team to provide Hai with
care for his mental illness. When considering legal principles, ensure that your answer
addresses only the law outlined under the Mental Health Act 2016 (Qld) – do not consider the
Mental Health Act 2000 (Qld) or the transitional provisions. You do not need to address the
ethical and legal issues concerning the treatment of Hai’s physical injuries in your answer.
Answer:
Hai a 20 year old male patient who was brought to the emergency Department of Brisbane hospital. Hai was brought to the hospital by the paramedics after a bystander saw Hai jumping out from a first floor building’s balcony. He sustained some injuries in his arm where the doctors ruled out that his arm was broken. Hai remained quiet after his admission and the doctors were not sure where triggered the incident. A nurse who works in the emergency department Mark Traves was able to make Hai talk about himself. Hai lived alone as he was a student in Brisbane university .Hai has a big brother who also study in Brisbane but his parent lived up north in Queensland. Mark had a connection with the patient and he was able to make him open up. Hai told the nurse that there were intruders in the house so he needed to jump to escape. After this Hai did not say more which left Mark with so many unanswered questions. This made the nurse curious as he went to check for Hai’s records relating to his admission (Storch, 2013).
The paramedic indicated that they did not find any intruder in the house and this left so many question unanswered. Mark went on and checked Hai background and history in the hospitals records. Mark found out that he was a psychiatric patients at the same hospital. Mark spoke to his psychiatrist who told him that mark experience psychiatric episodes which makes him delusional at times. The doctor told Mark that Hai had gone through a diagnosis in the hospital and the doctors ruled out that Hai was not a threat to himself or others.Dr chin, Marks colleague run some test which indicated that Hai experienced a psychotic episode which made him dilutional.As the doctor run up the test Hai told Dr Chin to hurry up as the intruders were on their way. Dr. Chin advised Mark the nurse to first treat the mental illness so that he can the physical injuries can be treated. Mark consulted the patients as required by the mental health Act 200 that the patients should be informed of any procedure before it is executed (Maity, 2011).
Mark told Hai that he was experiencing some hallucinations and the intruder did not exist. Hai denied the claim saying he has never experienced any hallucinations in his life. He further told Mark that he did not want any psychotic medication and he insisted on been discharged from the hospital. He told the nurse that he would take care of himself since he had medical training of which he never did. According to the mental health act, if the patient is involuntary about the treatment and he is admitted to the authored mental health the patients automatically becomes a voluntary patient who can be detained at the authorized hospital for up to 24 hours. The hours could be extended up to 72 hours if the doctor find out that the patient is not fit to be discharged. The time is calculated form the time the patient was admitted in the hospital. Hai older brother also came to the hospital and he gave the doctor the go ahead to treat his brother. A family member also gave the doctor the go ahead to treat Hai (Galliers, 2012).
Mark before initializing the psychiatric treatment of Hai he should consider the ethics issues as a nurse treating a mental patient without his consent. The ethical issue are there to guide and direct the medical practitioner in the hospital. Some of the ethical issue that registered nurses should follow include maintaining the commitment to the client choices, consulting other medical practitioner in medical cases, advocating for safe and competent nursing care in the hospital, engaging in the development of practice standards ,issue statement and position papers on professional issue, working with colleagues to identify crucial ethical issue for professions, encouraging and facilitating cooperation and collaborations between professional and between agencies to effect improvement within the health care. Mark should consider the choices of the patients before proceeding with any medical procedure. Hai had denied any medical care and he even insisted of leaving the hospital. Brisbane is Hai hospital where Hai was a psychiatric patients undergoing the medical care in the hospital before the doctors ruled him out that hi was not a threat to him life or other people. Since he was undergoing through the treatment in the hospital, the hospital become his authorized hospital. In this case the hospital has the right to admit the patients for 24 hours to treat him and if he is not stable by 24 hour the hospital has the right to extend up to 72 hours. The doctor had the consent of Hai’s order bother who wanted Hail to recover .Following the law on mental health act 2000 Hai decision were overruled in this case. Mark has to consult with other medical practitioners to ensure he is following the ethical rules of the hospital. Mark has to follow the practice standards, position papers and the issue statement on professional issues like in this case. Mark has to involve doctor who treated him in the psychiatric session since he understand the case better. The outcomes of the patient had to be shared to his brother and other close family members (Chin, 2008).
Hai told the nurse that there were intruders in the house so he needed to jump to escape. After this Hai did not say more which left Mark with so many unanswered questions. This made the nurse curious as he went to check for Hai’s records relating to his admission. The paramedic indicated that they did not find any intruder in the house and this left so many question unanswered. Mark went on and checked Hai background and history in the hospitals records. Mark found out that he was a psychiatric patients at the same hospital. Mark spoke to his psychiatrist who told him that mark experience psychiatric episodes which makes him delusional at times. The doctor told Mark that Hai had gone through a diagnosis in the hospital and the doctors ruled out that Hai was not a threat to himself or others.Dr chin, Marks colleague run some test which indicated that Hai experienced a psychotic episode which made him dilutional.As the doctor run up the test Hai told Dr Chin to hurry up as the intruders were on their way. Dr. Chin advised Mark the nurse to first treat the mental illness so that he can the physical injuries can be treated. Mark consulted the patients as required by the mental health Act 200 that the patients should be informed of any procedure before it is executed. Mark before initializing the psychiatric treatment of Hai he should consider the ethics issues as a nurse treating a mental patient without his consent. The ethical issue are there to guide and direct the medical practitioner in the hospital. Some of the ethical issue that registered nurses should follow include maintaining the commitment to the client choices, consulting other medical practitioner in medical cases, advocating for safe and competent nursing care in the hospital, engaging in the development of practice standards ,issue statement and position papers on professional issue, working with colleagues to identify crucial ethical issue for professions, encouraging and facilitating cooperation and collaborations between professional and between agencies to effect improvement within the health care. Mark should consider the choices of the patients before proceeding with any medical procedure. Hai had denied any medical care and he even insisted of leaving the hospital (Xiao, 2014).
Brisbane is Hai hospital where Hai was a psychiatric patients undergoing the medical care in the hospital before the doctors ruled him out that hi was not a threat to him life or other people. Since he was undergoing through the treatment in the hospital, the hospital become his authorized hospital. In this case the hospital has the right to admit the patients for 24 hours to treat him and if he is not stable by 24 hour the hospital has the right to extend up to 72 hours. The doctor had the consent of Hai’s order bother who wanted Hail to recover .Following the law on mental health act 2000 Hai decision were overruled in this case. Mark has to consult with other medical practitioners to ensure he is following the ethical rules of the hospital. Mark has to follow the practice standards, position papers and the issue statement on professional issues like in this case. Mark has to involve doctor who treated him in the psychiatric session since he understand the case better. The outcomes of the patient had to be shared to his brother and other close family members (Alberta, 2009).
Since he was undergoing through the treatment in the hospital, the hospital become his authorized hospital. In this case the hospital has the right to admit the patients for 24 hours to treat him and if he is not stable by 24 hour the hospital has the right to extend up to 72 hours. The doctor had the consent of Hai’s order bother who wanted Hail to recover .Following the law on mental health act 2000 Hai decision were overruled in this case. Mark has to consult with other medical practitioners to ensure he is following the ethical rules of the hospital. Mark has to follow the practice standards, position papers and the issue statement on professional issues like in this case. Mark has to involve doctor who treated him in the psychiatric session since he understand the case better. The outcomes of the patient had to be shared to his brother and other close family members (Tschudin, 2012).
References
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