Exemplification Essay on Legal, Ethical, and, Professional Issues for the Nurse

Introduction

Bellenger et al. (2017) claim that the physical restraint of a patient is one of the hotly debated matters within health care organizations. Some view it as a breach of an individual right, while others are perceived it as a measure to mitigate the risks posed by an aggressive patient. In the correctional background, the patient is at the heart of the nursing practice. The fact that a patient is restrained is only a condition of his/ her circumstances and does not and should not change how the nurses view patients. Correctional nursing permits a nurse to practice the principle of nursing while acknowledging that all patients have intrinsic value. Attaining and staying true to nursing professional while practicing in the correctional background can generate an exclusive set of legal, ethical, and, professional issues for the nurse.

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Risk and Mitigation Technique used by the adopted by the Hospital

The plaintiff (patient) was admitted to the ER where the staff knew him very well. The patient was a risk to himself and the staff because he was intoxicated and very aggressive. His situation restricted the nurse on duty from completing a preliminary review, and, 4-point restraints (ankle and wrist) were used to maintain the safety of both the patient and staff. In compliance with hospital protocol, the nurse sought the help of hospital security to utilize the limitations, this included checking if the patient was in possession of contraband. Later the nurser transferred the patient to a silence and isolated to reduce the stimulation and help him calm down and provide room for them to complete the assessment and accord him the necessary care. According to the hospital policy, the patient was to be assessed and monitored in isolation every 15 minutes for safety purposes. The nurse did all checks except the one where she was caring for a patient in critical condition. Weiss et al. (2016) assert that the ethical principles of nursing require the call for the need of doing good to the patient, by excluding the check that placed the patient at more risk is considered doing good on this occasion. She did documentation for all the checks and assessment information, including the missed one, and provided reasons why she missed it in the patient' s chart.

Actions that could have improved the outcome

The nurse could have considered the following as recommended by Cherry and Jacob (2016) to control an aggressive patient within a health care setting

utilization of patient physical restraint under doctor orders when clinically suggested protecting a patient from hurting themselves or others and file medical outcome that occasioned in the use of the restraint.

Applying and observing physical patient restriction as ordered, by patient requirements and in line with national guidelines, values of practice and institution policy and procedure.

carry out contraband exploration in adherence with institution strategy to ensure the welfare of patients at risk of harming themselves or others.

Maintaining controlled patients in an orderly surrounding to enable a quiet, calm environment for the patient and to inhibit interaction with non-staff who may present contraband or dangerous things to the patient. conduct recurrent checking and clinical valuation of controlled patients or those who are otherwise supposed unsteady and/or a threat of harming to themselves or others in agreement with the patient's situation, patient care orders, national guidelines, and, institution policies and procedure.

File all patient detecting, valuation, and, medical results.

File any difference in patient observations and valuation procedure and comprising the evaluation of results upon continuation of the observing and clinical valuation protocol.

Conclusion

The patient-centered concept is pushing ethical concern to the forefront since nurses are ethically required to ensure patient's right is not exposed to danger. As much as every patient are guaranteed self- determination right; this right is not applicable when patient him/ herself is in the position of causing damage not only to him/ herself but also to others. Moreover, there are few conditions/ situation may require a nurse as placing a patient in a restraint, who may feel he/ she is being denied his/ her liberty. This is applicable where restraining a patient can be the only effective risk management, nurses have no otherwise but to purse with the practice.

Reference

Bellenger, E. N., Ibrahim, J. E., Lovell, J. J., & Bugeja, L. (2017). The Nature and Extent of Physical Restraint-Related Deaths in Nursing Homes: A Systematic Review. Journal of aging and health, 0898264317704541.

Cherry, B., & Jacob, S. R. (2016). Contemporary nursing: Issues, trends, & management. Elsevier Health Sciences.

Weiss, S. M., Malone, R. E., Merighi, J. R., & Benner, P. (2016). Economism, efficiency, and the moral ecology of good nursing practice. Canadian Journal of Nursing Research Archive, 34(2).