Nurse Practice Act: Permitting Linda to Work in ICU & Professional Negligence - Essay Sample

Introduction

The nurse practice act permits Linda to work in the intensive care unit, mainly because the patient has a history of schizophrenia. Nonetheless, if the health practitioners fail to act according to their professional ethics, or if they do not predict the magnitudes that other healthcare providers with essential skills and knowledge ought to anticipate, then they are responsible for a tort of malpractice or professional negligence (Ottenwess et al. 2011). A tort of carelessness or negligence in health practice is a medical wrong that leads to injuries that can make the victim sue the wrongdoer to seek money damages (Ottenwess et al. 2011). Linda must not have agreed to practice in the intensive care unit if had no training on telemetry.

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Does the ability to practice legally in an area differ from the ability to practice competently in that area?

Although the nurse practice act permits a nurse to work in a department like the intensive care unit, it is not apparent that the nurse could practice competently and safely. Nurses should be trained in specific areas like management of patients in an intensive care unit. Combination of various healthcare information is vital because it can be incorporated in different nursing practice and decision making. Nurses should have regular training for continuous provision of direct care and protection of patient's lives. Proper training is critical for nurses to enhance their competency and use their skills in day-to-day routines. Competency provides the capability to work efficiently during emergencies (Fukada, 2018). If Linda had training on the telemetry, she could have operated it competently in Corey's absence. Competent nurses can use their traits, skills and knowledge to every situation they are assigned to. A nurse can have the ability to practice legally but lack competency due to its complexity.

Did Linda have any legal or ethical grounds to refuse the assignment to the intensive care unit?

Linda has ethical and legal responsibility to refuse the assignment to the ICU unit, especially if it concerns the safety of a patient. The authority for this kind of refusal can be accessed in various ethical publications such as Scope of Nursing Practice in the American Nurses Associations Guideline (ANA, 2019). Linda should have followed the process or policies offered by the hospital to guide her on how to deal with the situation. For instance, the process indicates the place to raise the concern, the circumstance where she cannot leave the assignment, and when the concern needs to occur. If a nurse is allowed to leave the assignment, he or she must stay or even take care of the patient until another nurse is assigned to the task. This is to ensure that the patient is not at risk of complication. Nurses must communicate the different types of safety issues because they can be accused of negligence if they fail to communicate. The ethical codes support the nurses who clearly state their knowledge limits. Nurses should practice in the restriction of their competency; hence, if an assignment is above their ability, the nurses should acquire more knowledge from the supervisor/ skilled health provider or request a different task (Hawkes, 2017)

The risks in accepting an assignment in an area of speciality in which a nurse is professionally unprepared to practice.

The patient that unprepared nurse is taking care of is at risk of more complications. Also, the nurse is at risk of losing the license of being a registered nurse. A nurse owns the consequences that occur to a patient if he or she accepts responsibility to practice in the area of less competency (Barloon, 2013). Linda should have stated the fact that she lacks knowledge of caring for patients in the intensive care unit. To make sure that the patient is safe in Corey's absence, a more experienced nurse should be provided to supervise and monitor the sick person's telemetry until Corey comes back. Additionally, Corey should not have gone for a break if Linda had told her she is not competent in handling the telemetry.

Would there have been any way for Linda to minimize the risk of retaliation by the employer had she refused the assignment?

If Linda was unprepared to practice in the ICU, it was her duty to inform the management. The refusal of unsafe assignment does not jeopardize the license of a nurse, but it provides patients with opportunities to have quality health care. If Linda refused the task, the employer could have searched for a nurse with experience in monitoring the patient's telemetry; thereby, preventing the patient's brain damage. Healthcare practitioners must prefer the wellbeing of a patient over the employer's retaliation (Fukada, 2018). Linda experienced an ethical dilemma between keeping quiet and telling the truth about her lack of ICU skills because she feared retaliation from her boss. However, the patient's welfare should be the priority to maintain the integrity of their career. The American Nurses Association position statement accurately indicates that RNs have a legal right to accept or refuse assignments that can harm a patient due to lack of enough knowledge (ANA, 2019).

If Linda is negligent, is the hospital liable for any harm to the patient caused by her?

Linda and Corey are liable for causing permanent brain damage to the patient. Also, Corey, the nurse who left Linda alone with the sick person, is responsible for the harm caused because she left the incompetent nurse who does not know how to operate telemetry. Lack of communication is among the significant negligence that leads to malpractices. Corey is negligent because she left untrained nurse to take her break. Therefore, the patient can sue Corey because Linda was working under her supervision. The hospital is responsible because it has not offered enough training regarding the monitoring of telemetry. In the legal theory of respondent superior, the hospital is typically liable for harm caused by nurses' negligence (Barloon, 2013). In this situation, Linda is working in the hospital; hence, the patient can sue the hospital for the damage caused. However, the patient can fail to sue the hospital if the nurse was working under the supervision of a doctor or another nurse.

References

Barloon, L. F. (2013). Legal aspects of psychiatric nursing. The Nursing clinics of North America, 38(1), 9-19. DOI: https://doi.org/10.1016/S0029-6465(02)00060-9

Fukada, M. (2018). Nursing competency: Definition, structure and development. Yonago acta medica, 61(1), 001-007. doi: 10.33160/yam.2018.03.001

Hawkes, B. (2017, August 1). Reasons for Refusing a Patient Assignment. Retrieved from http://nursecode.com/2015/02/reasons-refusing-patient-assignment/

Nursing Scope of Practice: American Nurses Association. (2019). Retrieved from https://www.nursingworld.org/practice-policy/scope-of-practice/

Ottenwess, D. M., Lamberti, M. A., Ottenwess, S. P., & Dresevic, A. D. (2011). Medical malpractice tort reform. Radiol Manage, 33(2), 30-35. https://www.thehealthlawpartners.com/files/rm332_p30-36_features.pdf