State Regulations and Nursing Standards
In this case study the patient, Mr. E, has made it abundantly clear through his words and his actions that he does not wish to be placed on a ventilator. In spite of these declarations, the doctor obtains consent from a family member who does not have the authority to grant permission. The nurse involved in Mr. E’s care has a legal obligation to intervene, something that he/she has failed to do. This obligation stems from the Standards of Competent Performance, California Code of Regulations Title 16 Section 1443.5 which clearly states: “the registered nurse acts as a client’s advocate, as circumstances require, by initiating action to improve health care or to change decisions or activities which are against the interests or wishes of the client, and by giving the client the opportunity to make informed decisions about health care before it is provided”. (http://www.rn.ca.gov/regulations/title16.shtml)
By ignoring the wishes of the patient, the nurse has clearly violated an important tenant of the California Code of Regulations. Situations like this can be very challenging are used to giving orders and not having them questioned. An intimidated nurse is, especially for new, inexperienced nurses. Advocacy is not for the faint of heart and many physicians an unsafe nurse and it is vitally important that nurses speak up when faced with dilemmas like this. If the nurse in this instance was afraid to speak up, he/she should have gotten the charge nurse or clinical manager involved to ensure that Mr. E’s rights were not violated. Laws like this were instigated for precisely this reason, to prevent providers from running roughshod over patient’s rights.
Code of Ethics
Not only does the nurse have a legal obligation to advocate for the patient, but an ethical one as well. Statement three in the ANA code of ethics mandates that: “The nurse promotes, advocates for, and
References: ANA Code of Ethics for Nurses. Retrieved from http://www.nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNurses/Code-of-Ethics.pdf Advanced Directives: Definitions. Retrieved from http://www.patientsrightscouncil.org/site/advance-directives-definitions/ HIPPA training for the healthcare staff. Retrieved from http://www.regalmed.com/pdfs/HIPAA_Handbook.pdf Standards of competent performance California code of regulations title 16 section 1443.5. Retrieved from http://www.rn.ca.gov/regulations/title16.shtml