NRS386 – Assessment 3: Case Study of Mrs. Emily Johnson (Term Paper Sample)

NRS386 – Assessment 3: Case Study of Mrs. Emily Johnson Part 1 a. Key Legal and Ethical Principles Relevant to Nursing Practice In Australia, nursing practice is founded on ethical principles for safeguarding rights of patients, promoting high care standards, and ensuring professional accountability (Cusack, Thornton, & Brytan, 2023). NMBA (2024) indicated that legal policies require nursing to comply with Nursing and Midwifery Board of Australia Standards of Practice, Health Practitioner National Law, and workplace legislation on mandatory reporting, documentation, and duty of care. Moreover, guidance under duty of care states that nurses should avoid patient harm by providing competent, safe, and evidence-based care (Varkey, 2020). Another important legal requirement is timely and accurate documentation, which promotes accountability and care continuity (Ahpra & National Board, 2025). On the other hand, NMBA Code of Conduct (NMBA, 2024) and ICN Code of Ethics (ICN International Council of Nurses, 2021) are the ethical standards that guide nursing practice in Australia. They support principles such as justice, beneficence, fidelity, autonomy, and non-maleficence (Cusack et al., 2023). To show respect for autonomy, the nurse must acknowledge the patient’s right to contribute to decisions concerning their care. A nurse demonstrates beneficence by acting in the patients’ best interest while non-malificence manifest when they attempt to prevent harm (Varkey, 2020). Moreover, ensuring equitable care shows adherence to justice principles while fidelity is reflected in maintenance of trust and upholding of professional integrity (Guerbaai et al., 2023). There are also the principles of accountability and veracity, which promote truthful communication and taking responsibility for care decisions (Varkey, 2020). b. Legal and Ethical Issues in Mrs. Johnson’s Case Good care entails maintaining adequate records, ensuring a balance between possible harm and benefit in all decisions, communicating effectively, alleviating distress and symptoms, and applying a framework that is evidence-based and patient-centred (Ahpra & National Board, 2025). As such, several legal and ethical issues emerge from Mrs. Johnsons case. Legally, the nursing staff breached the duty of care by failing to adequately monitor, reposition, and document Mrs. Johnson’s condition, a situation that led to deterioration of her pressure injury (Varkey, 2020). This includes negligence, as they did not prevent foreseeable harm irrespective of the established standards of practice (Ahpra & National Board, 2025). Errors with documentation also presented violation of legal demand for timely and accurate record keeping (ACSQHC, 2025). On the side of ethics, care omissions (that directly caused harm) breached the principle of non-maleficence (Haddad & Geiger, 2023). Furthermore, when the staff delayed provision of proactive wound management, they neglected the principle of beneficence as the act was not in the best interest of Mrs. Johnson (Varkey, 2020). Also, the absence of effective communication with the physician and Mrs. Johnson’s family did not adhere to veracity principle and, thus, undermined transparency and trust (Cusack et al., 2023). Failure to acknowledge the concerns raised by Mrs. Johnson’s daughter further disregarded autonomy and did not respect the role family plays in shared decision-making (Frakking et al., 2020). Borrowing from Ahpra & National Board (2025), proper application of these principles should have involved following wound care protocols, implementing routine repositioning, communicating effectively with the family and multidisciplinary team, and documenting changes accurately. c. Reflection on Importance of Legal and Ethical Principles Ahpra & National Board (2025) described patient care as the key concern in nursing practice that should include patient assessment, creating appropriate management plan, treating healthcare decisions as shared responsibility, and ensuring coordination and care continuity, among others. As such, maintaining safety and professional nursing standards proves difficult without legal and ethical principles. In the case study, for instance, preventable harm that affected Mrs Johnson demonstrated the consequences of failing to uphold these principles. Reflecting on duty of care, I realise that documentation, consistent monitoring, and repositioning are legal obligations, hence neglecting them can expose a nurse to legal accountability (Ahpra & National Board, 2025). Ethically, Mrs. Johnson’s case reminded me of my obligation to prioritise patients’ best interest (benficence) and prevent harm (non-maleficence)(Varkey, 2020). Reflecting on the dismissal of the daughter’s concerns and how it compromised autonomy and trust, for example, I understand the importance of faimily-centred care (Frakking et