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ETHICS
Student: Charle Ryan Paguel
Student No: 822-851-358
Date Submitted: November 04, 2014
Nurs. 217: SCHOLARLY ASSINGMENT: ETHICS
Humber College North

ETHICS

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On September 20, 2007 a 32 yr old, healthy woman undergone a liposuction surgery in
a clinic operated by a family physician centered on cosmetic surgery, wherein the alleged
practical nurse (Registration No. JB00014) was working as a circulating nurse. On the day of
surgery, after almost three hours postoperatively the client died of hemorrhagic shock. The
practical nurse who accepted the care of the client after surgery was found liable of professional
misconduct by contravening a standard of practice of the profession, or failing to meet the
standard of practice, (College of Nurses of Ontario), by not following the proper procedure of
nursing care after surgery, by not performing any necessary assessment, and without any
adequate documentation of client care. Moreover, the practical nurse was taking care of three
surgical clients on the day of the incident, and the practical nurse where also doing other duties
within the facilities, these are some contributing factors affecting the practical nurse at the time
of the incidents.
The Discipline committee decided to suspend the practical nurses certificate of
registration for three months. After the three months suspensions of the practical nurses
certificate of registration she will be limited to practice within her scope, and not including
immediate nursing care for post-operative client, or in other situations the client required more
complex nursing care. The practical nurse was also required to successfully complete a course or
courses approved by the director of professional conduct, and submitting a confirmation of
enrolment and completion of the required courses. In addition, the practical nurse was required to
report to the director all employers she will be employed within 18 months period.
In my opinion the decision of the Discipline Committee was fair and ethical because in
the incident, the practical nurse is not aware of her responsibilities about the complexity of the
clients conditions wherein the practical nurse admitted her fault by not providing necessary

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nursing care to the client after surgery. However, the Discipline Committee decision was base on
the fact that, working in an environment where there are more than one healthcare professionals
that has greater knowledge in understanding the clients condition, the practical nurse is not the
sole at fault but including the physician and registered nurse that delegate the responsibility of
the client to the practical nurse, in which the stability of the client condition is unpredictable. In
order to provide the best possible nursing care there are some ethical values needs to consider.
Throughout this paper I will discuss some ethical values that are very important in nursing care,
how this values affects nurses if they are neglected, and I will recommend some strategies to
reduce unsafe practice in occurring in the future.
The most important ethical values that the practical nurse contravened in her nursing
care were maintaining commitments to clients. According to standard of practice implemented
by College of Nurses Ontario, nurses are required to provide a comprehensive knowledge and
skills in delivering nursing care, by all means nurses must always centred their care in the clients
this includes continuous assessment and documentation to monitor the clients health status while
they are in there most vulnerable position of their lives. In the case of practical nurse
(Registration No. JB00014), she accepted the care for the client; however, she did not follow the
proper procedure of post operative care, for example, taking a comprehensive head to toe
assessment, vital sign of the client before accepting care, and documentations. While the client
was in the state of post-operative care whatever it maybe, she needs a constant monitoring. For
example, vital signs every 15 minutes, making sure it is stable, recording all drainage from any
wounds, intake and output, and continuous pain medications, and documentation.
Client well being is one of the ethical values the practical nurse did not consider in
providing care for her client. According to ethical standards, as a nurse they always need to

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consider the health and welfare of the client preventing them from harm while they are in nurses
care. In the case of practical nurse (Registration No. JB00014) she contravened this values
because she did not considered the well being of the client, as she admitted her fault of not
providing necessary care for the client because the client well being was 32 years old, healthy
and talkative after the surgery. In this case, according to the study, The value ground of nursing
by Snellman and Gedda, Everybody has opinion about what is good or bad in our common
reality, what is better or worse than anything else, of what ought to be different and how we
ought to respond in fluctuating situations. It is in our human nature to assumed our action
depending on what we see; however, in nursing we need to be assertive to make sure our client
are in stable state because when we assumed, and something happens to our client it is between
life and death.
Respect to life is another ethical value the practical nurse neglected that leads to lose a
precious life. From the ethical values standard, respect to life is protecting a client life and need
to be respected by all means. Being a nurse in all aspect of care, if he/she cannot provide the
necessary nursing care or he/she have limited knowledge about the client condition, he/she needs
to withdraw from caring the client, or asked for assistance from other healthcare providers if
necessary. In the case of the practical nurse (Registration No. JB00014), she admitted she does
not have enough knowledge and skills in post-operative care of the patient; however, she still
accepted the responsibility of care, and to make the situation worse she did not pay attention on
the patients change of health status that was evidence by failing of the client vital signs.
According to the article by Paganini and Egry, Responsibility is crucial to the course of ethical
action, because it is linked to the ethical foundations of conscience, freedom and values. Every

