Posted: December 28th, 2016

Rules surrounding mandatory reporting of sexual abuse?

Nursing professional ethics

Word count: 1,800 (+10% penalty will apply for non-adherence) – you cannot answer this paper in less than 1800 words. No work will be marked after 1980 words.

This assignment task aims to identify the principles of professional nursing practice, outline the ethical and legal framework for professional practice, and apply the Ethical Decision Making Framework to a complex scenario to establish an ethically and legally sound decision. Remember to incorporate evidence-based practice into quality patient care. You MUST include in your referencing 4(four) or more of the following;

· Health Practitioner Regulation National Law Act 2010 (WA)

· NMBA Registered Nurse Standards for Practice 2016

· NMBA NationalCode of Conduct for Registered Nurse2008

· NMBA Codeof EthicsforRegistered Nurses2008

· NMBA National Framework for the Development of Decision Making Framework: Scope of Nursing Practice (2007)

· NMBA Professional Boundaries 2010

Relevant Acts and Laws relating to the subject and health care practitioners – remember ALL your work must be referenced.

Use the model for Ethical Decision Making (included in your instructions, available on Blackboard) to determine the most favorable outcome of your chosen scenario.

General Instructions

There should be attention to spelling grammar and punctuation, this work is an academic paper and needs to reflect your ability to analyse, reflect and articulate in the written form. Take time to study the marking guide to assist you with your focus. Note that there is no requirement for an introduction or a conclusion. There should be evidence of critical thinking. Citations within text and reference list should conform to APA 6th ed format.

If you require assistance with your academic writing skills, many facilities on campus and online support you. Below is the link to access what is available.

Include a marking guide with your work. Put your name in full on your uploaded document; Surname first.

Using the model for Ethical Decision Making (Kerridge, Lowe and McPhee, p85 2005) to determine the most favorable outcome:

Model for EthicalDecision-Making

• Pleaseusetheseheadingswhenwritingyourcasestudy

· The word count provided is only an example – it also shows the weighting of the importance of each section.

1.Clearly state the problem: this should not be any more than 150 words (this is like an introduction)

Consider theproblemwithinitscontext; ethical, medical,socialandlegal considerations.

This should be a very brief summary of the issues as you see it – extract the issues:

o What is the ethical issue? What is the decision about?

o What is the medical condition? State this in a few lines

o What is the social situation of the patient? Is the person dependent, and do they have support?

o What appears (prima facie) to be the legal issues? Is it assault; is it the application of an Advanced Directive or informed consent, for example?

Example: The medical issues for this patient (Mr. S) are type 1 diabetes, depression, and Heart Failure. The ethical issue for Mr S is that he is concerned about the hospital’s lack of autonomy and justice. Mr S’s social situation is that he lives with his wife and one daughter; he states he is a Catholic. The legal issues for Mr S are consent, guardianship, and refusal of treatment. These issues will be explored throughout this paper. (80 WORDS – you don’t have to put the word count in each section at the end of your work – this is just an example for you).

2. Get the facts: this should not be any more than 350 words

Here, you need to find out what are the facts of the case – what is the medical condition & history, examination, relevant tests (investigations), define the medical condition is the pathophysiology of the condition/s – use scientific references

o What is the prognosis?

o What are the implications of the condition/s? For example, is it acute, chronic, or degenerative? What type of progression or prognosis might be expected?

o Are there any alternative treatments?

o What social factors might have an influence – family input, social interaction

3. Consider the four principles: this should not be any more than 250 words

o You need to define each principle and relate the principle to the patient

o Autonomy: what are the patient’s preferences?

o Beneficence: what benefits can be obtained for the patient?

o Non-maleficence: what are the risks, and how can they be avoided?

o Justice: how are the interests of different parties to be balanced?

4. Identify ethical conflicts: this should not be any more than 200 words

What are the ethical conflicts? To promote autonomy, are we in conflict with beneficence (Autonomy vs Beneficence)?

Explain why the conflicts relate to the patient and how they may be resolved.

Ref the NMBA Code of Ethics / ICN Code of Ethics in this section

5.ConsidertheLaw: this should not be any more than 450 words

Identify relevant legal concepts and laws and how they might guide management.

Consider the Practice Standards – how they apply to the case study, i.e. (NMBA Registered Nurse Standards for Practice 2016).

