No less than 450 words and demonstrate course-related knowledge and research. Each reply must be supported by at least 1 scriptural reference and at least 4 scholarly references other than the textbook. Current APA format must be used for citations. Pozgar, G. D. (2016). Legal aspects of health care administration (12th ed.). Burlington, MA: Jones & Bartlett. Response from student # 1 Nursing is a very important part of health care. There are many different types of nurses that have vastly different jobs and levels of education. The roles and responsibilities of different types of nurses can vary significantly, but one thing that does not change is that all nurses faces legal and ethical issues in the work place. Some of the various types of nurses include Registered Nurses, traveling nurses, Licensed Practical Nurses, nurse managers, Certified Nursing Assistants, float nurses, agency nurses, special duty nurses, student nurses, Nurse Practitioners, Clinical Nurse Specialists, Certified Nurse Anesthetists, and Certified Nurse Midwives (Pozgar, 2016, pg. 263-268). Depending on the specific title a nurse has, that nurse will face different legal and ethical issues. Registered nurses are nurses that have graduated from an accredited program and have passed an exam called the National Council Licensure Examination-RN (NCLEX-RN). Registered nurses face many ethical issues every day in the work force. These ethical issues range from meeting patient needs, to maintaining confidentiality, and effective communication (Ulrich, et. al., 2010). “Today's healthcare environment is demanding for nurses at a time when there is a critical shortage of staff to meet the multifaceted needs of patients” (Ulrich, et. al., 2010). A nurse manager, also known as the Chief Nursing Officer (CNO), is a registered nurse that has substantial experience and thus more responsibilities and authority. Chief Nursing Officers have “administrative authority, responsibility, and accountability for the function, activities, and training of the nursing staff” (Pozgar, 2016). These nurse managers are responsible for creating standards that other nurses are required to follow such as standards of practice, policies and procedures, and developing training and orientation programs for new hires (Pozgar, 2016). In addition, these nurses are also responsible for staffing, making recommendations, and coordinating nursing services and patient services (Pozgar, 2016). As a manager, these nurses are required to provide oversight and supervision of their staff. In the text, Pozgar (2016), mentions failure to supervise as an example of a legal issue that a chief nursing officer might face. If a nurse manager knowingly does not supervise the performance of an employee that they are supervising they can be held liable if a patient is injured. Additionally, the chief nursing officer can also be held liable if they allow a staff member to do a job that they know is above the competence of the n ...

1. No less than 450 words and demonstrate course-related
knowledge and research. Each reply must be supported by at
least 1 scriptural reference and at least 4 scholarly references
other than the textbook. Current APA format must be used for
citations.
Pozgar, G. D. (2016). Legal aspects of health care
administration (12th ed.). Burlington, MA: Jones & Bartlett.
Response from student # 1
Nursing is a very important part of health care. There are many
different types of nurses that have vastly different jobs and
levels of education. The roles and responsibilities of different
types of nurses can vary significantly, but one thing that does
not change is that all nurses faces legal and ethical issues in the
work place.
Some of the various types of nurses include Registered Nurses,
traveling nurses, Licensed Practical Nurses, nurse managers,
Certified Nursing Assistants, float nurses, agency nurses,
special duty nurses, student nurses, Nurse Practitioners, Clinical
Nurse Specialists, Certified Nurse Anesthetists, and Certified
Nurse Midwives (Pozgar, 2016, pg. 263-268). Depending on the
specific title a nurse has, that nurse will face different legal and
ethical issues.
Registered nurses are nurses that have graduated from an
accredited program and have passed an exam called the National
Council Licensure Examination-RN (NCLEX-RN). Registered
nurses face many ethical issues every day in the work force.
These ethical issues range from meeting patient needs, to
maintaining confidentiality, and effective communication
(Ulrich, et. al., 2010). “Today's healthcare environment is
demanding for nurses at a time when there is a critical shortage
of staff to meet the multifaceted needs of patients” (Ulrich, et.
al., 2010).
A nurse manager, also known as the Chief Nursing Officer
(CNO), is a registered nurse that has substantial experience and

