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You are a surgical nurse at Memorial Hospital. At 4 pm, you receive a patient from the recovery room who has had a total hip replacement. You note that the hip dressings are saturated with blood but are aware that total hip replacements frequently have some postoperative oozing from the wound. There is an order on the chart to reinforce the dressing as needed, and you do so. When you next check the dressing at 6 pm, you find the reinforcements saturated and drainage on the bed linen. You call the physician and tell her that you believe the patient is bleeding too heavily. The physician reassures you that the amount of bleeding you have described is not excessive but encourages you to continue to monitor the patient closely. You recheck the patient’s dressings at 7 pm and 8 pm. You again call the physician and tell her that the bleeding still looks too heavy. She again reassures you and tells you to continue to watch the patient closely. At 10 pm, the patient’s blood pressure becomes nonpalpable, and she goes into shock. You summon the doctor, and she comes immediately. ASSIGNMENT:  What are the legal ramifications of this case? Using the components of professional negligence outlined in Table 5.3, determine who in this case is guilty of malpractice. Justify your answer. At what point in the scenario should each character have altered his or her actions to reduce the probability of a negative outcome?

You are a surgical nurse at Memorial Hospital. At 4 pm, you receive a patient from the recovery room...

 

 
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Mrs. Shin is a 68-year-old patient with liver cancer. She has been admitted to the oncology unit at Memorial Hospital. Her admitting physician has advised chemotherapy, even though she believes that there is little chance of it working. The patient asks her doctor, in your presence, if there is an alternative treatment to chemotherapy. She replies, “Nothing else has proved to be effective. Everything else is quackery, and you would be wasting your money.” After the doctor leaves, the patient and her family ask you if you know anything about alternative treatments. When you indicate that you do have some current literature available, they beg you to share your information with them. ASSIGNMENT:  What do you do? What is your legal responsibility to your patient, the doctor, and the hospital? Using your knowledge of the legal process, the Nurse Practice Act, patients’ rights, and legal precedents (look for the case Tuma v. Board of Nursing, 1979), explain what you would do, and defend your decision.

 

 
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Think of celebrated cases where defendants have been tried in both civil and criminal courts. What were the verdicts in both cases? If the verdicts were not the same, analyze why this happened. Do you agree that taking away an individual’s personal liberty by incarceration should require a higher burden of proof than assessing for monetary damages? Also complete a literature search to see if you can find cases where a nurse faced both civil and administrative charges. Were you able to find cases where the nurse was found guilty in a civil court but did not lose his or her license? Did you find the opposite?

 

 
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You have been the evening charge nurse in the emergency department at Memorial Hospital for the last 2 years. Besides yourself, you have two LVNs and four RNs working in your department. Your normal staffing is to have two RNs and one LVN on duty Monday through Thursday and one LVN and three RNs on during the weekend. It has become apparent that one of the LVNs, Maggie, resents the recently imposed limitations of LVN duties because she has had 10 years of experience in nursing, including a tour of duty as a medic in the first Gulf War. The emergency department physicians admire her and are always asking her to assist them with any major wound repair. Occasionally, she has exceeded her job description as an LVN in the hospital, although she has done nothing illegal of which you are aware. You have given her satisfactory performance evaluations in the past, even though everyone is aware that she sometimes pretends to be a “junior physician.” You also suspect that the physicians sometimes allow her to perform duties outside her licensure, but you have not investigated this or actually seen it yourself. Tonight, you come back from supper and find Maggie suturing a deep laceration while the physician looks on. They both realize that you are upset, and the physician takes over the suturing. Later, the doctor comes to you and says, “Don’t worry! She does a great job, and I’ll take the responsibility for her actions.” You are not sure what you should do. Maggie is a good employee, and taking any action will result in unit conflict. ASSIGNMENT:  What are the legal ramifications of this case? Discuss what you should do, if anything. What responsibility and liability exist for the physician, Maggie, and yourself? Use appropriate rationale to support your decision

 

 
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