An inexperienced nurse looking after a diabetic Essay Example

An inexperienced nurse looking after a diabetic Essay Example An inexperienced nurse looking after a diabetic Essay An inexperienced nurse looking after a diabetic Essay The facts of the inquiry province that the nurse increased the dosage of the patient’s insulin with ‘no prescription from the doctor’ . The first inquiry we must inquire is whether or non Insulin is a prescription merely medicine [ P.O.M. ] ; if it is, it would look that the nurse in inquiry was moving in breach of s58 ( 2 ) ( B ) of the Medicines Act 1968 which provinces, that no individual shall administrate a POM unless he is an appropriate practician or a individual moving in conformity with the waies of an appropriate practician. If we can presume that the drug was administered intravenously, which is the standard method of presenting insulin into a human organic structure ; by virtuousness of the Medicines ( Products Other Than Veterinary Drugs ) ( Prescription Merely ) Amendment Order 1988, Insulin should non be considered a P.O.M. : Article 2 of this Order provinces, â€Å" [ n ] otwithstanding Article 3 ( 1 ) ( vitamin D ) , any readying of insulin for parenteral [ 1 ] disposal to human existences shall non be a prescription merely medical specialty. The nurse in inquiry was therefore non obliged to obtain a written, or verbal, prescription prior to administrating the drug. We must presume, despite the fact that we are told that the nurse is ‘inexperienced’ , that he or she was to the full trained to administrate endovenous medicine ; after all, we are besides told that the nurse was delegated the duty of ‘looking after a diabetic patient with unstable diabetes’ , administrating a ‘dose of insulin [ of ] 12 units per hour’ , connoting that she is to the full qualified to present drugs in this manner ; rule 7 of the NMC ( 2004 ) a provinces, â€Å"a rehearsing accoucheuse shall merely provide and administrate those medical specialties, including anodynes, in regard of which she has received the appropriate preparation as to utilize, dose and methods of administration.† If the nurse did non hold such competency, so irrespective of the fact that he or she had been delegated to this patient, under s1.18 of the NMC ( 2004 ) , the nurse is responsible for informing her higher-ups of her deficiency of equal prepara tion, and merely undertaking pattern and accepting duties for those activities in which he/she is competent. Sing any possible civil jurisprudence claim of carelessness against the nurse: it should be noted foremost, that it is improbable that the patient would of all time convey such an action against the single nurse ; after all, the true purpose of such claims is to retrieve fiscal compensation, compensation which is more likely available from the Health Authority employer of that nurse, who can be held vicariously apt for any carelessness of its staff. Second, if such a claim was to be brought against the nurse, her rawness would non itself provide a defense mechanism, nor a lowering of the criterion of attention which the jurisprudence would anticipate of her ; in the instance of Wilsher v Essex Area Health Authority [ 1987 ] [ 2 ] the bulk of the tribunal rejected the statement that what was expected of an single health care practician was what was moderately to be expected of a individual of his makings andexperience. As Lord Justice Mustill remarked in this instance, to take the pra ctitioner’s subjective experience into history when puting the range of his/her responsibility of attention would imply that â€Å"the criterion of attention which the patient is entitled to demand [ would ] vary harmonizing to the opportunity of enlisting and rostering. [ 3 ] † Therefore, whilst the nurse is improbable to confront a civil jurisprudence claim in the civil wrong of carelessness, if she does, she will be expected to hold acted with the same due attention and diligence that would hold been expected of anyone of her occupation description, irrespective of her existent experience within that place [ 4 ] . Likewise, the nurse is expected to hold a good sense of when it will be necessary to seek more specialist advice from a superior [ 5 ] , and one such method of cognizing his/her competency is by mention to the NMC ( 2004 ) . In our instance, it is implied that the nurse did seek such advice from her higher-ups, for non merely was she ‘pressurised