Feeding tube case study

I. Feeding Tube Case Study

The two cases in question here have several similarities and differences. The two cases are similar because they are dealing with two elderly patients who are not in a position to take care of themselves. In the first case of Eleanor Dawson who is 92 years old, apart from having a urinary tract infection and developing a large pressure on her coccyx, she is also suffering from senile dementia which is further worsening the case at hand. Senile dementia which is a disease characteristic of old age, affect brain cells and thus resulting to progressive memory loss and mental abilities. There is no known cure for this disease. As a result, the patient is difficulties in reasoning and accepting new things making her completely incapable of self care including bathing and eating. This is the reason why the doctor the order has ordered that a feeding tube to be used on Eleanor who has ultimately refused. The second case involves Helen Jefferson who is 88 years old and suffering from a terminal illness (untreatable breast cancer). Her cancer has spread to several parts of her body including bones and lungs. As a result she has given up hope on her life and she is ready to die. Consequently, she refuses to eat and that is the reason why the doctor has ordered a nasogastric feeding tube for her. This makes the two cases similar in that, it involves two elderly women suffering from untreatable diseases. Both of them also have refused to eat and both refuse feeding tubes to be used on them (Newson & Aldous, 2005).

These two cases are however different in the sense that Eleanor is suffering from senile dementia which means that she cannot reason normally. As a result her rejection of the feeding tube is absolutely normal because patients with that type of disease refuse to accept new things. Helen on the other hand understands clearly the consequences of her actions and she is refusing to eat intentionally which makes her case different from that of Eleanor.

These two cases are however very complex due to their legal implications. First, it is a crime to allow someone to die from dehydration or starvation in our state and hence it is a must to report such incidents. Secondly, there is a living will statute in our state which mandates all the nurses and doctors to respect incompetent patient’s wishes. The last complication in these cases is the fact that both of the patients have living wills stating that they do not wish to be maintained on life support devices such as a ventilator. The appropriate action to take in such a scenario is to report these two incidents to the relevant authorities, explaining the legal complications surrounding these two cases, conclude by asking for permission to be allowed to use feeding tubes on these two patients since they will both die of starvation if not fed through the tubes because they are not in a position to feed themselves (Newson & Aldous, 2005)

II. Malpractice Case Study

In this case, I think the nurse is liable for the patient injury because they would not have occurred if she had ensured that her assistant had clearly understood what she meant by placing a hot water bottle on the patient’s left lower leg. Assumption/omission is one of the mistakes nurses should never make in their profession. She would have clearly explained the procedure to the assistant and make a follow up after a while to ensure that the instructions were followed to the letter. Since she omitted giving her assistant the right instructions, the patient was injured hence making her liable for the injury (Dimond, 2005).

All elements of malpractice were present in this case because: the care provided by the nurse to the patient did not meet the standard of care required of her (breach of duty of care) secondly the nurse had accepted to care of the patient (Abele, 2004) and hence she was supposed to treat him with care and diligence which she did not do (duty of care), thirdly if standard care would have been followed to take care of the patient injury would not have occurred (proximate cause), and finally whatever happened was careless and inappropriate behavior on the part of the nurse which resulted to injury (injury was proved) (Morissette, 2008).

References

Abele, J. R. (2004). Medical errors and litigation: investigation and case preparation. UK:

Lawyers & Judges Publishing Company

Dimond, B. (2005). Legal aspects of nursing. New York: Pearson Longman

Morissette, E. L. (2008). Personal Injury and the Law of Torts for Paralegals. New York: Aspen

Publishers Online

Newson, L., & Aldous, J. (2005). The Legal Maze: VCE Units 1 and 2. South Melbourne:

Macmillan Education Aus.