2. thus more responsibilities and authority. Chief Nursing Officers
have “administrative authority, responsibility, and
accountability for the function, activities, and training of the
nursing staff” (Pozgar, 2016). These nurse managers are
responsible for creating standards that other nurses are required
to follow such as standards of practice, policies and procedures,
and developing training and orientation programs for new hires
(Pozgar, 2016). In addition, these nurses are also responsible
for staffing, making recommendations, and coordinating nursing
services and patient services (Pozgar, 2016).
As a manager, these nurses are required to provide oversight
and supervision of their staff. In the text, Pozgar (2016),
mentions failure to supervise as an example of a legal issue that
a chief nursing officer might face. If a nurse manager
knowingly does not supervise the performance of an employee
that they are supervising they can be held liable if a patient is
injured. Additionally, the chief nursing officer can also be held
liable if they allow a staff member to do a job that they know is
above the competence of the nurse performing the task (Pozgar,
2016).
Liability is not the only thing that a chief nursing officer has to
worry about if they fail to supervise their staff. Nurse managers
can also receive disciplinary action from their state regulatory
agency for inappropriate conduct (Pozgar, 2016, pg. 264). One
example of a nurse manager’s failure to supervise turning into a
legal issue is the case of Hicks v. New York State Department
of Health (Pozgar, 2016).
Certified Nursing Assistants work under registered nurses or
Licensed Practical Nurses. These assistants do a lot of physical
work, such as moving the patients, turning the patients, and
lifting the patients. Certified Nursing Assistants also conduct
various tests and provide some treatments (Pozgar, 2016 pg.
264).
Certified Nursing Assistants can face many different legal
issues if they do not act appropriately. When Certified Nursing
Assistants do not adhere to policy patients can be injured.

3. Pozgar (2016, pg. 265), provides various examples of cases
where certified nursing assistants have cause patients harm or
death by not following policies. Examples of such include
Ovitz, who died after a certified nursing assistant prepared a
bath for a paralyzed patient who could only speak to words.
This nurse did not check the temperature of the water even
though he was aware that the thermostat on the water heater was
not working properly and exceeding the temperature policy for
bathing. The patient obtained third degree burns, pneumonia,
and eventually died (Pozgar, 2016, pg. 265). Another example
includes the case of Bowe v. Charleston Area Medical Center,
where an assistant helped a patient to the toilet and left him
there unattended for ten minutes. When the nursing assistant
returned the patient was lying on the floor in a pool of blood
(Pozgar, 2016, pg. 265).
Certified Nurse Midwives are registered nurses that have
completed additional graduate level training in midwifery. This
training is approved by the Accreditation Commission for
Midwifery Education, also known as ACME (Walker, et. al.,
2014). These nurses provide prenatal care for pregnant women
who are low risk. In the absence of complications these
midwives can deliver babies, provide post-partum care, and
newborn care (Pozgar, 2016, pg. 268).
There are many ethical issues that surround obstetrics and
midwifery care. Some ethical issues that involve midwifes
include new diagnostic tests, screening options, and treatments
for women who are considered advanced reproductive age
(Sharp, 1998).
Since nurses need to be licensed as midwives to provide
prenatal care as Certified Nurse Midwives individuals can face
legal issues if they provide midwifery care if they are not
licensed. Pozgar (2016), mentions a case where a nurse was
providing prenatal care a “lay midwife” while she was not
licensed as a Certified Nurse Midwife. This nurse lost her
nursing license and was required to pay a $2,500 fine.
It is apparent that nurses face many different legal and ethical

