Ethics and law for Nurses

Ethics and law for Nurses

Introduction

The utilization of the case study as a an approach for research within medicine shares a number of the aspects of case studies on the whole; on the other hand, the conventional alignment of the area of medicine within natural science approaches together with the close affiliation between the clinical practice of medicine and the case study research have ensued in quite a lot of distinct kinds of case study research. The mainstream of the projects of case study research in medicine are grounded on empiricist conventions, yet there continues to be two separate approaches to the utilization of case study research in the field of medicine: the very first resolutely anchored in the verbal communication and epistemic suppositions of a logical practical research paradigm, and the next, which has held close an interpretive orientation or a managerial analytic approach.

Discussion

The Case Study

Mr Jones a 27 year old man, was admitted to hospital on a Saturday afternoon via the emergency department of a small rural hospital with a diagnosis of acute appendicitis. He underwent an emergency appendectomy. Post-operatively he became unwell with an elevated temperature and heart and respiratory rate. He was complaining of severe abdominal pain. The nurses contacted the medical officer who reviewed Mr Jones, and ordered an abdominal x-ray, urine for micro and culture, urea and electrolytes, FBE, and C reactive protein. The medical officer also ordered further pain relief for the patient.

The x-ray was normal but the blood results were delayed due to technical issues. The blood results were returned to the ward in the early evening after the medical officer had left the hospital. The results showed a significantly elevated white cell count, and C reactive protein level. The nurse on duty in the evening wasn't sure about the results so she filed the pathology results in the patient's history and did not attempt to contact the medical officer. The results were not reported to any of the other nurses. Brief verbal handovers were given to the other RN's who came on duty over the weekend, because on the weekends it is normal practice for the nurses like to go home early. None of the RN's reviewed the patient's notes or noticed the pathology results. The medical officer did not contact the hospital to ascertain the results until the Monday morning. The patient was given further doses of narcotic analgesia at regular intervals over the next day to control the pain.

On the Monday morning the patient's condition was assessed and the blood results reviewed. On review of the patients notes the nurses reports were limited in detail, the trend of the vital signs indicated a gradual reduction in his blood pressure and increase in his heart rate, and his urine output had not been recorded. The patient was immediately commenced on IV antibiotics, and subsequently returned to theatre for an exploratory laparotomy, at which time it was identified a leak of faecal fluid had given rise to ...