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
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.
3. Was the interaction between the nurse and the student appropriate? Did it
violate any laws?
No, the interaction between the nurse and the student was not appropriate. There was not a
need for the student to know the assumed information in order to provide care for the
patient. Yes, a law was violated. There are two ways to look at laws that may have
been broken. An intentional tort is an action taken by one person with the intent to harm
another person. The harm does not have to be violent, hostile, or cause a significant
amount of pain or distress to the other person. Under invasion of privacy, it states that a
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
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.
3. Was the interaction between the nurse and the student appropriate? Did it
violate any laws?
No, the interaction between the nurse and the student was not appropriate. There was not a
need for the student to know the assumed information in order to provide care for the
patient. Yes, a law was violated. There are two ways to look at laws that may have
been broken. An intentional tort is an action taken by one person with the intent to harm
another person. The harm does not have to be violent, hostile, or cause a significant
amount of pain or distress to the other person. Under invasion of privacy, it states that a