4. issues in their profession. The Bible is clear that we, as
Christians, are to follow the laws that are set forth for us.
Romans 13:1-5 tells us “Let every person be subject to the
governing authorities. For there is no authority except from
God, and those that exist have been instituted by God.
Therefore, whoever resists the authorities resists what God has
appointed, and those who resist will incur judgment. For rulers
are not a terror to good conduct, but to bad. Would you have no
fear of the one who is in authority? Then do what is good, and
you will receive his approval, for he is God's servant for your
good. But if you do wrong, be afraid, for he does not bear the
sword in vain. For he is the servant of God, an avenger who
carries out God's wrath on the wrongdoer. Therefore, one must
be in subjection, not only to avoid God's wrath but also for the
sake of conscience.”
We are called to follow the authorities that have been appointed
over us. God tells us that we need to subject ourselves to those
governing authorities and do what we are supposed to do. If we
are acting in a way that is good and right there is no reason for
us to fear. This can be applied to the nursing profession, our
daily lives, and any other profession that a person may have.
References
Kafulafula, U., Hami, M., & Chodzaza, E. (2005). The
challenges facing nurse-midwives in working towards Safe
Motherhood in Malawi. Malawi Medical Journal: The Journal of
Medical Association of Malawi, 17(4), 125–127.
Pozgar, G. D. (2016). Navigate 2 Premier Access for Legal
aspects of health care administration (12th ed.). Burlington,
MA: Jones & Bartlett. ISBN: Book + Access: 9781284120110.
Sharp, E. (1998). Ethics in reproductive health care: a
midwifery perspective. Journal of Nurse-Midwifery,43(3), 235-
245. doi:10.1016/s0091-2182(98)00011-1
Ulrich, C. M., Taylor, C., Soeken, K., O’Donnell, P., Farrar, A.,
Danis, M., & Grady, C. (2010). Everyday Ethics: Ethical Issues
and Stress in Nursing Practice. Journal of Advanced

5. Nursing, 66(11), 10.1111/j.1365–2648.2010.05425.x.
http://doi.org/10.1111/j.1365-2648.2010.05425.x
Walker, D., Lannen, B., Rossie, D., (May 31, 2014) "Midwifery
Practice and Education: Current Challenges and
Opportunities" OJIN: The Online Journal of Issues in
Nursing Vol. 19, No. 2, Manuscript 4.
Response from student # 2
The medical profession has long subscribed to a body of ethical
guidelines developed primarily for the benefit of the patient. A
central duty of health care managers is to foster an
organizational culture that enables staff to act in a manner that
is consistent with ethical norms and standards (Bottrell, 2009).
Ensuring that individual and organizational practices are
consistent with ethical norms and standards depends on more
than nurturing individual virtue (Bottrell, 2009). The capacity
of staff to adhere to ethical norms and standards is powerfully
shaped by factors extrinsic to the individual, namely, the
organizational environment (Bottrell, 2009). Physicians must
recognize their responsibility to provide high quality care to
patients, their responsibility to the society, and other health
professionals as well. A code of medical ethics has been
established for health care professionals. They include such
items like “a physician shall be dedicated to providing
competent medical care, with compassion and respect for human
dignity and rights”, and “a physician shall respect the law and
also recognize a responsibility to seek changes in those
requirements that are contrary to the best interests of the
patients.” The code of medical ethics has nine major points for
physicians and health care professionals to abide. Health care
consists of a series of personal interactions between those
receiving care and those delivering it (Merry, 2007). Thus, the
medical professionals have an ethical obligation to uphold care
and understanding of their patients. Becoming an ethics-based
administrator begins with a foundation in ethics theory and
practice. The foundation is necessary because your work will