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human is given only one life, so when this precious life are handed to nurses, this nurse need to
handle it with care because when life was lost, nothing in this world can bring it back.
One strategy that I will recommend to avoid a situation like this in happening would be
competence in nursing practice. According to the article by Paganini and Egry, Competence
relates to a combination of knowledge, skills, attitudes and values. I believe by satisfying all the
aspect of competence, there is no doubt that nursing care would be much more safe and ethical in
any healthcare settings. Im aware it may take some times to become competence in nursing
profession; however, when nurses keep their knowledge up to date, practicing their skills in the
right way, being prepared and they know how to priorities their plan of care, and most of all
values nurses needs to reflects what is the right thing to do in every step they take for the safety
of their client.
Another strategy that I can recommend is to always document all nursing care. College
of nurses practice standard, Documentation, revised 2008, Complete documentation can
demonstrate: communication, accountability and legislative requirements. I believed that
documentation is very important in part of nursing profession because it provides an overall
nursing care that was provided to the client. This document can also indicate where the nurse
needs to focus on a given client, and serve as a communication tools to provide a necessary
nursing intervention. I believed that nursing documentation can also show a capability of a nurse
to deliver safe and ethical practice by taking time to assess the client response to care provided.
In conclusion the practical nurse (Registration No. JB00014) was found guilty of
professional misconduct by not practicing according to Health Professions Procedural Code of
the Nursing Act, 1991, in regards to assessment, care and documentation as part of the standard

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of practice in nursing. The practical nurse admitted she did not provide a necessary care for the
client after surgery, and she does not have enough knowledge and skills to care for patient with
unpredictable health condition. The ethical values that the practical nurse has contravened
includes; maintaining commitment to the client by not providing the necessary care for the client
after surgery, client well-being by means of assuming the client was in good condition, and
respect to life was neglected because the nurse accepted the care even she does not have enough
understanding about the client health condition. To prevent this kind of situation in happening in
the future, nurses needs to be competence in nursing care, building their knowledge through self
study, constant practicing their skills in the right way, if needed some guidelines nurses can
access the online learning to update their skills, being responsible in caring for the client
knowing when to take action if needed, and values by always doing the right action for the safety
of the client. Documentation is very important in nursing profession, with proper documentation
the nurse advocate in safe and ethical practice.

References
College of Nurses of Ontario. (n.d.). Retrieved November 2, 2014, from
http://www.cno.org/CNO/PageTypes/DisciplineDecision.aspx?id=3737&epslanguage=en

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Colege of Nurses of Ontario.(n.d.). Retrieved November 4, 2014, from
http://www.cno.org/Global/docs/prac/41001_documentation.pdf
College of Nurses of Ontario. (CN0). (2009). Practice Standard. Ethics. Ethical Values: Client
well being. Retrieved from http://www.cno.org/Global/docs/prac/41034_Ethics.pdf
College of Nurses of Ontario. (CNO). (2009), Practice Standard. Ethics. Ethical Values:
Maintaining Commitments to Clients. Retrieved from
http://www.cno.org/Global/docs/prac/41034_Ethics.pdf
College of Nurses of Ontario. (CNO). (2009). Practice Standard. Ethics. Ethical Values: Respect
for life. Retrieved from http://www.cno.org/Global/docs/prac/41034_Ethics.pdf
Lewis, S. M., Heitkemper, M. M., Dirksen, S. R., OBrien, P.G., & Bucher, L. (2014). Medicalsurgical nursing in Canada: Assessment and management of clinical problems (3rd ed.).
Toronto: Elsevier.
Paganini, M. C., & Yoshikawa Egry, E. (2011). The ethical component of professional
competence in nursing: An analysis. Nursing Ethics, 18(4), 571-82.
doi:http://dx.doi.org/10.1177/0969733011408041
Professional Misconduct. (2014). Retrieved November 2, 2014, from
http://www.cno.org/Global/docs/ih/42007_misconduct.pdf
Snellman, I., & Gedda, K. M. (2012). The value ground of nursing. Nursing Ethics, 19(6), 71426. doi:http://dx.doi.org/10.1177/0969733011420195