Class 6 Unit 3 Topic 1 Comment 1

Purpose: Comment the Discussion (Class 506 Unit 3 Topic 1 Comment 1 M) Rebecca

Thing to Remember:

Answer this discussion with opinions/ideas creatively and clearly. Supports post using several outside, peer-reviewed sources.

1 References, find resources that are 5 years or less

No errors with APA format 6 Edition

To Comment:

Case Study 2: Wrongful Death by Howard Carpenter on Behalf of Wilma Carpenter, Deceased.

In this case study, Wilma Carpenter died shortly after undergoing hip replacement surgery.  In the post-surgical unit, she was given an epidural and had an episode of hypotension requiring Ephedrine for blood pressure support.  Wilma was then sent to the medical surgical unit for routine post-operative care.  During report the PACU nurse failed to inform the RN assuming care for the patient that she had an episode of hypotension that required intervention.  When the patient came to the floor she had an episode of vomiting after a respiratory treatment.  The patient was later found unresponsive and needed resuscitation.  Shortly after her transfer to the ICU she was declared brain dead from anoxia.  The timing of when the patient was found and by who is not clear.

Standards of care are how situations should be handled by reasonable, prudent nurses.  Standards are measured by the conduct expected of other nurses under similar circumstances (Cartwright-Vanzant, 2011).  Nursing standards are not laws, but they do provide an outline for typical duties and rules of conduct for nurses.  The laws that pertain to nursing are individual states nurse practice acts.

I have evaluated this situation using the state of Wisconsin’s laws on standards of practice and rules of conduct for nurses.  The first violation of rules of conduct came from the PACU nurse’s failure to report significant observations and patient condition changes to appropriate staff (Wisconsin State Legislature, 2016, August).  The RN assuming care of the patient on the medical surgical unit should have been notified of the issues the patient had in the PACU.  The second violation of care came from the medical surgical nurse’s failure to document pertinent assessment findings (vital signs, epidural site), leaving others involved in the case to guess what had or had not been done (Wisconsin State Legislature, 2016, August).  A third violation comes from medical surgical nurse as well.  She did not observe and monitor the actions of the LPN on duty nor did she follow up with the patient’s nausea and vomiting (Wisconsin State Legislature, 2016, October).  The final infraction I would like to point out is the corporation’s responsibility to “provide competent, qualified healthcare providers and to monitor and enforce its patient care policies” (Westrick, 2014, p. 228).  They should have ensured that the float nurse was able to care for post-operative patients with epidurals as well as ensure she knew the policies and procedures for post-operative nursing care.

The standards of care and state nurse practice acts govern nursing actions.  Nurses are held liable for any care that does not meet the minimum standard.  Nurses are expected to follow the nursing process that includes assessment, planning, intervention, and evaluation as well as accurate documentation of each (Cartwright-Vanzant, 2011).  These standards are universal to all nurses.  Clearly these standards have not been met in this case.

References

Cartwright-Vanzant, R. (2011). Standards of care. Journal of Legal Nurse Consulting, 22(1), 14-

18.

Russell, K. A. (2013). Continuing Education. Nurse Practice Acts Guide and Govern Nursing

Practice. Missouri State Board of Nursing Newsletter, 15(1), 8-10.

Westrick, S. J. (2014). Essentials of nursing law and ethics (2nd ed.). Burlington, MA: Jones &

Bartlett Learning.

Wisconsin State Legislature. (2016, October).  Chapter n 6: Standards of practice for registered

nurses and licensed practical nurses.  Retrived from: https://docs.legis.wisconsin.gov/code/admin_code/n/6

Wisconsin State Legislature. (2016, August).  Chapter n 7: Rules of conduct. Retrieved from:

https://docs.legis.wisconsin.gov/code/admin_code/n/7