6. challenge one to balance the financial and human aspects of
health care industry (Morrison, 2009).
Medical institutions have organized their staff into
committees that all fulfill certain obligations assigned by the
governing body of a particular medical institutions. The
executive committee oversees the activities of the medical staff.
It is responsible for recommending to the governing body such
things as medical staff structure, a process for reviewing
credentials and appointing members to the medical staff, a
process for delineating clinical privileges, a mechanism for the
participation of the medical staff in performance improvement
activities, a process for peer review, a mechanism by which
medical staff membership may be terminated, and a mechanism
for fair hearing procedures (Pozgar, 2016). The bylaws
committee functions as a committee that supports and enforces
by laws that describe the functionality of different departments
within a medical institution. The blood and transfusion
committee develops blood usage policies and procedures. The
credentials committee oversees the application process for
medical staff applicants, requests for clinical privileges, and
reappointments to the medical staff. The infection control
committee is responsible for the development of policies and
procedures for investigating, controlling, and preventing
infections. The medical records committee develops policies
and procedures as they pertain to the management of medical
records, including release, security, and storage. The pharmacy
and therapeutics committee is charged with developing policies
and procedures relating to the selection, procurement,
distribution, handling, use, and safe administration of drugs,
biologicals, and diagnostic testing material. The quality
improvement council functions as a patient care assessment and
improvement council. It generally consists of representatives
from the organization’s administration, governing body, medical
staff, and nursing. The tissue committee reviews all surgical
procedures. Finally, the utilization review committee monitors
and evaluates utilization issues such as medical necessity and

7. appropriateness of admission and continued stay, as well as
delay in the provision of diagnostic, therapeutic, and supportive
services (Pozgar, 2016). Such committees have been designed to
ensure the compliance of medical institutions with standards
and obligations set forth by the health care industry of the
United States; to include ethical concerns.
There are many common errors that occur in the
medical industry of the United States that are worth noting here.
One error is that of unsatisfactory history and physical. Failure
to obtain an adequate family history and perform an adequate
physical examination violates a standard of care owed to the
patient (Pozgar, 2016). Failure to obtain a second opinion is
also another common medical error. A physician has a duty to
refer his or her patient whom he or she knows or should know
needs referral to a physician familiar with and clinically capable
of treating the patient’s ailments. A failure to do this is another
common medical error. Physicians could also fail to promptly
review test results, and in some cases, the prompt review of test
results could mean life or death for a patient. Other common
medical errors are failure to consult with a radiologist, failure
to read images, a delay in conveying imaging results, a failure
to order appropriate imaging studies, failure to monitor patients,
failure to communicate imaging results, and failure to make a
timely diagnosis (Pozgar, 2016). A misdiagnosis can also occur.
Misdiagnosis is the most frequently cited injury event in
malpractice suits against physicians (Pozgar, 2016).
Misdiagnosis may involve the diagnosis and treatment of a
disease different from that which the patient actually suffers or
the diagnosis and treatment of a disease that the patient does
not have. There can also be many issues concerning the
treatment of illnesses and diseases. A choice of treatment could
cost the patient their life, and a delay in treatment could also do
the same. Failing to treat a known condition also occurs, and
also a failure to respond to emergency calls is another common
medical error.
Another area of potential medical error is that of

8. psychiatry. The major risk areas of behavioral health
professionals include commitment, electroshock, duty to warn,
and suicide. The recent emphasis on patient rights has had a
major impact on the necessity to perform an appropriate
assessment prior to commitment (Pozgar, 2016). Patients could
be committed by a parent or even a spouse. They could also be
committed by the government’s court system. Also, the hospital
system in Pinnacle Health Systems v. Department of Public
Welfare was found to have been properly denied Medicaid
reimbursement for providing inpatient psychiatric patient
services that fell below the requisite standard.
References
Foglia, M. B., Pearlman, R. A., Bottrell, M., Altemose, J. K., &
Fox, E. (2009). Ethical Challenges Within Veterans
Administration Healthcare Facilities: Perspectives of Managers,
Clinicians, Patients, and Ethics Committee
Chairpersons. American Journal Of Bioethics, 9(4), 28-36.
Merry, A. P., Walton, M. P., & Runciman, B. P. (2007). Safety
and ethics in healthcare. Ashgate Publishing.
Morrison, E. E. (2009). Ethics in health administration.
Burlington, MA Jones & Bartlett Publishing.
Pozgar, G. (2016). Legal Aspects of Health Care
Administration. Burlington, MA Jones & Bartlett Publishing.