Legal Ramifications for Exceeding One’s Duties FO
You have been the evening charge nurse in the emergency department at Memorial Hospital for the last 2 years. Besides yourself, you have two LVNs and four RNs working in your department. Your normal staffing is to have two RNs and one LVN on duty Monday through Thursday and one LVN and three RNs on during the weekend. It has become apparent that one of the LVNs, Maggie, resents the recently imposed limitations of LVN duties because she has had 10 years of experience in nursing, including a tour of duty as a medic in the first Gulf War. The emergency department physicians admire her and are always asking her to assist them with any major wound repair. Occasionally, she has exceeded her job description as an LVN in the hospital, although she has done nothing illegal of which you are aware. You have given her satisfactory performance evaluations in the past, even though everyone is aware that she sometimes pretends to be a “junior physician.” You also suspect that the physicians sometimes allow her to perform duties outside her licensure, but you have not investigated this or actually seen it yourself. Tonight, you come back from supper and find Maggie suturing a deep laceration while the physician looks on. They both realize that you are upset, and the physician takes over the suturing. Later, the doctor comes to you and says, “Don’t worry! She does a great job, and I’ll take responsibility for her actions.” You are not sure what you should do. Maggie is a good employee, and taking any action will result in unit conflict.
ASSIGNMENT: What are the legal ramifications of this case? Discuss what you should do, if anything. What responsibility and liability exist for the physician, Maggie, and yourself? Use appropriate rationale to support your decision.
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Solution
Brief Summary of the Case
In this paper, I will be seeking to solve the case of the legal ramifications for exceeding one’s duty. In the case study presented, the LVN on duty, which is known as Maggie, is caught by the charge nurse performing duties that are outside her licensure, as the supervising physician looks on. Maggie has also been accused numerous times of pretending to be a junior physician in the healthcare facility.
Legal Ramifications
The legal ramifications in the case where an LVN is caught performing duties that are outside her licensure include malpractice lawsuits that can befall a healthcare facility. In the case that the LVN performs activities that are not under their licensure and patients experience adverse outcomes, such patients can decide to sue a healthcare facility for malpractice. The malpractice lawsuit will therefore be directed to the supervising physician who would be liable for delegating duties to professionals that do not have the necessary qualifications and license to perform such duties. In the case of adverse outcomes among patients as a result of having received inadequate healthcare services from qualified staff such as LVN, the liability that exists for the charge nurse would be related to deciding to cover up for the irregularities noted (Renkema et al., 2016). If the charge decided not to report an LVN who performs duties and responsibilities that are beyond her licensure, they would also be liable for malpractice. On the other hand, the supervising physician would also be liable for malpractice as they allowed a junior staff member such as an LVN to perform duties beyond their licensure. Finally, the LVN would be liable for malpractice for knowingly performing duties and roles beyond their licensure (Renkema et al., 2016).
Integrated Ethical Problem-Solving Model
As a charge nurse in the emergency department, I would utilize the integrated ethical problem-solving model to determine the actions that I will take in the case where an LVN is caught performing roles that are outside her licensure. Utilizing the integrated ethical problem-solving model, the first step would therefore be to determine whether there is an ethical issue or dilemma (Park, 2017). The case study presented ethical issues related to beneficence, and nonmaleficence, which would therefore be noted (Stone, 2018). In the case study, the LVN would therefore endanger the patient by performing duties that she’s not qualified for and be going against the principles of beneficence and nonmaleficence. The LVN would also be abusing the principle of autonomy of patients by pretending to be a junior physician. In my professional judgment, I would therefore rank the ethical principles of beneficence and nonmaleficence as being the most important and most relevant to the ethical dilemma (Park, 2017). As a charge nurse, I would also develop an action plan based on the different ethical priorities that have been determined central to the ethical dilemma. The ethical principles of beneficence and nonmaleficence would be central to my action plan. Considering the lack of principles of beneficence and nonmaleficence, the charge nurse should therefore consider the option of reporting the LVN to the responsible authorities in a workplace. This would be done through drafting an incidence occurrence report which would imply that the reported incident would be stopped immediately and the involved parties committed to following ethical principles. Finally, I would reflect on the ethical decision-making process and evaluate the consequences of the process involved for the different stakeholders such as patients, healthcare practitioners, and the healthcare facility in general (Stone, 2018).
References
Park, E. J. (2017). An integrated ethical decision-making model for nurses. Nursing Ethics, 19(1), 139–159. https://doi.org/10.1177/0969733011413491
Renkema, E., Broekhuis, M., & Ahaus, K. (2016). Conditions that influence the impact of malpractice litigation risk on physicians’ behavior regarding patient safety. BMC Health Services Research, 14(1). https://doi.org/10.1186/1472-6963-14-38
Stone, E. (2018). Evidence-Based Medicine and Bioethics: Implications for Health Care Organizations, Clinicians, and Patients. The Permanente Journal. Published. https://doi.org/10.7812/tpp/18-030