How does the duty of care apply to the patient?

· How do the Practice Standards relate to the Act?

· You need to use the Acts (legislation) that apply to the case study, for example:

o Consent to Treatment – Age of Majority Act

o Human Tissue and Transplant Act

6. Making the ethical decision: this should not be any more than 250 words

o Clearlystatethe clinical ethical decision and justify it eg:

o Specify how the guiding principles were balanced and why (i.e., justify the decision). Use your information in the Law and Get the Facts section to support your decision. MUST Reference

o Take responsibility for the decision & provide alternative management – reference this!

7. Evaluate the decision and discuss the legal relevance and importance of accurate documentation: this should not be any more than 150 words

· Identifying how you would evaluate your decision is our fundamental tool for establishing the efficacy/outcome of an action/decision. – here, you will research what the literature says about evaluation – also, use the NMBA Registered Nurse Standards for Practice 2016

o State where you would document and why it is a fundamental practice in healthcare. Here, you will research the literature about evaluation – and use the NMBA Registered Nurse Standards for Practice 2016.

Tip for 7. – Review Kozier and Erb’s Fundamentals of Nursing 2008 Vol 1 – Evaluating p 245 and Documentation and reporting Chapter 15 p255


Further information:

· A minimum of 18 references are required for this assessment.

· Review the marking rubric when doing your assessment.

· Good luck




Case Study 1 Mr. Alphonse

Mr Alphonse Martinez[1], a retired Italian man, married, his wife also retired, and they have two grown-up sons who still live at home. They are a close family who go to church every Sunday. Mr Alphonse had just recently made an Advanced Health Directive (AHD) that stated if he had another serious heart attack, he was not to be resuscitated. His wife and two sons opposed his Advanced Directive and instructed the staff to take no notice of the AHD.

Alphonse has been discharged from the coronary care unit (CCU) and placed in a step-down cardiac ward following his myocardial infarction (MI). While he had been in CCU, the staff had felt that he had exaggerated his chest pain. That is, when they asked him to rate his pain from 0 – 10 he sometimes stated that it was 12 or 14. In response, staff reacted in a rather disapproving manner.

During the first evening in the cardiac ward, Alphonse asked Mark, one of the student nurses on clinical practice, to contact the hospital priest to come and see him and give him the last rites. Mark did so immediately and then went back to sit with Mr Alphonse.

Later, Mark’s clinical supervisor (RN) called him to one side and asked why he was sitting with Mr Alphonse. Mark (student nurse) replied that Mr Alphonse was anxious so he was sitting with him. The RN asked Mark, “Do you think you could make him more anxious by sitting with him?” Mark replied that he didn’t think so and was only doing so until the priest came.

The RN then asked why the priest was coming, and Mark said that Mr Alphonse had asked for the priest, so he had contacted him to come. The RN asked Mark, “Did you not think you should have told me what you had done?” With that, Mr. Alphonse’s buzzer went, and, turning to go back into the room, the RN and Mark saw Mr. Alphonse have a cardiac arrest.

Despite vigorous and sustained effort, Mr Alphonse could not be resuscitated.


Case Study 2 Miss Mary-Jane

Mary-Jane is 14 years old; her parents are newly separated, and they both work. She has three younger siblings, and Mary-Jane does much of the child minding. She has been complaining of abdominal pain, moderate now severe, and has had some vaginal spotting (bleeding) for the past 24 hours. She presents to the emergency department at her local hospital with her parents, who are concerned that their daughter is so unwell. Mary-Jane looks pale, sweaty, light-headed, nauseated, and has stomach bloating. On admission, you have taken her baseline observations: temperature 37.8C, pulse 118bpm, BP 90/50, Respirations 28bpm, shallow breathing. A possible diagnosis would be an ectopic pregnancy, and to rule this out, a pregnancy test is essential. As the student nurse and the Registered Nurse caring for Mary-Jane consider the legal and ethical issues, one being consent and the other confidentiality, these and others will need to be considered for Mary-Jane.

What are the rules surrounding mandatory reporting of sexual abuse?


[1]Alphonse Martinez (Hawley, G. (p 212, 2007). Ethics in clinical practice: An interprofessional approach. London. Pearson Education Ltd.

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