Please analyze the following nursing legal situations?
Analyze the following situations based on the following;
a. Facts of the case
b. Analysis of the case/legalities
ms. Hocobo is a staff nurse in the surgical Unit. She has been caring for Mr. Adan, 80 y/0 man. Mr. Adan has been having trouble in breathing for several days and it is progressively getting worse. Dr. dela Serna wants to do a thoracentesis.
Dr. dela Cerna told ms. Hocobo to get a consent form signed by Mr. Adan forprocedure. Mr. Adan requested that her daughter be contacted to give permission for the procedure. Ms. Hocobo tried several times to contact the daughter but was unable to reach her. Dr dela cerna said that he has to to thr procedure or the patient's condition will deteriorate. What will you do as a nurse?
You are a nurse in arehabilitation unit, oyu are worried about the usual practice of sending patients home on temporary pass. patients in the unit often go home at their request without written order. Most of the patients need medication, so nurses give them what they will need to tkae while they were gone. What are you going to do? What are the legal implications of your decision/action? explain.
It was 1:00 Am in the morning and ms. Hover (a nurse) has blood transfusion to be hooked to one of her patients. She checked the blood, called for the resident physician to have it double checked. Unfortunately she entered the wrong patient's room without even noticing it. But before she left the room, the relative noticed the blood and asked why her patient has a blood transfusion? what should be done to prevent these incidents?
mrs Roses has a history of osteoporosis. One night she fell down while in the comfort room, sustaining a fracture on her left shoulder. Her daughter is extremely anxious about her mother's condition. She was brought to the hospital. The doctor did his rounds but inadvertently left the client in the patient's room. Later the nurse found the daughter reading the chart, what should the nurse do?
Asked By: Xtel - 10/6/2009
Case # 1- Check and see if the daughter is the POA for healthcare. If she is, the nurse can't get the paperwork done without her. If she can't be reached, this situation needs to go through the chain of command, charge nurse, unit manager, patient care liason. (It doesn't take as long as it sounds on paper.) If the patient is his own power of attorney a simple chat may fix the situation if he has all of his cookies and understands that it could be life threatening to go without it. If the patient crashes and has the proceedure ordered after recussitative treatment, informed consent is not necessary. Another factor to consider is the patient's DNR status. If the patient is a DNR, and he crashes, a thoracentisis won't be necessary, since he wanted to check out. As for Dr. de la Cerna, if he is depending on the nurse to "convince" the patient or a family member that the patient needs this proceedure, then he isn't doing his job. Most doctors keep up with who to call for what reason, and they get verbal consent from the patient or the next of kin, or the POA, and they rely on nursing to get the paperwork signed, pre-proceedure testing, labs, medications, and processing the M.D. orders from the chart. Bottom Line: You can't schedule a proceedure on a patient without informed consent from SOMEBODY, unless it is a life or death emergency and the patient is a full code.
Case 2: All patients have the right to sign themselves out of a facility unless their judgement is impaired in some way. Then the person responsible for their healthcare should be the one to sign the patient out from the facility. As for medication, without an order, legally you are not required to send meds home, however, most facilities have a standard proceedure for this. Since it would be life threatening to let Mrs. X go home without meds, especially if they are diabetic, meds are usually packed up, sent home, and the nurse circles the sign off box on the mar and documents that meds were not given by the nurse. To avoid all of the above, just call the doc, and get a telephone order to pack up the meds and send them home. At the end of your shift drop a note to risk management, or whomever handles that department, and suggest that it might be a good idea to get a standing order for home meds. As for liability, yours ends as soon as they are outside the door of the facility. Bottom Line: It is legal to allow the patient to go home without an order. No standing orders for home meds needs to be addressed if it has become a problem. Technically the nurse is covered if she documents on the mar what happened to the medication, but liability is a grey, grey, area with out direct clarification of facility proceedure and a legal M.D. order.
Case 3- Never, ever, ever give blood without at least a triple check. Check the patient, check the chart, and have a second set of eyes check behind you. Bottom Line: Giving blood is one of the most dangerous things that nurses do. Chances are, if the situation above actually occurs... Congratulations, you have just killed your patient.
Case 4: Talk to her. Answer her questions. You will get the chart back as soon as she starts asking stuff and you have to look it up. Document in the nurses notes what you observed the daughter doing. As long as she didn't remove anything, the nurse is covered.
Now, who's med-surg homework am I doing?
Answered By: Lydia B - 10/7/2009