HLTENN041

Apply legal and ethical parameters to nursing practice

Student Assessment

ASSESSMENT TASK 2 – CASE STUDY

Student Details

☐ I have read and understand unit information and assessment instruction

Student ID sa2793 Date 02/08/2022

Student Name Muskanpreet Kaur
Assessment Information

Conditions of  The student will have access to the relevant learning resources, listed under the
Assessment learning resource of this document, for this assessment.
 Assessment task may be completed at student’s own time.
 Responses to the questions must be typed.

Student Instructions
for completion
 This task requires you to read the case studies provided. You must answer all
questions correctly to complete this assessment with the satisfactory result and
you may utilise the relevant learning resources related to this assessment.
 The questions within this assessment relate directly to the integrated knowledge
contained within the unit of competencies and are fundamental to the student’s
knowledge and performance evidence. Use of correct grammar and spelling is
required to demonstrate foundation skills, so please ensure to proofread your
answers prior to submission.
 You may have up to three (3) attempts to be deemed Satisfactory outcome with
this assessment.
 Failure to receive the Satisfactory outcome after the three (3) attempts, the
result for the unit will be deemed Not Yet Satisfactory, and you must re-enroll
and repeat the unit to be eligible to be assessed again.
 APA referencing must be used where original sources have been used. Do not
copy and paste text from any of the online sources. SCEI has a strict plagiarism
policy and students who are found guilty of plagiarism, will be penalised.
 The written assessment standards (8.2) outlined in the PP77 Assessment policy
and procedure apply to this assessment task.

Explanation of the  List/identify/state/give = present in brief form

common command  Outline= give the main facts about something, more than naming, but not a
words used in the  detailed description
Assessment Task  Describe = Give full details of characteristics and/or features, more needed
 than an outline or than a list
 Explain/Discuss = Give reasonable argument to discuss cause and effect
 and/or make links between things clear in your own words
 Analyse = Identify parts, the relationship between them, and their relationships
with the whole. Draw out and relate implications
 Demonstrate = Present, show or illustrate through example or action

Assessment  You will be provided with a briefing on the assessment and the opportunity to
Procedure seek clarification on the conduct of the assessment.

HLTENN041 Apply legal and ethical parameters to nursing practice

CRICOS Provider Code 02934D
HLT54121 Diploma of Nursing Page 32 of 52 RTO Number 121952
Student Assessment - Version 2.0 March 2022
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Apply legal and ethical parameters to nursing practice
Student Assessment

 You may seek clarification at any point in time during the assessment task. If
you feel you need more time to complete the assessment, you must negotiate
the time needed with the assessor prior to the assessment due date.
 Following the assessment, your responses are to be assessed and marked as
appropriate. Where responses have been assessed in one (1) or more
questions as unsatisfactory, students will be required to resubmit these
questions. For more information, detailed information can be found in PP77
Assessment Policy and Procedure
Due Date  14 days after the unit completion date as outlined in the PP77 Assessment
Policy and Procedure.

Case Study 1:

Scenario:
Your shift handover from AM nurse Mark, a fellow EN, was rushed – he was finishing early so he could get
home in time to watch an AFL game, and seemed distracted. One of the patients he’s handing over is Mrs.
Lee, a frail 75-year-old woman who recently emigrated to Australia with her family from China. Neither she nor
her accompanying daughter speak English.

Mark tells you that she has verbally agreed to a renal biopsy. As directed by the nephrologist, she has been
fasting for the procedure, and would be called down to radiology soon. Because it’s a weekend, you’ll have to
accompany Mrs Lee, and stay throughout the procedure.

As soon as Mark leaves, you get a phone call from the Ultrasonography room. The nephrologist and the
radiologist are ready for you to bring Mrs Lee down for an ultrasound-guided biopsy; as you hang up the phone,
an orderly appears to take her down on the bed. You pick up her files, and accompany Mrs Lee and her
daughter, Ji-yeon, to ultrasound.

