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Nurse Accountability – Consent For Catheterisation, Professional Law And Ethics.

3789 words - 15 pages

An elderly lady, 78 year old Mrs Jones was admitted to the unit from a local nursing home following an acute myocardial infarction. In order to gain in my clinical skills experience I was asked to accompany and observe the staff nurse who was to carry out the catheterisation. The nurse told Mrs Jones that she was just going to pop a catheter in. There were no explanatory details towards Mrs Jones about what the procedure precisely entailed, and she was not informed of the risks or benefits. Therefore Mrs Jones was unable to ask any questions, or express any fears or anxieties. On commencement of the catheterisation Mrs Jones was quite clearly very distressed by what was happening to her. She was lashing out at the staff nurse, shouting "no get off me", and with great force tried to keep her own legs shut, but the nurse continued to proceed until after several attempts the catheter was in place. This was a procedure that was carried out without the patient's consent.Based on a case actually experienced by the author, this assignment considers how the concept of informed consent is articulated in nursing care, by exploring the legal, ethical and professional issues surrounding the subject.To give the reader an insight surrounding the issue of consent, definitions and different types of consent will be considered.A nurse could find herself in court under a charge of battery or negligence if a patient makes a complaint that the nurse did not gain consent or that insufficient information was given. The issues surrounding the importance of gaining patients consent will be discussed together with the legal implications for the nurse. Alongside the discussion will be real life cases that have already been to court and the author hopes to relate these to the case experienced.Ethical dilemmas such as consent force nurses to decide on possible actions to take.By discussing the ethical principles of autonomy, beneficence and non-maleficence and applying the ethical theories of consequentialism and deontology the author hopes to make it clear how nurses justify their actions.Nurses are advised on their standards of practice through the professional code of conduct. The advice the code gives surrounding the issues of consent, accountability, advocacy and record keeping will be explored, together with the relevant clauses outlined, as these are all important factors in gaining consent.For the sake of confidentiality as outlined in the UKCC (1992) the patients name in the case experienced by the author has been changed and will therefore be referred to as Mrs Jones.LEGAL ISSUESThere are two types of consent, which can be given: implied and expressed. Dimond (1995) Suggests that Implied consent is non-verbal; this is related to the behaviour of the patient, which could be a nod of the head instead of responding by saying "yes" to the question. The nodding conveys to the nurse that the patient is agreeing to the procedure. However this non-verbal consent may lead...

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