Identify and explain at least three legal considerations.
- death due to improper medication
weak disaster preparedness plan
The main issue in this case is the snow storm. Is it the hospital's responsibility to maintain the level of care that they had previously promised when a natural occurrence causes a lack of staff? According to Medicare law and the World Health Organization, both agencies which protect the rights of healthcare professionals and patients, the hospital is responsible (WHO, 2009). The hospital was adequately staffed, albeit with staff who had worked on the previous shift. The nurses may have been tired, but they were supplemented by fresher staff members. There were adverse circumstances due to the storm, but the courts would look at the staffing of the hospital and see that these accidents could have been avoided.
The people who fell from their beds could either have been more closely monitored, or in some mechanical way been more safely quartered. What were they in the hospital for in the first place? Was it common for them to fall out of bed? Should they have been watched more closely than they were by the hospital staff? This could be a case of negligence, but these questions need to be answered by the courts. There are ways to make sure that people do not fall out of bed such as mechanical restraints or raised bed rails (Tabak, 1996). The hospital's statement that the people had no issues that would cause them to be watched more closely is a not valid. The procedures performed and medications given will incapacitate patients formerly able to ambulate easily.
Of course, the most serious issue is that a patient died due to a medication being improperly ordered. Fault for the death may be a more convoluted issue than the falls. The doctor could have accidentally ordered the wrong medication. The RN who was to administer the medication could have been hurried because of the staffing problems and given the wrong medicine. The problem could also have arisen as a result of a poor disaster preparedness plan. With the administrator away, there would have been a hierarchy established in case of emergency. The nurse on duty, may be at fault because she chose a critical time to leave, but the weight of the decision could also have resulted from the preparedness plan. When a medical professional is at fault in a case such as this, the proper medical board will conduct an investigation (Overdose Law, 2010). In a case this dire, there would also be action taken by the district court to determine fault and restitution.
2. Identify and explain at least three ethical considerations.
- do no harm
- ethical responsibility of care
Ethics is an issue that is clearly defined when a nurse or doctor passes their national boards and is licensed. Every licensing agency has a code of conduct that they expect licensees to adhere to, and the medical professions are no different. Of course, doctors take the Hippocratic oath the main element of which is to do no harm (North, 2002). Nurses are also tasked with this guideline as are all who work in helping professions. This, then, is the main ethical consideration for the hospital to consider. Did the hospital truly "Do no harm" when they made nurses stay late to look after patients and did not determine some way to get fresh staff into the hospital? Was there a way that they could have better used the personnel that were available to them rather than using exhausted staff? The do no harm question is the largest ethical dilemma that they faced.
Second, the hospital is the responsibility of the administrator. Should he or she have been away when there was the potential in the region for such an event. The staff that was at the hospital does not have as much clout as the administrator. Ethically the administrator has an obligation to all who expect treatment from the hospital. There is an unwritten contract between the two parties. On the patient's side, they say that they will pay for services that are received. The hospital agrees to provide those services. This contract was not fulfilled by the hospital.
Another potential ethical issue is that the hospital was not prepared for such an emergency. Again, the hospital has obligation to the patients that they will be taken care of to a certain standard. If this standard is not met, whether there is a legal question or not, the hospital has not met its part of the bargain. The staffing was a problem because weather reports are such that the hospital had to know at least two or three days ahead of time that a large storm was coming. The hospital should have overstaffed for this eventuality. If the storm did not happen, then they could allow people to leave early. Since the storm did happen, the hospital would have been properly staffed for the emergency. Unfortunately, they did not have the foresight, and the hospital is now suffering through the lawsuits.
Finally, a nurse, who is tasked with the immediate care of patients, should not leave his or her post. The nurse who left to go to Wendy's may not be at legal fault for any reason. However, a nurses first responsibility is to the patients.
3. Identify and explain at least three professional considerations.
- medication distribution
- nursing negligence
- hospital negligence
The hospital would have at least three professional bodies which governed at least some of what the hospital itself and the health professionals did. The American Medical Association (AMA) has governance over the doctors. The nurses are governed by a similar nursing association and the hospital is also governed by a state licensing organization which grants the operation of the facility.
The doctors who worked in the hospital may not have been available during the storm, but they have the obligation to make sure that their patients are properly cared for. Professionally, it may be seen as the doctors fault that a medication allergy was not identified.
The nurses are under the same strictures as the doctors to make sure that they do no harm. Therefore, the patients who fell out of bed were still the responsibility of the nursing staff even though they were supposedly completely able to care for themselves. The nursing staff is professionally required to monitor the patients and assume control of all elements of their care. A patient received the wrong medication and several patients fell from their beds. If the resulting injuries are proved to have been incurred due to negligence the nurse(s) responsible could lose their licenses.
For the hospital's part, they are professionally obligated to provide the best possible care of their patients (Walker, 2002). They can lose their license if there is any question as to their culpability in either the death or the falls. Hospitals are also rated, and the hospital could suffer financially if patients see that the hospital has received a low rating.
4. Identify and explain at least three business and reputational considerations
- loss of business
- loss of reputation
This may be the most damaging to the hospital. Reputation is the only way that these institutions are able to attract patients and keep the doors open. The only way that the hospital could survive something like this is if they can win in court and prove they were not negligent. People still may go to another hospital even if it is out of the way if this hospital is found.
The business aspect is not helped by the fact that the administrator was away from the hospital during a period of the year when…