Chastity Caulder
1/29/14
Legal Issues Case Study (1)
You are in your final clinical rotations of nursing school. The clinical instructor assigns each
student to two patients. Although you accept your assignment, you feel uneasy about providing
care for two patients, especially since both have congestive heart failure. You are extremely
cautious as you check the prescribed medications in your reference book, check each patient's
name band, check the medications with the staff nurse, and administer the doses. To save time,
you take both patients' medications into the room at the same time. You document every nursing
action, including the education on medications given to patients. When the instructor asks how
things are going, you feel confident in stating that you are handling two patients very well. You
further explain how you took the initiative to educate one of your patients on the side effects of a
new blood pressure pill when the patient stated he never took the medication before. The
instructor asks to see the order for the drug, but when you look for the physician's order, you are
unable to find it! You suddenly realize that you switched the patients' medications and wrongly
dosed both patients. Later in the shift, one patient's blood pressure drops to the point of requiring
a transfer to ICU and the other goes into renal failure, requiring dialysis.
1. Who is liable for the actions of the student nurse—you (because you gave the
medications), the staff nurse (who checked the medications), or the instructor (who was
supervising)?
The student nurse is liable for the actions because they actually handled the medication
administration. As far as liability, the student nurse is held to the same standards as an RN for
the tasks they perform. Even if the student nurse felt like she could handle two patients, she
should have communicated with her instructor to add an additional ‘check’ before administering
the medications. Also, she should not have taken both patients’ medications into the room. She
should only have taken the corresponding, single patient’s medication first, then after
administration and documentation, she could have gone into the second patient’s room with his
medication. Also, when the patient stated that he had never take the blood pressure medication,
the student should have stopped administration and rechecked the medication order, possibly
with an instructor.
2. Did the instructor meet the standards for supervisory liability?
Yes, the instructor does meet the standards for supervisory liability. The medication
administration was assigned to a competent ‘worker’ as the student is in the final clinical rotation
of nursing school. The instructor did provide adequate supervision, and could not have known
that the student felt uneasy since the student didn’t mention it. The instructor provided
appropriate follow-up and evaluation of the delegated task. However, the instructor should have
questioned the student about the medications before the administration, which could have
This study source was downloaded by 100000831525611 from CourseHero.com on 02-03-2022 16:58:01 GMT -06:00
https://www.coursehero.com/file/27148143/Caulder-NUR-112-Legal-Issues-Case-Study-Studentdocx/
, Chastity Caulder
1/29/14
eliminated the medication error. Also, the instructor should have followed-up with the student
directly after administration, not after a while by asking how things are going.
3. Suppose you had requested supervision for the medication administration but could not
find your instructor. Who would be liable in this case and why?
As the student nurse, you would still be liable regardless if you requested supervision. If this
were the case, and the nurse knew she felt uneasy, she should have alerted the staff nurse and had
the staff nurse give the medications instead. The student nurse should never have given the
medication. Also, the staff nurse could not watch the student nurse because it has to be the
clinical instructor who is responsible for the student and the associated institution.
Legal Issues Case Study (2)
A student is doing a clinical rotation on a medical-surgical unit. In the hallway outside a patient's
room, a staff nurse explains the patient's diagnosis to the student, mentioning that the medical
condition typically is seen in patients with long-term cocaine use. When providing care for the
patient, the student asks about any illegal drug use. The patient becomes upset and says that he
has never used illegal drugs in his life. The student tells the patient that his condition is usually
seen with long-term cocaine use. The patient orders the student out of his room, yelling that she
has violated his constitutional rights and he is going to sue her for not providing a reasonable
standard of care.
1. Did a breach of confidentiality occur between the student and the patient or between the
student and the nurse? Explain.
A breach of confidentiality occurred between both the student-patient and between the student-
nurse. The student-nurse breach occurred as intentional torts, because you are not supposed to
communicate patient information with the patient’s consent; keep info about patient’s to yourself.
The nurse should not have told the information about illegal drugs to the student because you
only need to share information with other health care workers as needed. Also, the student-
patient confidentiality was breached because the student gave information that was not
necessary, and also the student assumed that information was true. Making assumptions about a
patient’s care can be seen as a form of discrimination.
2. Was a constitutional law broken in this scenario?
Yes, a constitutional law was broken in the scenario because no injury occurred to the patient,
and the client’s constitutional and human rights were not violated. Nursing is under statutory
law.