You demonstrate to Mrs Lee that she needs to lie prone, and undo her gown so the nephrologist and
radiographer can access her kidney. Before you cover her exposed buttocks, you notice several longitudinal
bruise-like marks on her buttocks, as if she was hit with a belt. Mrs Lee winces when you gently touch them.
The Nephrologist exclaims,” It looks like elderly abuse to me. Please ask the intern to make note of this in the
patient history.”

The nephrologist then asks you if there’s a consent, and you absent-mindedly reply yes because you’re
thinking about the marks, and because Mark said Mrs Lee had finally agreed to the procedure.

The nephrologist shows the biopsy needle to Mrs Lee, who starts shouting, banging her fists to the bed and
complains that she doesn't want to undertake the procedure. It takes you and Ji-yeon half an hour to calm her
down, after which the biopsy is successfully performed.

1. Identify a key concern regarding consent in the above scenario?

Informed consent is prescribed for most medical procedures. The highlighted case
present multifaceted issues warranting for informed consent. The medical practitioners
involved should outline the risks and the probability of the procedure to the patient,
especially that it involves invasive testing. particularly, the involved party ough to be
thorough in their discussion with the patient when explainining the need for the biopsy
and the methodology involved in the process.

HLTENN041 Apply legal and ethical parameters to nursing practice

CRICOS Provider Code 02934D
HLT54121 Diploma of Nursing Page 33 of 52 RTO Number 121952
Student Assessment - Version 2.0 March 2022
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Student Assessment

2. You know that elder abuse is wrong. You took a picture of Mrs Lee’s buttocks on your phone after the
procedure. You want to report this to the highest authority and think posting it on twitter will raise
awareness regarding abuse. By doing this, you will be:

Statement A: Breaching the patient’s privacy and confidentiality.

Statement B: Breaching the legislative requirements and the organisational policies and procedures

Select the correct answer:

 Statement A is correct and Statement B is incorrect.
 Statement B is correct and Statement A is incorrect.
 Both statements are correct.
 Both statements are incorrect

3. Would it be a good idea to restrain Mrs. Lee’s fists to the biopsy table? What strategies can you use to
respond to her agitation and complaint?
Commence by being respectful and understanding to their agitation and show them that
your intentions are noble and meant to help them. Be calm and gentle when handling
them. Be respectful to their personal space. Listen to them and identify their wants and
feelings. Consequently, it would be a bad idea to restrain Mrs. Lee’s fists to the biopsy
table without explaining to her the need for such an undertaking.

Scenario continues:
The next day you learn that Mrs Lee had bleeding from her biopsy site overnight, and has been transferred
to ICU for monitoring. You are told she will probably recover, but that is not certain; though the biopsy was
performed appropriately, but there was not a valid consent for the procedure

4. An EN has responsibility to obtain signed consent for the treatment from the patient and to interpret
referrals or requests for tests on receipt, ensuring the nature and requirements of tests are correctly
identified. What were your obligations here? Did you show negligence in this EN case?
The nurse should ensure that the patient is competent to make a voluntary decision
about their intentions to undergo a procedure. The nurse is obligated to consider both
ethical and legal issues regarding patients’ rights when obtaining consent. The nurse
was negligent and her acts constitute a crime, whereas she should involve the
administration in seeking an amicable solution to the issue and involve the patient.i

5. What is the duty of care?

Duty of Care describes a moral and legal obligation imposed on individuals with
authority, affirming the need to adhere to existing standards, to ensure the safety and
well-being of others.

HLTENN041 Apply legal and ethical parameters to nursing practice

CRICOS Provider Code 02934D
HLT54121 Diploma of Nursing Page 34 of 52 RTO Number 121952
Student Assessment - Version 2.0 March 2022
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Apply legal and ethical parameters to nursing practice
Student Assessment

6. The hospital might be sued in a court of law. State at least (2) legal terms is applicable to a civil suit in
this situation?
Practitioners’ negligence, as they failed to take proper care considering that the patient
was adequately informed of the risks and procedures involved in managing her condition.
Non-compliance to duty of care as they were not keen when conducting the procedure
leading to her bleeding and admission to the ICU

7. If Mrs Lee dies, this case will also be referred to the coroner, because it will be the direct result of medical
intervention. One of the things the coroner will scrutinize is all the documentation associated with the lead
up to, process, and subsequent events of the biopsy and death.

