The need for civic education in 21st-century schools.
Assignment is from Ch. 5
LEARNING EXERCISE 5.8
Legal Ramifications for Exceeding One’s Duties
You have been the evening charge nurse in the emergency department at Memorial Hospital for the last 2 years. Besides yourself, you have two licensed vocational nurses (LVNs) and four registered nurses (RNs) working in your department. Your normal staffing is to have two RNs and one LVN on duty Monday to Thursday and one LVN and three RNs on duty 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 minor 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 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 the 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.
Answer to Maria Hernandez Calixto discussion & answer 2 questions at the end of Maria’s discussion.
Maria Hernandez Calixto Discussion Week 2 / Group 2 / 5.8 Exercise
As a charge nurse, one of the responsibilities is to ensure conditions for patient care that are courteous, safe, and compassionate for the personnel, patients, and visitors. As the charge nurse in this scenario, it would be my responsibility to inform my superiors of what happened. While considering the possible legal consequences, they could both lose their licenses, and since I am aware of the issue, if I do nothing, my license will be suspended as well. Maggie was authorized by the doctor to conduct an activity that is outside her qualifications as a license vocational nurse. Therefore, the physician is the one who is ultimately liable for what happened. Even if Maggie performs a great job, if something goes wrong during the procedure her actions would be considered medical malpractice. She cannot suture a wound with her current credentials and should refuse to do such procedures. A model for a healthy work environment consisting of six requirements was created by the American Association of Critical-Care Nurses. A positive work atmosphere can result in more engaged nurses, less burnout, less absenteeism, and improved patient’s care.
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.
- Demonstrate leadership and communication skills to effectively implement patient safety and quality improvement initiatives within the context of the inter-professional team.
