Question

Lisa is employed at a long-term care facility. For each shift, there is one nurse on duty for 40 patients. The major nursing responsibility is to give medications to patients. On average, patients have 10 medications each. Lisa must take the blood sugar readings of 10 residents every morning, because they are on sliding-scale insulin orders. The personal support workers provide hands-on care for the patients. Lisa has told her unit manager that she is overworked. She recommends that the institution get unit-dosing and employ more registered nurses and registered practical nurses for safety reasons. Her manager says these options are too costly. Lisa replies that she will not continue to work under these conditions. She submits her resignation, giving her employer two weeks' notice.

That night, the evening nurse calls in sick. The unit manager tells Lisa she must stay until he can find an agency nurse to replace her. Lisa says she is not happy about this, but she will stay because she does not want the patients to be without a nurse. Lisa administers the evening medications and leaves when a replacement registered nurse arrives at 2200 hours. When she returns to work the next day, Lisa finds the coroner is present because a new resident died during the night. The resident, Mrs. Marj, had a respiratory arrest; CPR was given, but she did not survive. Lisa looks at the medication record with the coroner. It is clear from the narcotic count that she had given Mrs. Marj 100 mg of morphine and not 10 mg, as ordered.

Questions

1. After being shown the documentation in the narcotic count book, Lisa sees that she made an error when administering Mrs. Marj's medication. Do you think Lisa is fully responsible for the patient's death, or were there mitigating circumstances? What should Lisa say and do when asked about her care of Mrs. Marj?

2. Under what circumstances are coroners required to investigate a death? Should the coroner have been called in this case? After the coroner makes a report, what are the next steps? How will Lisa be involved in the coroner's report and any further actions?

3. The family thinks Mrs. Marj's death was preventable. They complain to the college and consider using litigation. What resources are available to assist in Lisa responding to charges of professional misconduct and malpractice, and a criminal charge?

Answer 1

In the present scenario, Nurse Lisa administered to Mrs.Marj 100mg of Morphine instead of 10 mg as ordered during her last shift at 2200. The new resident Mrs.Marj had a respiratory arrest and she died during the night.CPR was given, but she does not survive.

1. Surely we can see malpractice and professional misconduct done by Lisa. But the fact that the death of the patient results from the drug overdose. But there is a mitigating circumstance where we can avoid the death of the patient by timely management of drug Morphine overdose.

Here not only the professional misconduct is done by Lisa but also the replaced nurse after Lisa at 2200. Why because while taking the handover the next shift nurse is totally responsible to take the handover of a patient clearly including the medication chart also. During the handover time if the next shift nurse realized the mistake early and managed the case properly thus may be the death of Mrs.Marj can be avoided.

She will report regarding the work overload of the organization and complaint coroner that on hospital management regarding, they are not giving any consideration to the staff regarding their wellness and the workload is more that is difficult to concentrate in each and every patient at a time. Suddenly just before the completion of her duty shift the management has allocated a new patient to her for doing the over duty because of the actual nurse calls in sick.

2.The coroner required to investigate the death because Mrs.Marj death is due an unexpected respiratory arrest. They will investigate the reasons for the respiratory arrest. The coroner's found that the death of Mrs.Marj is due to Morphine overdose. They found that the staff Lisa has done professional misconduct or negligence or malpractice that is an overdose of morphine that resulted in crime or death of the patient. The coroner after the investigation they will file a report of crime done by Lisa as misconduct, negligence or malpractice.

The coroner made a recommendation to the management to management to minimize the significance of her conduct that the staff has to required better training about the dangers of opioid medication.

3. In the case of Lisa, it's an unintentional tort made by Lisa due to her mental state and workload resulted in an unintentional overdose of drug morphine and resulted in patient death is a crime.

A quick honest apology might prevent a future claim, or provide an opportunity for a settlement without the need for litigation