Legal and ethical frameworks by Sharon Frankland https://padlet.com/s_frankland/7o4ydjb69qdz en-us 2018-02-28 08:45:19 UTC 2025-10-07 05:00:05 UTC hello@padlet.com From Sharon Frankland s_frankland https://padlet.com/s_frankland/7o4ydjb69qdz/wish/236293375 Please write your comments on here about scenario 1 from the ppt. 
Has anybody broken the law?
Has the Code been breached?
Is there a Fitness to practice issue?]]> 2018-02-28 08:50:58 UTC https://padlet.com/s_frankland/7o4ydjb69qdz/wish/236293375 At that time the nurse used her professional judgement to decide that it would be in the patient best interest to take this drug in order to help settle her. We cannot know for sure but it doesnt appear that she viewed the whole situation holistically because it is known that such medication can indeed make one very sleepy and can put an individual at risk of a fall due to sleepy/drowsiness. Due to the fact that this lady is in an EMI home I assume she was also confused and likely had some form of dementia which puts her even more at risk as she clearly wanders around a lot and this and sleepiness can very much result in a fall. Therefore it doesnt appear her safety was taken into consideration and if it was there should have been measures in place to monitor this lady and the possible side effects. The nurse who did indeed notice these side effects should have reported them and insisted on the new medication being reviewed also. All new medication should be reviewed within a timely manner so that such side effects do not cause something like this happening. I feel that such medication should be ran by the patients doctor also before being prescribed. The nurse prescriber also could have started with a lower dosage to see how the patient went on, eg, 2mg prn rather than three times daily every day. This seems quite excessive. Also, was the patient informed of this decision and did they consent? - was the patient deemed to have no capacity before this decision was made solely by the nurse prescriber? Or had this not been considered - dependent on the answers to these questions the law could have been broken, there could be fitness to practice issues and there could be NMC breaches. It doesnt appear to me that the best evidence based practice was used when making this decision and that the patient was not considered holistically either. It seems that maximum effectiveness, minimum risk, minimum costs and the respect of the patient was not taken fully into consideration when this choice was met which are key factors when making a clinical safe and effective prescribing decision. https://padlet.com/s_frankland/7o4ydjb69qdz/wish/236492822 2018-02-28 16:24:02 UTC https://padlet.com/s_frankland/7o4ydjb69qdz/wish/236492822 https://padlet.com/s_frankland/7o4ydjb69qdz/wish/236555850 2018-02-28 17:51:09 UTC https://padlet.com/s_frankland/7o4ydjb69qdz/wish/236555850 After reading Scenario 1 my first thought that legally and within the NMC's code of conduct, consent could be an issue. The nurse in charge would presumably know Mrs Smith well and would be aware if she had consent or not. Mental Capacity Act 2005 presumes capacity until proven otherwise. Therefore, during the nurse's assessment Mrs Smith should have been consulted with, explained what the medication is for, why she needs it, side effects etc and together the nurse and Mrs Smith would decide if this should be prescribed. The nurse that prescribed should have been fully aware of the side effects and should have known that drowsiness, lightheadedness and dizziness are some of the side effects and should have considered that the risks out weighed the benefits - if she was unsure she could have involved other members of the multi-disciplinary team eg GP or ANP. Also noted in the BNF is that although the starting dose of diazepam is 2mg, in the elderly (although we do not know Mrs Smith's age) this should be halved. The nurse who prescribed the diazepam also must review Mrs Smith after prescribing the new medication possibly after a few days. If the other nurse had informed the prescribing nurse that Mrs Smith had been stating she had been feeling dizzy and had stumbled the medication may have been stopped prior to the fall. So possibly there are some fitness to practice issues or some re-training issues. https://padlet.com/s_frankland/7o4ydjb69qdz/wish/239079577



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