St.

Jude College Manila

NCM 105 CASE STUDY

Submitted by: De Los Reyes, Adrian L. Martinez, Ilona Jane BSN IV- 02

Submitted to: Aileen Quiogue RN, MAN On September 30, 2011

SUMMARY OF THE STORY An 83-year-old resident of a nursing home was physically in good health, but had been diagnosed with Alzheimers disease. At times, this resident would become confused and wander toward the doors of the nursing home, looking for her parents and a way to exit the facility. To prevent the resident from leaving the nursing home, she was fitted with a special bracelet that automatically locked an outer door if the resident came within 30 feet of the door. For fire-safety purposes, the door automatically unlocked within 15-second time frame. Thus, staff members had essentially a 15 second time frame to notice an elopement and redirect the resident. Early one morning, the resident was trying to get out of the door and a staff member came up behind her, slapped her on the buttocks, grabbed her by the shoulders, turned her around, and shoved her back into an interior hallway. This episode was reported to the director of nurses. The director interviewed the other nursing staff members who were present during this incident; the director also examined the resident, noting that a red mark was present on the residents buttocks. Discussion of issue in terms of Nursing Standards that are NOT met/ performed First is Safety and Quality Nursing Care - Provides sound decision-making in the care of individuals/ groups considering their beliefs and values Why? The nurse wasnt able to select an appropriate action towards the patient. He should have been more persistent in dealing with the patients situation. Professional Nursing |Venzon page 318 Next is.. Legal Responsibility - Adheres to practices in accordance with the nursing law and other relevant legislation including contracts, informed consent. Why? The nurse wasnt able to act in accordance with the terms of employments rules and regulations. Professional Nursing |Venzon page 321 And how do you say so? Upon verification of the said violation, the director reported the nursing staff member to the proper state agency, and the staff member was charged with criminal abuse of a nursing home resident.

Ethico- moral Responsibility

- Respects the rights of individual/ groups Why? The nurse wasnt able to render nursing care consistent with the patients bill of rights specifically, giving the patient the kind of care her condition needs. Professional Nursing |Venzon page 322 Then.. Personal and Professional Development - Projects a professional image of the nurse. Why? The nurse failed to demonstrate good manners and right conduct when he intentionally hurt the patient as his way of not letting the patient get out of the nursing home. Professional Nursing |Venzon page 323 Next will b

 Communication
- Establishes rapport with patients. Why? The nurse failed to create patients trust and confidence because of his action. Professional Nursing |Venzon page 326 And the last one is still under Communication - Responds to needs of individuals Why? The nurse failed to provide reassurance through therapeutic touch, warmth and comforting words of encouragement. Professional Nursing |Venzon page 326 In terms of Legal Doctrines Involved Doctrine of Respondeat Superior - The term means Let the master answer for the acts of the subordinate. Under this doctrine, the liability is expanded to include the master as well as the employee and not a shift of liability from the subordinate to the master. Therefore, when a person, through his negligence, injures another, he remains fully responsible. This doctrine APPLIES only to those ACTIONS PERFORMED by the EMPLOYEE WITHIN the scope of EMPLOYMENT. Professional Nursing |Venzon pages 164- 165 In terms of.. Tort or Crime Assault and Battery - Assault is the imminent threat of harmful or offensive bodily contact. Battery is an intentional, unconsented touching of another person. A patient who gets injured while being restrained may cause the attendant/ nurse to be liable for assault and battery. Professional Nursing |Venzon pages 179 - 180 -Assault and battery is obvious when early one morning, the resident was trying to get out of the door and a staff member came up behind her, slapped her on the buttocks, grabbed her by the shoulders, turned her around, and shoved her back into an interior hallway. A red mark was present on the residents buttocks. What is Philippine Nursing Act of 2002 or what we call now R.A. 9173? This is the bible of nurses in the Philippines. The duties and responsibilities as well as the scope of nursing practice is clearly stated here. There are certain roles of nurses that needs training and specialization to legally practice in Philippine hospitals. What Provision in RA 9173 was violated? Rule V, Nursing Practice 10.1 Scope of Nursing Duties and Responsibilities of the Nurse C. Observe the Code of Ethics and the Code of Technical Standards for Nursing Practice Maintain competence through continual professional education. Why? Professional Nursing |Venzon page 154 - The nurse needs continual professional education for him to be aware of the latest updates and approaches especially in handling difficult patients. Other Laws Violated: Jane

Republic Act 4704 #8. The scope of nursing practice was broadened to circumscribe the whole management of the care of patients and the acts constituting professional practice of nursing were spelled out to include such services as reporting, recording and evaluation of a patients case, supervision of persons contibuting to the nursing care of patients, EXECUTION OF NURSING PROCEDURES and techniques, direction and education to SECURE PHYSICAL and MENTAL CARE, and the application and execution of physicians orders concerning treatment and medication. Professional Nursing |Venzon page 139 Legal Responsibilities of the Nurse: Jane Acts in accordance with the terms of contract of employment and other rules and regulations. Professional Nursing |Venzon page 321 Acts in accordance with the established norms of conduct of the institution/ organization. The director reported the action of the nurse since he was fully aware of the violation of his staff. Professional Nursing |Venzon page 322 When nurses undertake to practice their profession, they are held responsible and accountable for the quality of performance of their duties. Responsibilities of the nurse is to give quality care. They are responsible of their patients safety and they should not inflict pain to their patient. In the situation, the staff member is responsible for the patient that was diagnosed with Alzheimers disease, he/she should not slapped the patients buttocks, grabbed her by the shoulders, turn her around and shoved her back into an interior hallway, that causes the patient to have a red mark on her buttocks. The staff member can talk to the patient and lead her to go back to her room without inflicting any pain to the patient.