Unprofessional Conduct, or Is It?
American InterContinental University Online
HCM410-0901A-02: The Ethical and Legal Aspects of Healthcare March 2, 2009
This paper will examine a 1979 Idaho case where a nurse met a woman diagnosed with myelogenous leukemia, a form of cancer. The patient had kept her condition under control for the past twelve years but has had a flare up. The patient was admitted into the hospital, and told by her physician, that any chance of survival would be found in chemotherapy treatment (LSU Law Center, 1998). The patient consented and began treatment. However, after the first dose, she explained to the nurse that she was having second thoughts. At the patient’s request, the nurse returned later that evening, and met with the patient and her family. After two hours of conversation about the alternative methods, as well as the chemotherapy, and both of the risks and side effects, all agreed that the patient would stay and continue the chemotherapy. Prior to the nurse returning to see the patient, the patient’s daughter-in-law had called to inform the doctor of what was going to take place between the nurse, patient, and family. The doctor ordered the chemotherapy stopped until the family made a decision. The patient died two weeks later. Later that month the nurse was reported to the State Board for unprofessional conduct, after a hearing her license was suspended for six months. Was this fair? This paper will review the ethical implications of this case, for instance, did this nurse do anything wrong? Did she move beyond her scope of practice? Could her actions be justified under the patient advocate portion of her job? In addition, should she have been sanctioned? RIGHT OR WRONG
The hearing officer in the case found the nurse guilty of unprofessional conduct. However, in 1976, there were no set standards in place, through either the Board or statutes specifically defining unprofessional conduct. Encarta defines unprofessional conduct as “contrary to the expected standards of a profession”; if there are no definite expectations, how can one do something contrary to what is expected? In this author’s opinion, this nurse was not guilty of unprofessional conduct, if anything, she could have informed the patient’s physician of the information the patient wanted and informed him that she was going to talk to her. In saying that, it was stated in transcripts from LSU Law Center (1998), the student nurse, Candice Freeman, and the patient’s son, both testified that the defendant stated that what she was telling them was “somewhat unethical”. If the defendant thought that, then she should have mentioned it to the patient’s physician. In addition, the International Council of Nurses, in 1973, wrote a Code of Ethics for Nurses that stated, “The nurse, in providing care, promotes an environment in which the values, customs, and spiritual beliefs of the individual are respected”. In reading this, one could interpret that the defendant was only respecting the patient’s spiritual beliefs since she believed that her reliance on her religion and faith was what kept her alive for the previous twelve years. OUTSIDE SCOPE OF PRACTICE
In determining if the defendant practiced outside of her scope of practice, one must know how scope of practice is determined. Each state has developed a Nurse Practice Act that outlines and defines the scope of duties for each level of nursing such as licensed practical nurses (LPN), registered nurses (RN), and others. Prior to 1903, there were no such acts, nurses did what they wanted, and what they thought was right. New York became the first state to enact a mandatory Nurse Practice Act (NPA) that had to be followed by nurses practicing in New York State (Smith, 2008). Each state has some form of a Nurse Practice Act that not only provides definitions of nurses but also what education and examinations need to be taken in...