Mr. ard
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Mr. ard Document Transcript

  • 1. Legal Risk to Nurses ASHFORD UNIVERSITYLegal Risk to Nurses James A. Davis Jr. Dr. Cynthia Davis – MHA 622 Health Care Ethics and Law 6/20/2011
  • 2. Legal Risk to NursesAbstractThis paper will attempt to prove that Mr. Ard did not have a chance to survive because of lack ofsupervision by his nursing staff. We will further attempt to prove that the employer is responsiblefor the actions or non actions of its medical staff. The medical staff did not make appropriaterounds and they did not provide the proper care that one would require and need in a medicalsetting. Communications between the patient and staff did not take place until Mr.Ard was neardeath. Mrs. Ard rang the bell for nearly a two hour period of time and no help came to assistanceof Mr. Ard. Where were the nurse, were they asleep or were they off duty? These questions willbe answered during this paper. 1
  • 3. Legal Risk to NursesIntroduction We will attempt to answer some very basic questions about a case that took place on May20, with a patient by the name of Mr. Ard. This patient was in pain and had a shortness ofbreathe; he was given medication for nausea. It seems to me that this patient needed somethingfor his pain and shortness of breathe. There appears to be a problem with the response time of themedical personnel. After, Mr. Ard was given something for his nausea, he was not checked on byany of the medical staff to determine if he was doing any better. Based on the testimony of Mrs.Ard her husbands condition became worse and it lead to his death (Ard vs. East Jefferson Gen.Hospital, 1994). The question then becomes what took place doing this incident and could it have beenprevented if staff would have responded appropriately? 1. What happened? 2. Why did things go wrong? 3. What were the relevant legal issues? 4. How could the event have been prevented? 5. What is your verdict During this paper we will attempt to answer all of these very vital questions for the reader.What happened? There was a failure to communicate and a failure to supervise the patient.Nursingdocumentation has been stigmatized as burdensome, excessive, and of little use or interest toothers. It is not surprising that practicing RNs view documentation as a low priority (AmericanNurses Association (2001). In, this case there was very little documentation of the patient’scondition and the rounds that needed to be made to ensure that he was getting the medical 2
  • 4. Legal Risk to Nursesattention that he needed. It would seem to me that if a patient wo has his attention bell ringing formore than an hour an half, someone would have heard it. As outcome-based measures ofperformance become increasingly adopted in healthcare, accurate and comprehensivedocumentation of nursing practice must be essential to maintaining and increasing nursingsinfluences within institutions and in health policy decisions. Nurses need to resist the eliminationof comprehensive nursing documentation for a short-term gain, but a long term loss.Documentation is a critical component of nursing practice, not an afterthought (American NursesAssociation (2001).Why did things go wrong? Things might have gone wrong because there may have been an omission in the patient’shealth care plan of him being a high risk patient. If, he was high risk he should have been in ahigh risk area. There are potential legal risks to the exclusion of documentation or the adoptionof new documentation methods. Again, the comprehensiveness of nursing documentation and itsrelevance to the clients health are critical. None of these areas were seen as a priority in thiscase. With the emergence of methods such as "charting by exception," nurses face increased riskof not having the evidence they might need to defend themselves in the event of legal actions, asin this case.What were the relevant legal issues?Whenever, a practitioner fails to make use of available information in the case of Mr.Ard there isa very high risk of being sued. This is especially true when making practice decisions. Forexample, if nursing decision-supportsare available, and a nurse does not use it, and an incorrectdiagnosis or intervention plan is made, there is potential liability. When there is access toscientific knowledge bases that would improve the accuracy of the practitioners clinicaldecisions and the nurse does not access those knowledge bases, there is greater legal risk in the 3
  • 5. Legal Risk to Nursesevent of an incorrect and harmful decision. All of these issues were disregarded and in ouropinion helped to cause his death. The assigned nurse was Ms. Florscheim who did not perform afull assessment of Mr. Ard, s status after he vomited. This action was in direct violation of anurse’s policies and procedures. A test to determine if the patient could swallow was not doneand documentation was done to rule out this as being a concern. Proper care was not a concern inthis case. There is an expectation of standard care whenever patients are in the care and custodyof professionals (American Nurses Association. "Nursing Facts: Todays Registered Nurse -Numbers and Demographics" Washington, D.C., American Nurses Association, 2006).Could it have been prevented? Yes, there is no doubt that the patient could have been given better care. If, he would havelived out the night is another question. Was it his time to leave this world and would he havedied of something else? We will never know. But, what we do know is that he did not get thecare that he needed.ConclusionAn attempt to answer some very basic questions about a case that took place on May 20, with apatient by the name of Mr. Ard. This patient was in pain and had a shortness of breathe; he wasgiven medication for nausea. It seems to me that this patient needed something for his pain andshortness of breathe. There appears to be a problem with the response time of the medicalpersonnel. After, Mr. Ard was given something for his nausea, he was not checked on by any ofthe medical staff to determine if he was doing any better.Based on the testimony of Mrs. Ard herhusbands condition became worse and it lead to his death.Nurses need to resist the elimination ofcomprehensive nursing documentation for a short-term gain, but a long term loss. 4
  • 6. Legal Risk to NursesDocumentation is a critical component of nursing practice, not an afterthought.When there isaccess to scientific knowledge bases that would improve the accuracy of the practitionersclinical decisions and the nurse does not access those knowledge bases, there is greater legal riskin the event of an incorrect and harmful decision. All of these issues were disregarded and in ouropinion helped to cause his death. The assigned nurse was Ms. Florscheim who did not perform afull assessment of Mr. Ard, s status after he vomited. This action was in direct violation of anurse’s policies and procedures. A test to determine if the patient could swallow was not doneand documentation was done to rule out this as being a concern. Proper care was not a concern inthis case. There was an expectation of standard care whenever patients are in the care andcustody of professionals. There is no doubt that the patient could have been given better care. If,he would have lived out the night is another question. Was it his time to leave this world andwould he have died of something else? We will never know. But, what we do know is that he didnot get the care that he needed. The court was right to find in favor of Mrs. Ard. References 1. American Nurses Association (2001). ANA workplace health and safety guide for nurses: OSHA and NIOSH resources. Washington, D.C. ANA Publishing. 2. American Nurses Association (2001). Code of ethics for nurses with interpretive statements. Washington, D.C. ANA Publishing. 3. Ard vs. Jefferson General Hospital, 636 So. 2d 1042 (la. Ct. App. 1994) 4. American Nurses Association. "Nursing Facts: Todays Registered Nurse - Numbers and Demographics" Washington, D.C., American Nurses Association, 2006. 5