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Nurse Accountability – Consent for Catheterisation, Professional Law and Ethics.

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Nurse Accountability – Consent for Catheterisation, Professional Law and Ethics.
An elderly lady, 78 year old Mrs Jones was admitted to the unit from a local nursing home following an acute myocardial infarction. In order to gain in my clinical skills experience I was asked to accompany and observe the staff nurse who was to carry out the catheterisation. The nurse told Mrs Jones that she was just going to pop a catheter in. There were no explanatory details towards Mrs Jones about what the procedure precisely entailed, and she was not informed of the risks or benefits. Therefore Mrs Jones was unable to ask any questions, or express any fears or anxieties. On commencement of the catheterisation Mrs Jones was quite clearly very distressed by what was happening to her. She was lashing out at the staff nurse, shouting "no get off me", and with great force tried to keep her own legs shut, but the nurse continued to proceed until after several attempts the catheter was in place. This was a procedure that was carried out without the patient 's consent.

Based on a case actually experienced by the author, this assignment considers how the concept of informed consent is articulated in nursing care, by exploring the legal, ethical and professional issues surrounding the subject.

To give the reader an insight surrounding the issue of consent, definitions and different types of consent will be considered.

A nurse could find herself in court under a charge of battery or negligence if a patient makes a complaint that the nurse did not gain consent or that insufficient information was given. The issues surrounding the importance of gaining patients consent will be discussed together with the legal implications for the nurse. Alongside the discussion will be real life cases that have already been to court and the author hopes to relate these to the case experienced.

Ethical dilemmas such as consent force nurses to decide on possible actions to take.

By discussing the ethical principles of autonomy, beneficence and non-maleficence and applying the ethical



References: olam v. Feirn Hospital Management Committee (1957) 1 WLR 582. Document No:C1745651, From Lawtel DatabaseBrazier, M. (1992) Medicine, Patients and the Law. 2nd ed. Penguin books: London, UK. Chatterton v. Gearson (1981) 3 WLR 1003. Document No: C11260, From LawtelDatabaseDepartment of Health and Welsh Office (1994) Code of Practice; Mental Health Act (1983). London. HSMO. Devi v. West Midlands AHA (1980) 7 CL 44. Cited in: Mkee, D. (1999), The Legal Framework for Informed Consent. Professional Nurse 14(10) pp.688-690. Dimond, B. (1995) legal Aspects of Nursing, 2nd ed. Prentice Hall International, London, UK. Donoghue v. Stevenson (1932) AC 562. Document No C1750767, From Lawtel Database. Edwards, S. (1996) Nursing Ethics a principle based approach. Macmillan Press: London. Fletcher. N. Holt, J. Brazier, M. Harris, J. (1995) Ethics, Law and Nursing. Manchester University Press: Manchester, UK. Furlong, S. (1998) Legal Accountability in Changing Practice. Nursing Times, 94, (39), 61-62. Gillon, R. (1986) cited in Rumbold, G. (1999) Ethics in Nursing Practice. 3rd ed. Bailliere Tindall: London, UK. Green, C. (1999) Nurses and the law of consent. Nursing Times 95 (5): 44-45. Kant, I. (1973) Cited in Rumbold, G. (1999) Ethics in Nursing Practice. 3rd ed. Bailliere Tindall: London, UK. Re C (1994) 1 All England Law Reports 819 Cited in Stauch, M. (1998) consent in Medical Law. British Journal of Nursing 7(2) pp.84. Re T (1992) 4 All England Reports 649 Cited in Stauch, M. (1998) consent in Medical Law. British Journal of Nursing 7(2) pp.84. Rumbold, G. (1999) Ethics in Nursing Practice, 3rd ed. Bailliere Tindall: London, UKSchloendorff v. Society of New York Hospital (1914), Cited in: Stauch, M. (1998) consent in Medical Law. British Journal of Nursing 7(2) pp.84. Sidaway v. Board of governors of the Bethlem Royal and the Maudsley Hospital (1984) 2 WLR 480. Document No: C1747515, From Lawtel Database. Singleton, J. Mclaren, S. (1995) Ethical Foundations of Health Care. Mosby: England. United Kingdom Central Council (UKCC) (1992) Code of Professional Conduct. London, UK: UKCC. United Kingdom Central Council (1996) Guidelines for professional practice. London, UK: UKCC. United Kingdom Central Council (1993) Standards for Records and Record Keeping. London, UK: UKCC. Young, A. (1989) Legal Problems in Nursing Practice. 2nd ed. Harper and Row: London, UK.

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