al., 2020). In my practice, I observe safe and holistic care by recognising roles of both the patients and their families and listening to them actively. Taking the case of Mrs. Johnson, for instance, if I observed redness on a pressure area, I would document and escalate it and also let the family know the recommended care plan (ACSQHC, 2025). This would align with fidelity and veracity principles through improved transparency and trust building (Guerbaai et al., 2023). Therefore, the legal and ethical principles are practical safeguards whose role is to promote patient safety and maintain professional integrity (Varkey, 2020). Mrs. Johnson’s experience, thus, reinforces the commit I have towards applying these principles consistently. Part 2 a. Application of Two Caritas Competencies In nursing, Watson's Caritas refers to the process of developing reliable human caring connection to achieve healing support and integrity (Akbari & Nasiri, 2022). For Mrs. Johnson, the most relevant Caritas Competencies are the first (no. 1) (embracing altruistic values and practice of loving kindness) and the fourth (no. 4), which emphasises developing a helping-trusting, human caring relationship (Horton-Deutsch et al., 2024). Applying Caritas 1 may involve incorporating kindness and compassion, acknowledging that cognitive impairment and stroke have made her vulnerable (Horton-Deutsch et al., 2024). Looking at Mrs. Johnson’s case from this viewpoint may have helped the nursing staff to see repositioning and wound care as opportunities for preserving the patient’s comfort and dignity, rather than some routine tasks (Delgado-Galeano et al., 2023). Moreover, ensuring the patient’s participation in decision-making and explaining the interventions respectfully would strengthen her sense of autonomy and foster trust (Akbari & Nasiri, 2022). On the other hand, Caritas 4 promotes development of authentic, trusting relationships and applying it to the case study means that the staff should listen actively to Mrs. Johnson’s daughter and validate her concerns (Horton-Deutsch et al., 2024). Strengthening nurse-family relationship would have ensured timely intervention for the pressure injury (Akbari & Nasiri, 2022). Combining these competencies would have helped to attain a holistic person-centred care extending past clinical duties to relational, spiritual, and emotional care dimensions (Ahpra & National Board, 2025; Horton-Deutsch et al., 2024). This could have also helped to prevent harm, build trust with the daughter, and made Mrs. Johnson feel valued as a person. b. Reflection on Caritas in My Nursing Practice Reflecting on Mrs. Johnson’s case, I understand that Caritas changes caring concept into greater ethical commitment, informed by responsibility for others (Akbari & Nasiri, 2022). A recent example from my placement is when I cared for an elderly patient with dimentia, who often resisted hygiene care. I could have rushed them but instead, I applied Caritas 5, which requires being present and supportive of expression of positive and negative feelings (Horton-Deutsch et al., 2024). So, I dedicated time to listen and acknowledge their distress before utilising a calm and reassuring tone (Nursing and Midwifery Board of Australia, 2024). I observed that treating them this way reduced their anxiety and opened way for dignity in care (Horton-Deutsch et al., 2024). If I were caring for Mrs. Johnson and applying Caritas 1 and 4, for instance, I would explain the procedures for wound care in simple language, offer reassurance, and encourage the daughter to express her feelings and observations (Delgado-Galeano et al., 2023). Adopting the Caritas concept of transpersonal care, I would like to employ mindfulness in my future practice so I remain completely present in interactions to make patients feel seen and heard (Delgado-Galeano et al., 2023). Reflecting on incorporation of Caritas Competencies in the case has also helped me discover that nursing care should combine technical skills and human connection (Akbari & Nasiri, 2022). There is a possibility that consistent use of these principles when working with Mrs. Johnson could have eliminated neglect and replaced it with compassionate self-care. Part 3 a. Analysis of Key Issues in Mrs. Johnson’s Case (≈300 words) Ethical, clinical, communication, and legal issues are evident in Mrs. Johnson’s case. Clinically, this patient experienced deterioration of a pressure injury that could have been prevented. This issue, which resulted from lack of repositioning, prompt wound care, and skin assessments, also reflected a lack of compliance with quality standards for aged care and evidence-based practice (Ahpra & National Board, 2025). Legally, the case demonstrates violation of documentation requirements and duty of care (Ahpra & National Board, 2025; ACSQHC, 2025) . Keeping accurate clinical records and preventing foreseeable harm are the obligations of nurses...