Legal and Ethical Cases in Nursing Assessment

Legal and Ethical Scenarios in Nursing: A Discussion
Part One
Yes, one can conclude that the lack of documentation in the admitting nurse’s assessment and notes did have an impact on the ultimate outcome of the case. It demonstrates that there was a gap in recording-keeping and this impeded the clarity and accuracy of patient information. This information could potentially have saved this patient’s life and been able to redirect the type of care that he received.
One can conclude without at a doubt that there was in fact negligence on the part of the nursing staff in the care of this patient. The testimony of the wife is very clear in demonstrating this negligence. She reached out to the nurse at 3:22pm and “The nurse… informed her that the doctor was aware of the patient’s breathing pattern and that there was nothing about which she should worry. The nurse did not leave the nursing station” (Guido, 2014, 185). This is in direct contradiction to the nurse’s testimony that “she had called the surgeon immediately to report that the patient’s respiration were 50, that she had taken vital signs that were within the normal limits for this patient, and that she had obtained a pulse oximeter reading that was acceptable. She also testified that she kept calling the physician’s office to report these findings” (Guido, 2014, 185). Based on these two very different accounts, it is clear that one of the people involved in this incident is lying. Since the patient outcome was so negative and so tragic, it is most likely the nurse who is lying and covering up her negligence, as she appears to describe actions she should have taken and could have taken, but did not in actuality take. Had the nurse been as on top of things as she claims to be, then the patient might have survived this incident. Further proof that the nurse is lying and covering up her own negligence is the testimony of the nurse in the surgeon’s office, who testified that a call was received from the hospital at 4:00pm, and that the surgeon then made haste to the hospital. Not only had the nurse been misrepresenting the truth to the patient’s wife, as she had not spoken to the doctor about the patient’s breathing any time soon, she then waited 38 minutes before reaching out to the surgeon. This is clear, doubtless negligence. Had the nurse done everything she had claimed to have done during her testimony (but did not), the patient might have survived. I would decide this case by putting complete and total guilt and negligence on the nurse.
Part Two
Many of the provisions were located in the sample professional liability insurance policy. Some of them were definitely more difficult to find than others. This would not be an example of a professional liability insurance policy that I would want to purchase. The main reason for this is that there’s no coverage for the costs incurred for legal defense, if counsel is needed. In the case of litigation, hiring legal counsel is one of the most expensive costs incurred—the costs can be staggeringly high. There’s no point in having professional liability insurance if this isn’t properly covered.

Part Three
The provisions of an insurance policy that I would consult to determine if an insurance company would pay such a claim would be the individual professional liability sections, along with the exclusions to such a section. In addition, I would also check the limits of liability section of well.
One could argue that the insurance company is incorrect in arguing that this is a professional judgment issue. The case clearly states that this occurred during a heat wave. By definition, a heat wave is a dangerous weather phenomenon. Refusing to turn on the air conditioner during a heat wave is like refusing to board up the windows during a hurricane. According to the government science website, which explains that heat wave are an extreme weather phenomenon because they are the result of trapped air that hangs out above a continents. The last example of an extremely hot time was in “late June and early July 2012 in the United States. During that time period, more than 8,000 warm temperature records were broken or tied. Many of these records had been unchallenged since the 1930s. Roads actually buckled in Chicago. Many deaths were attributed to the heat nationwide” (scijinks.gov, 2018). Hence one can conclude that this is an obvious common sense issue, for which the administrator and the nursing home insurance company are liable.
Hence, because this is a clear common sense issue the liability is shared: it falls on both the nursing home and the administrator of the nursing home, if she has coverage. This issue is not within the realm of “professional judgment.” This decision was so egregious that it should impact all involved insurance companies. Finally, yes, the physician was neglectful in this case: any person with a working brain should have the basic sense and decency to turn on the air conditioning during a severe and dangerous weather related event. Just as anyone with common sense would shut the windows and turn on the heat during a blizzard, the same needs to be true during a heat wave. For an insurance company to deny coverage in the name of saying this falls under the gray area of professional judgment is absurd and a violation of policy. Any person who was also involved in enabling this incompetent administrator in such an egregious decision needs to also bear liability.



























References
Guido, G. W. (2014). Legal and ethical issues in nursing.
Scijinks.gov. (2018, May 16). NOAA SciJinks :: What is a Heat Wave? Retrieved from https://scijinks.gov/heat/