This study source was downloaded by 100000831525611 from CourseHero.com on 02-03-2022 16:58:01 GMT -06:00
https://www.coursehero.com/file/27148143/Caulder-NUR-112-Legal-Issues-Case-Study-Studentdocx/
1/29/14
Legal Issues Case Study (1)
You are in your final clinical rotations of nursing school. The clinical instructor assigns each
student to two patients. Although you accept your assignment, you feel uneasy about providing
care for two patients, especially since both have congestive heart failure. You are extremely
cautious as you check the prescribed medications in your reference book, check each patient's
name band, check the medications with the staff nurse, and administer the doses. To save time,
you take both patients' medications into the room at the same time. You document every nursing
action, including the education on medications given to patients. When the instructor asks how
things are going, you feel confident in stating that you are handling two patients very well. You
further explain how you took the initiative to educate one of your patients on the side effects of a
new blood pressure pill when the patient stated he never took the medication before. The
instructor asks to see the order for the drug, but when you look for the physician's order, you are
unable to find it! You suddenly realize that you switched the patients' medications and wrongly
dosed both patients. Later in the shift, one patient's blood pressure drops to the point of requiring
a transfer to ICU and the other goes into renal failure, requiring dialysis.
1. Who is liable for the actions of the student nurse—you (because you gave the
medications), the staff nurse (who checked the medications), or the instructor (who was
supervising)?
The student nurse is liable for the actions because they actually handled the medication
administration. As far as liability, the student nurse is held to the same standards as an RN for
the tasks they perform. Even if the student nurse felt like she could handle two patients, she
should have communicated with her instructor to add an additional ‘check’ before administering
the medications. Also, she should not have taken both patients’ medications into the room. She
should only have taken the corresponding, single patient’s medication first, then after
administration and documentation, she could have gone into the second patient’s room with his
medication. Also, when the patient stated that he had never take the blood pressure medication,
the student should have stopped administration and rechecked the medication order, possibly
with an instructor.
2. Did the instructor meet the standards for supervisory liability?
Yes, the instructor does meet the standards for supervisory liability. The medication
administration was assigned to a competent ‘worker’ as the student is in the final clinical rotation
of nursing school. The instructor did provide adequate supervision, and could not have known
that the student felt uneasy since the student didn’t mention it. The instructor provided
appropriate follow-up and evaluation of the delegated task. However, the instructor should have
questioned the student about the medications before the administration, which could have
This study source was downloaded by 100000831525611 from CourseHero.com on 02-03-2022 16:58:01 GMT -06:00
https://www.coursehero.com/file/27148143/Caulder-NUR-112-Legal-Issues-Case-Study-Studentdocx/
, Chastity Caulder
1/29/14
eliminated the medication error. Also, the instructor should have followed-up with the student
directly after administration, not after a while by asking how things are going.
3. Suppose you had requested supervision for the medication administration but could not
find your instructor. Who would be liable in this case and why?
As the student nurse, you would still be liable regardless if you requested supervision. If this
were the case, and the nurse knew she felt uneasy, she should have alerted the staff nurse and had
the staff nurse give the medications instead. The student nurse should never have given the
medication. Also, the staff nurse could not watch the student nurse because it has to be the
clinical instructor who is responsible for the student and the associated institution.
Legal Issues Case Study (2)
A student is doing a clinical rotation on a medical-surgical unit. In the hallway outside a patient's
room, a staff nurse explains the patient's diagnosis to the student, mentioning that the medical
condition typically is seen in patients with long-term cocaine use. When providing care for the
patient, the student asks about any illegal drug use. The patient becomes upset and says that he
has never used illegal drugs in his life. The student tells the patient that his condition is usually
seen with long-term cocaine use. The patient orders the student out of his room, yelling that she
has violated his constitutional rights and he is going to sue her for not providing a reasonable
standard of care.
1. Did a breach of confidentiality occur between the student and the patient or between the
student and the nurse? Explain.
A breach of confidentiality occurred between both the student-patient and between the student-
nurse. The student-nurse breach occurred as intentional torts, because you are not supposed to
communicate patient information with the patient’s consent; keep info about patient’s to yourself.
The nurse should not have told the information about illegal drugs to the student because you
only need to share information with other health care workers as needed. Also, the student-
patient confidentiality was breached because the student gave information that was not
necessary, and also the student assumed that information was true. Making assumptions about a
patient’s care can be seen as a form of discrimination.
2. Was a constitutional law broken in this scenario?
Yes, a constitutional law was broken in the scenario because no injury occurred to the patient,
and the client’s constitutional and human rights were not violated. Nursing is under statutory
law.
This study source was downloaded by 100000831525611 from CourseHero.com on 02-03-2022 16:58:01 GMT -06:00
https://www.coursehero.com/file/27148143/Caulder-NUR-112-Legal-Issues-Case-Study-Studentdocx/
