Mr Jones, a registered nurse (RN) with a previous working history of 25 years with an unblemished record, had been dealing with a patient’s family in the Emergency Department after a motor vehicle accident and multi-trauma. Jones was on an evening shift in charge of a busy Emergency Department with 4 ambulances ramped and a department full of patients. The resuscitation bays were also both full. He agreed to look after the patients of another nurse (Ms Oaklands – an enrolled nurse who had 10 years’ experience), as she left for a meal break. After a brief handover as Oaklands was getting her meal out of her locker, Jones was informed by her that a patient was to be administered Fentanyl IV 100mcg/2mls. The patient, referred to as Patient BZ, was in Bed 8. The drug was handed to Jones by Oaklands in a kidney dish, prior to going on a tea break. Jones was busy organising other staff for breaks as he made his way to Cubicle 8 (not Bed 8) alone and began to administer the fentanyl to the patient as directed by the nurse going on break. When Oaklands returned from her break, she saw Jones was in Cubicle 8, not at Bed 8 and was in the process of administering the drug to the wrong person (Patient SY). Jones had administered half the fentanyl dose prior to being stopped by Oaklands and put the syringe back in the kidney dish. Patient SY had no immediate obvious reaction to the medication. Patient SY remained unaware of a medication error despite being administered a drug they were not charted. Jones inveigled the Registered Nurse (Ms Laylor), who had originally checked the medication out of the Dangerous Drug (DD) cupboard, and Oaklands, not to report the incident. Initially, Oaklands and Laylor agreed to do this but then thought better of it and together notified their supervisors which led to an internal investigation. Question: examine the key legal and ethical aspects of one of the case studies, taking into account the scope of practice of the registered nurse and consideration of safety and quality in medication management practices via national standards.
Mr Jones, a registered nurse (RN) with a previous working history of 25 years with an unblemished record, had been dealing with a patient’s family in the Emergency Department after a motor vehicle accident and multi-trauma. Jones was on an evening shift in charge of a busy Emergency Department with 4 ambulances ramped and a department full of patients. The resuscitation bays were also both full. He agreed to look after the patients of another nurse (Ms Oaklands – an enrolled nurse who had 10 years’ experience), as she left for a meal break.
After a brief handover as Oaklands was getting her meal out of her locker, Jones was informed by her that a patient was to be administered Fentanyl IV 100mcg/2mls. The patient, referred to as Patient BZ, was in Bed 8. The drug was handed to Jones by Oaklands in a kidney dish, prior to going on a tea break. Jones was busy organising other staff for breaks as he made his way to Cubicle 8 (not Bed 8) alone and began to administer the fentanyl to the patient as directed by the nurse going on break.
When Oaklands returned from her break, she saw Jones was in Cubicle 8, not at Bed 8 and was in the process of administering the drug to the wrong person (Patient SY). Jones had administered half the fentanyl dose prior to being stopped by Oaklands and put the syringe back in the kidney dish. Patient SY had no immediate obvious reaction to the medication. Patient SY remained unaware of a medication error despite being administered a drug they were not charted.
Jones inveigled the Registered Nurse (Ms Laylor), who had originally checked the medication out of the Dangerous Drug (DD) cupboard, and Oaklands, not to report the incident.
Initially, Oaklands and Laylor agreed to do this but then thought better of it and together notified their supervisors which led to an internal investigation.
Question: examine the key legal and ethical aspects of one of the case studies, taking into account the scope of practice of the registered nurse and consideration of safety and quality in medication management practices via national standards.
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