Question

What are the legal facts of the case? How might the nurse have prevented a lawsuit? What is a possible defense the nurse might use?

Case Study 1: Failure to Take Action

A nurse was sued for failure to take appropriate nursing action when she improperly administered a tube feeding. Toward the end of the shift, the nurse remembered that she had to give a client a tube feeding. In a hurry to get home, she did not check the position of the tube before administering the feeding. She poured the feeding rapidly into the nasogastric feeding tube and continued to do so even though the feeding fluid was coming out of the client’s nose and mouth, and he was gagging and in respiratory distress. Despite the client’s distress, the nurse left the room and went home. An orderly came into the room after report and sought assistance for the client, who was now unresponsive. The client died a short time later. (Source: Aiken, TD. Legal, Ethical, and Political Issues in Nursing. Philadelphia: FA Davis, 1995.)

Answer 1

Nasogastric tube is considered as an essential procedure to resuscitate patients in intensive care care and who are unable to eat on their own secondary to oral cancers, oral surgery,altered sensorium.

Nasogastric insertion is done mainly by blind method in any hospitals, as it is difficult to transfer the patient to Radiological unit to insert NG tube under fluoroscopic guidance.

Nurses plays an important role in doing naso gastric tube feeding. Before feeding it is mandatory to check the position of the NG tube position by withdrawing the gastric fluid using a syringe .Whoosh test can be performed by injecting air through the syringe and hearing gurgling sound using stethoscope.

Positioning patient in semi Fowler's position also helps to prevent aspiration. If the position of tube is correct if still the patient experience any distress it is necessary to stop the procedure and reinsert the naso gastric tube.

Negligence is an act of nurse that results in uneventful harm to the patient. In this given scenario the nurse intentionally poured feeding rapidly without checking the NG tube position. She also fails to recognize the discomfort like fluid was coming out of the client’s nose and mouth, and he was gagging and in respiratory distress.

The end result of the nurse negligence results in death of patient. The nurse and the hospital is under law pursuits. This results in cancellation of nursing license, penalty to the health care for not supervising unacceptable behavior of the workers.

Imprisonment also possible if the law suit is proved again the nurse for her negligence.