Case Study #2 Legal Issues and Professional Accountability Clinical practice is a process closely regulated by legal parameters to ensure safety of both the patients and the practitioners. Knowledge of the laws and regulations is vital to every nurse in practice to protect all parties involved in our complex health-care delivery systems. The parameters that guide professional practice also guide your practice as a nursing student. Pamela Selkirk, a practical nursing student, has been assigned by the clinical instructor to assist in the care of the following patients during her clinical rotation in the Emergency Department at the local hospital: Patient A: 42-year-old female who is unresponsive secondary to a narcotic overdose Patient B: 2-month-old female with scald burns to lower extremities Patient C: 91-year-old male with a bladder infection and malnutrition Patient D: 24-year-old female with suspected miscarriage The patient admitted with a bladder infection and malnutrition is slightly confused. He knows who he is and why he is in the hospital, but not what day it is. He wants to go home and does not see that it is necessary for him to stay. He has been stabilized and is scheduled for admission to the medical unit. He frequently attempts to get up off the ED bed and the staff is concerned for his safety. The orderly, showing a waist restraint to the patient says, "Mr. Wells, if you cgntlnugwe're going to put a restraint belt on you and tie you down so you can't get up\". Orders are received for the care of the 2-month-old with burn injuries. The skin is cleansed and dressed Mg: m and the child is to be admitted to the pediatric unit. The parent has decided they do not want their child admitted and plans to leave AMA (against medical advice). The parent states that she i_s_glgl_e_t_q care for the child at home and requests instructions for care of the burns. #3. How should the nurse handle this situation including aspects of informed consent regarding leaving AMA. What are the elements of informed consent that are normally used in the healthcare setting (factors that need to be veried for consent to be legally valid)?I After the patient with the narcotic overdose receives Narcan (antidote to narcotics), she is more awake but is now feeling nauseated. An order is received to insert an IV. The ER nurse asks the student practical nurse to insert the IV. Pamela replies me never done that before or had a lab on it, but I've read about it\". The ER nurse assures her that she will help her through the procedure. The ER nurse tells the patient that the physician has ordered IV \"to help with the nausea\". The patient requests medication by mouth rather than an IV. Without consulting the physician, the nurse tells the patient that the doctor does not want to order the medication this way. The patient reluctantly agrees to the IV. Pamela's first attempt at inserting the IV is unsuccessful but her second attempt goes well. The ER nurse verifies m and the medication is started. The patient complains, \"It hurts. It feels like it's burning. Please take it ou \". The ER nurse assures the patient that it is a common feeling to have after an IV is inserted. When checking on the patient 20 minutes later, Pamela nds her arm red, swollen, and very painful. The patient states they can no longer feel their fingers or move their hand. The IV is immediately stopped. The ER physician states \"She was already in rough shape because of all her IV drug use anyway\". After the patient is stabilized, she is transferred to a private addictions and mental health clinic for follow -up. Six months later, the inserted. When checking on the patient 20 minutes later, Pamela finds her arm red, swollen, and very painful. The patient states they can no longer feel their fingers or move their hand. The IV is immediately stopped. The ER physician states "She was already in rough shape because of all her IV drug use anyway". After the patient is stabilized, she is transferred to a private addictions and mental health clinic for follow-up. Six months later, the hospital, the ER staff, as well as the practical nursing student (Pamela) are named in a malpractice suit by this patient. She is suing for damages related to enforced hospitalization and the IV insertion which resulted in nerve damage and the loss of movement in three of her fingers. The patient is a tattoo artist and this has negatively affected her employment opportunities. #4. Define the four elements necessary to prove a malpractice or negligence case. Are there any aspects in this situation that may indicate there is sufficient or insufficient evidence? #5. How did Pamela violate professional standards of practice in her student role in this situation