by a nursing co-worker to increase the dosage of insulin’ , but she besides clearly contacted the supervision physician, for ‘he said he [ would ] come to the ward to order [ the insulin ] subsequently when is free’ . In visible radiation of this reading, it is really improbable that the nurse would of all time be considered carelessness at civil jurisprudence, even if her misguided actions so went on tocause[ 6 ] personal hurt to the patient ; â€Å"If [ the practician ] does seek such aid, he will frequently hold satisfied the trial [ of rationality ] , even though he may himself hold made a error. [ 7 ] † Sing possible condemnable liability originating from breach of the Medicines Act 1968 ( as amended ) or the Misuse of Drugs Act 1971, as stated earlier, there is nil within the facts of this inquiry which suggest that the nurse acted reprehensively ; she was following the instructions of both a more-experienced nurse and, presumptively, the oversing physician besides, and she administered a drug which is non a P.O.M. There is some counsel provided pertaining to where a nurse has identified an mistake in the dose of medicine NMC ( 2004 ) : where a nurse has identified an mistake in the disposal of a drug to a patient, a 2nd practician should look into any complex drug computations. In our instance, the nurse should hold checked the computations of her co-worker, who pressured her into amending the dose. If the nurse did non execute these collateral computations, so there is small uncertainty that she would be deemed to hold breached the NMC ( 2004 ) guidelines, which might travel some manner towards turn outing carelessness should such a civil action arise. The NMC ( 2004 ) guidelines besides province that a nurse or accoucheuse should non administrate or alter medicine which has been ‘drawn up by another practitioner’ ; in our instance, the nurse might hold altered the physicians dose, but she had informed the physician of her concerns, and he had expressed his consent to such amendments in saying that he would fix a prescription to consequence the alterations in dose. If the nurse is found to be in breach of the professional codifications of behavior in respects to the misadministration of medicine, the fact that she was pressured into such behaviors should supply her with some defense mechanism to any ensuing disciplinary processs: As stated in the NMC ( 2004 ) , ‘where the mistake was the consequence of reckless or unqualified pattern or was concealed, and those that resulted from other causes, such as serious force per unit area of work, and where there was immediate, honest revelation in the patient’s interest’ . Sing any ethical concerns, as contained in the NMC codification of professional behavior of professional behavior: criterions for behavior, public presentation and moralss ( NMC, 2004b ) ; as stated earlier, the nurse is under an ethical responsibility to merely move within her competency, and where he or she knows him/herself to be excessively inexperient, it is his/her ain responsibility to forbear from that activity until advice has been sought and provided by a more experience practician. In this instance, there is non indicant that the nurse was in any manner in breach of her ethical responsibility in these respects. Mentions: Luxmore-May V Messenger May Baverstock [ 1990 ] 1 WLR 1009 Bolam V Friern Hospital Management Committee ( 1957 ) 1 WLR 583 Wilsher V Essex Area Health Authority [ 1987 ] Q.B. 730 The Medicines Act 1968 The Misuse of Drugs Act 1971 The Medicines ( Products Other Than Veterinary Drugs ) ( Prescription Merely ) Amendment Order 1988 U.K.C.C. [ 1992 ] Code of Professional Conduct for Nurses, Midwives, and Health Visitors. UKCC, London Steadman, ( 2000 ) . Stedman s Medical Dictionary. Lippincott Williams A ; Wilkins ; 27th edition NMC ( 2004 ) Guidelines for the Administration of medical specialties. Nursing the Obstetrics Council, London. Nursing A ; Midwifery Council ( 2004a ) Midwifes regulations and criterions NMC, London Jackson, Powell and Stewart, ( 2002 ) . Jackson and Powell on Professional Negligence. Sweet and Maxwell Publishing. 19ThursdayDecember 2002. Pyne R, Accountability in rule and in pattern, British Journal of Nursing, Vol 1, No6, 1992, p301 – 304 Nursing A ; Midwifery Council ( 2004b ) NMC codification of professional behavior of professional behavior: criterions for behavior, public presentation and moralss NMC London.