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NURSE CONSULTING.
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Examines legal and ethical issues involved in a court case.... More...
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Paper Abstract:
Examines legal and ethical issues involved in a court case. Case scenario of how nurses handled an intoxicated alcoholic female partient in a hospital, & their subsequent loss of their jobs based on patient abuse. Discusses 3 ethical issues and 2 legal issues of the case. Recommended strategies for this case scenario.

Paper Introduction:
LEGAL NURSE CONSULTING Case Scenario An intoxicated alcoholic female patient was brought into the hospital. Two female registered nurses and other personnel applied physical restraints to the patient since she behaved in an assaultive and combative manner. The patient would not let go of one of the nurse's hands and her fingernails were puncturing the hand. The other nurse administered a painful pinch to the patient on the inside of her upper arm to get the patient to release her grip. Both nurses were fired for patient abuse. The case was brought to the Court of Appeals of Arkansas in 1996. The court ruled that the nurse did not administer intentional patient harm or intentional disregard of professional nursing standards and that the nurses should not have been fired. At

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. LegalEagle Eye Newsletter for the Nursing Profession. In this case the nurses had the responsibility toidentify the priority of care and provide appropriate care. Constantino, R. Doing No Harm or primum non-nocere. Found online at:www.nursinglaw.com/default.htm When a case such as this results in thenurse being fired, or any other possible legal action, it is alsorecommended that the case be referred to the ethics committee to assist allinvolved regarding rights and responsibilities (Constantino, Boneysteele,Gesmond, & Nelson, 1997). The nurse, above all else,must avoid harming the patient. Assault and battery is recognized as anintentional tort of a civil nature. Negligence. References Constantino, R. It is also recommended that recording oncharts include all communications and consultations regarding the patient-nurse transactions, to include date, time, steps taken, care decisions, andverbal and physical interactions. A., & Nelson, B.(1997). Two female registered nurses and other personnel appliedphysical restraints to the patient since she behaved in an assaultive andcombative manner. 3. Thecourt ruled that the nurse did not administer intentional patient harm orintentional disregard of professional nursing standards and that the nursesshould not have been fired. Restraint of combative patient:Nurse's painful pinch to release patient's grip was not . . Responsibility and Accountability for Nursing Judgment andAction. E. Both nurses were fired for patient abuse.The case was brought to the Court of Appeals of Arkansas in 1996. Thus the only way toavoid ultimate harm was to hurt the patient with a pinch (Constantino,1995). In this case, to fulfill this duty, the nurse had torelease the grip on her hand and apply restraints. Whether patients should be held accountable for their actionsthat affect nurses and other hospital personnel, such as nurse handpuncturing, in a critical care setting? For this case the court ruled against negligenceand assault and battery since the nurse did not administer intentionaldisregard of professional nursing standards, or intentional patient harm.The act was viewed as an indiscretion or good-faith error in judgement.This error in judgement could have been avoided with adequate informationregarding protocol for abusive patients and staff knowledge of thisinformation. Two legalissues involved were assault and battery and negligence. In this case the two nursesconsulted each other as well as other hospital professionals in thedecision to use restraints and assist each other in releasing the patient'sgrip (Constantino, Boneysteele, Gesmond, & Nelson, 1997). Escorting the family out of the ICU:Ethical and legal issues. Ethical Issues Three ethical issues involved in this case include the following: 1. 2. The rule to do no harmmay result in harm to another, in this case the nurse, and ultimately thepatient, and yet the nurse must not hurt the patient. Thenurse has the duty to provide a safe environment and appropriate andadequate care. Dimensions of Critical Care Nursing, 16(3),144-151. Whether staff shortages result in nurse's actions, such apinching the patient, that might otherwise be avoided? Restraining an aggressive suicidal, paraplegic patient: A look atthe ethical and legal issues. The nurse must assumeresponsibility and accountability for their actions and judgment and mustconsult appropriately when necessary. Dimensions of Critical Care Nursing, 14(3), 154-158. Inthis case the nurse did not act intentionally to bring about a harmful oroffensive act. Clinical Research/Policy Questions Three clinical research/policy questions based on the case presentedare the following: 1. At the worst the act was viewed as anindiscretion or good-faith error in judgement (Legal Eagle Eye Newsletter,1997). Since thepatient was displaying combative behaviors and was intoxicated withalcohol, physical restraint was identified as appropriate to preventfurther self and other-inflicted injuries. (1995). Three ethical issues involved includedresponsibility and accountability for nursing judgment and action, autonomyversus beneficence, and doing no harm or primum non-nocere. Recommendationsincluded universal treatment protocol for abusive patients, accurate andcomplete chart recording of all details, and legal and ethical consultationfor problem situations. . Nurses face the "act versus rule" dilemmawhen attempting to uphold this ethical principle. 2. (1997). Summary In summary, this case scenario presented with more than one issue.The nurses chose to use physical restraints without consent of the patient,and one nurse pinched the patient, without consent, to release thepatient's hold on another nurse. Breach of duty of caremust be proven to claim negligence and in this case the nurse's act was inthe line of fulfilling the duty to provide the patient with a safeenvironment. A third recommendation is that the nurseconsult with either a Psychiatric Nurse Liaison or legal counsel/riskmanagement, regarding any acts which are questionable such as the touchingof a patient without consent. Assault includes the apprehension of a harmful or offensiveact. The other nurse administereda painful pinch to the patient on the inside of her upper arm to get thepatient to release her grip. To reduce ethical and legal dilemmas it is recommended that theentire treatment team be apprised of a consistent plan with regard totreatment of abusive patients. The nurse has the responsibility to identify any ethical or legaldilemmas, and is accountable for the seeking of resources to formulateappropriate decisions. Proximate cause of injury and damages cannot be proved inthis case since the nurse's actions did not result in an injury and therewas no actual loss due to the nurse's conduct (Constantino, Boneysteele,Gesmond, & Nelson, 1997). Legal Eagle Eye Newsletter. Battery requires intent and act. E., Boneysteele, G., Gesmond, S. 2. Autonomy versus Beneficence. 3. LEGAL NURSE CONSULTING Case Scenario An intoxicated alcoholic female patient was brought into thehospital. Assault and Battery. The plaintiff would need to prove that the nurse acted with intent tocommit assault and battery and in this case there was no intent to commit aharmful or offensive act (Constantino, 1995; Constantino, Boneysteele,Gesmond, & Nelson, 1997). The loss of decision-making forthe patient results in a loss of autonomy and this must be weighed againstthe benefits of the nurse's decisions regarding care of the patient(beneficence). Recommendations/Strategies Four recommendations or strategies are recommended for this casescenario. In this case the use of restraints without the patient'sconsent resulted in a loss of autonomy but considering the risk of harm toself and others, this decision maximized benefits and minimized risks forthe patient (Constantino, Boneysteele, Gesmond, & Nelson, 1997). To establish negligence there must be fourelements, duty, and breach of duty, proximate cause, and damages. The patient would not let go of one of the nurse's handsand her fingernails were puncturing the hand. What appropriate means could be used by nurses in a situationsuch as patient abuse of nurses? Legal Two legal issues involved are as follows: 1.

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