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What are the legal ramifications of this care?

January 20, 2022
Christopher R. Teeple

Critical Thinking, Ethics and Legal Nursing: Assignments
1. Who is responsible for harm to this patient? You decide.
You are a surgical nurse at Memorial Hospital. At 4pm, you receive a patient from the recovery room who has had a total hip replacement. You note that the hip dressings are saturated with blood but are aware that total hip replacements frequently have some postoperative oozing from the wound. There is an order on the chart to reinforce the dressing as needed, and you do so. When you next check the dressing at 6pm, you find the reinforcements saturated and drainage on the bed linen. You call the physician and tell her that you believe the patient is bleeding too heavily. The physician reassures you that the amount of bleeding you have described is not excessive but encourages you to continue to monitor the patient closely. You recheck the patient’s dressing at 7 and 8pm. You again call the physician and tell her that the bleeding still looks too heavy. She again reassures you and tells you to continue to watch the patient closely. At 10pm, the patient’s blood pressure becomes nonpalpable, and she goes into shock. You summon the doctor, and she comes immediately.
Assignment: What are the legal ramifications of this care? Using the components of professional negligence, determine who in this case is guilty of malpractice. Justify your answer. At what point in the scenario should each character have altered his/her actions to reduce the probability of a negative outcome?
Instructions for all short answer questions.
Please respond using double space, font 12. Identify references used.
2. Mrs. Brown’s chart
Mrs. Brown has been diagnosed with invasive cancer. She has been having daily radiation treatments. Her husband is a frequent visitor and seems to be a devoted husband. They are both interested in her progress and prognosis. Although they have asked many questions and you have given truthful answers, you know little because the physician has not shared much with the staff. Today, you walk into Mrs. Brown’s room and find Mr. Brown sitting at Mrs. Brown’s bedside reading her chart. The radiation orderly had inadvertently left the chart in the room when Mrs. Brown returned from the X-ray department.
Assignment: Identify several alternatives that you have. Discuss what you would do and why. Is there a problem here? What follow-up is indicated?
3. To Float or Not to Float
You have been an obstetrical nurse for 25 years. The OB unit census has been
abnormally low lately, although the patient census in other areas of the hospital has been extremely high. When you arrive at work today, you are told to float to the thoracic surgery critical care unit. This is a highly specialized unit, and you feel ill prepared to work with the equipment on the unit and the type of critically ill patients who are there. You call the staffing office and ask to be reassigned to a different area. You are told that the entire hospital is critically short staffed, that the thoracic surgery unit is four nurses short, and that you are at least as well equipped to handle the unit as the other three staff who are also being floated. Now your anxiety level is even higher. You will be expected to handle a full RN patient load. You also are aware that more than half of the staff on the unit today will have no experience in thoracic surgery. You consider whether to refuse to float. You do not want to place your nursing license in jeopardy, yet you feel conflicting obligations.
Assignment: To who do you have conflicting obligations? You have little time to make this decision. Outline the steps that you use to reach your final decision. Identify the legal and ethical ramifications that may result from your decision. Are they in conflict?
Who is liable for the intentional torts of hospital staff?
4. FACTS: A female patient was admitted to a hospital ICU in a diminished mental and physical condition. She claimed that the medications she was given keep her in an impaired mental state. She alleged that while in the ICU in this diminished capacity, she was sexually assaulted by a male registered nurse. The patient sued the hospital for assault, battery, and intentional infliction of emotional distress. Although the patient could have named the assailant in this case, the plaintiff did not sue him.
Is the hospital liable as the employer?
What is the difference between assault and battery?

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