question archive HLTENN008 – Apply legal and ethical parameters to nursing practice – Careers University Scenario : On 15 th April 2015, EN Rose Baxter is working on the day surgical ward alongside RN Simone Jones
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HLTENN008 – Apply legal and ethical parameters to nursing practice – Careers University
Scenario :
On 15 th April 2015, EN Rose Baxter is working on the day surgical ward alongside RN Simone Jones. EN Baxter
has been allocated the following two clients, both of whom are booked for surgery today.
Client 1.
Mr John Smith DOB 6/9/1945
Mr Smith is a diabetic – type 1, fasting from midnight for surgery at 0800 for removal of skin lesions. As Mr Smith is diabetic, his treating doctor has ordered an antibiotic (intra venous Cephalexin 500mg), to be delivered during his surgery as a prophylactic. (He has an increased risk of wound infection associated with his diabetes).
Client 2.
Mr John Smythe DOB 6/9/1945
Mr Smythe has been fasting from 0200 for surgery to remove polyps from his bowel. Culturally, Mr Smythe is
a practicing Buddhist and has requested no narcotic analgesia, preferring to meditate to relieve any pain. Mr Smythe is partially deaf and with poor hearing, unless he has his hearing aids in place. He has a medication alert on his chart as he has an allergy to Cephalexin. When EN Baxter admits him, she notes this in his chart and she places an allergy alert band on Mr Smythe’s wrist.
Actions
Neither of the clients has been flagged during the admission process as having similar names and identical dates of birth. EN Baxter reports this to RN Jones and places an alert band on each client and an alert notation in their medical record, to notify all staff.
At 0800 Mr Smith is called for theatre and EN Baxter checks his blood glucose level (BGL) before his transfer to theatre. As she approaches him with the BGL kit Mr Smith holds out his hand ready for the finger prick test for his BGL. EN Baxter hands over his diabetic status and BGL to theatre staff.
At 0810, the theatre staff called for Mr Smythe to come down to theatre. The doctor handed EN Baxter a pathology slip for skin lesions, and a medication order to start an IV antibiotic, Cephalexin. When EN Baxter looks at the documentation she was given, she notices it has Mr Smith’s details on the pathology request and on the Medication order, and that it is incorrect for Mr Smythe to have this order.
Answer the following questions:
1. As an enrolled nurse, your practice is guided by legislation. The Standards for Practice: Enrolled nurses, are an element of the legislation. Identify what these standards are used for, generally.
2. Explain the duty of care the enrolled nurse had in caring for Mr Smith and Mr Smythe, taking into account if there was a breach, or a potential breach of duty of care during this scenario. Use any actions or evidence from the scenario to discuss the answer.
3. In regard to Mr Smith having his BGL taken before transfer to theatre, briefly explain how he consented to the BGL procedure and what type of consent does this represent.
4. Conduct Statement 1, from the Code of Professional Conduct for Nurses states; “Nurses practice in a safe and competent manner.” Identify how the enrolled nurse applied Conduct statement 1 in the scenario.
5. Explain what EN Baxter should do when she realises the pathology slip and medication order is for the wrong client, including who must be notified of this error.
6. Identify if the enrolled nurse was working within her scope of practice during this scenario. Explain how you came to this conclusion, based on the enrolled nurse’s actions.