Statement A: It is essential that all the nursing notes and other charting are written according to legal
requirements in line with organizational policies when the patient is not a native English speaker.

Statement B: When negligence was identified, all the incidents that resulted in harm to the patient should
have been openly disclosed to the patient, their family, carers and other support persons.

Statement C: When negligence was identified, all health professionals involved in the care for Mrs Lee
have obligations to disclose the incidents to Mrs Lee and her family.

Pick the correct answer:

a. Statement A and C are correct and Statement B is incorrect.
✔ b. Statement B and C are correct and Statement A is incorrect.
c. Both Statements are correct.
d. Both statements are incorrect

8. Mrs Lee’s son in law asks you to send the photographs you took, however, as this is an outsider’s
request you are in a dilemma. Whom do you consult?
Mrs Lee to seek her consent and authorization, after consultation with the administration

Case Study 2:

The patient Mr Green is a 57 year old gentleman with aggressive prostate cancer who is took care of by the
nursing team in the oncology department of a general hospital in Brisbane, QLD, Australia. Mr Green was
diagnosed with prostate cancer seven years ago but refused medical and surgical treatment at the time. He
chose to seek alternative treatment and did not follow up with the urologist over that seven year period. Mr
Green has now presented with anemia and hypoproteinemia. After several diagnostic tests over a period it
was discovered that the cancer had metastasized to his bones, it had spread locally to his lymph nodes and
the primary tumor was invading the bladder and partially obstructing the left kidney. Mr Green had several
admissions over a two month period for various reasons. On the last admission Mr Green was told that he
may only have 4–6 weeks (previously it was 6–12 months) to live after a cystoscopy showed further
extensive growth of the tumor, it was determined that any further surgical/medical intervention would not be
appropriate in this case and that a palliative care regimen was the next step. At this point the patient reported
to the health care team that he had resigned himself to the fact that he was going to die. Mr Green confided
to the nurse that he planned to kill himself and that it was a secret that the nurse was not to tell anyone.
(Lin, 2015)

HLTENN041 Apply legal and ethical parameters to nursing practice

CRICOS Provider Code 02934D
HLT54121 Diploma of Nursing Page 35 of 52 RTO Number 121952
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Reference: Jie, L. (2015). The patient suicide attempt–An ethical dilemma case study. International Journal
of Nursing Sciences, 2(4), 408-413.

9. What ethical dilemma arose from this clinical case?

The patients conditions and intentions highlight a possibility of euthanasia, which attract
opposition from religious sectors. There are concerns about active and passive
euthanasia. Most importantly, there should be consideration about the family’s concern
over the issue measured against the time left to live. Notwithstanding, active euthanasia
is unacceptable and should not be considered.

10. What ethical principles cause this dilemma?

Non-religious reasonable arguments against euthanasia present ethical dilemma to the
involved medical practitioners. There are concerns of the implication of suicide in
devaluing human life, considerable limit, and alleviation of pain using the procedure,
especially to the involved individuals and family members.

11. How is the International Council of Nurses Code of Ethics for Nurses considered into this case?
The international council of nurse’s code of ethics for nurses prescribes four
fundamental responsibilities that highlight the essence of promoting health to prevent
illness and restore health while alleviating suffering. This realization implies that the
involved practitioners need to consider the four principles when considering aiding the
patient in committing suicide. In other words, the code of ethics limits, rather governs
practitioners in adopting acceptable standards involved with euthanasia.

12. Based on the ethical decision making model, what ethical decisions and actions can you make to
respond to Mr Green’s suicide attempts?
There is a need to evaluate the dilemma by thinking ahead and calculating the risk aided
with available information. Consequently, the nurse involved should consider the
appropriateness of permitting euthanasia, Mr. Green’s relatives’ concern about the
issue, and long-term implication to all parties involved.

HLTENN041 Apply legal and ethical parameters to nursing practice

CRICOS Provider Code 02934D
HLT54121 Diploma of Nursing Page 36 of 52 RTO Number 121952
Student Assessment - Version 2.0 March 2022