Does Work Overload Justify Negligence?

Does Work Overload Justify Negligence? Muhammad Qasim Introduction According World Health Organization (WHO), Pakistan is one of the 57 countries with acute deficiency of healthcare workforce and with no well-defined human resource development policy in place. The country is facing dual burden of communicable and non-communicable diseases with Doctor to patient ratio of as high as one doctor per 1254 population (WHO, 2013). The health care’s facilities remain overcrowded by patients, specially the public sector, which result in work overload and stress among the healthcare professionals. Medical officers (MOs) and Post graduate trainees have duty hours as long as 90 hours per week. Healthcare professionals under stressful condition and work overload are more prone to commit negligence and medical errors. The consequences of medical negligence range from a minor harm to loss of human life. This paper will discuss medical negligence, malpractice in relation to work overload in the light of ethical principles and theories. Moreover, some recomme ndation will be put forward to minimize negligence, establish proper reporting system and minimize work overload among healthcare provider. Scenario A 27 years old male was admitted to the general surgery ward with gunshot injury. He was on injection Nalbuphine10 mg as per need. This patient was constantly complaining of severe pain. The assigned nurse assessed his pain and informed the doctor about his condition. She also informed that the patient has already received Nalbuphine up to its maximum limit i.e. four doses in the last 8 hours. The doctor was overwhelmed with the workload of ward and emergency unit as well. He told the nurse that the patient and his family are exaggerating the condition. Meanwhile, the doctor visited the patient and informed the nurse that he has reassured the patient and his family. After one hour, the patient developed breathing difficulty and went into respiratory arrest. Patient was resuscitated promptly for twenty minutes, but he did not revive, and hence expired. The family showed a strip of tablets Lorazepam 2mg, and added that two tablets are given to the patient on the advice of the duty doct or. It was found that the drug was neither mentioned in patient’s file nor was it verbally ordered to the nurse. The doctor requested not to report the incidence. Later on inquiry revealed that consequences occurred due to additive effect of concurrent CNS depressants. Issue Analysis In the above scenario, the patient was in acute pain, the family was worried about his restless condition. His cries and complaints were disturbing other patients in the units. Doctor was burdened with too many responsibilities and had to manage the patients in ward, recovery room, and emergency department at the same time. Being overwhelmed with too many responsibilities he advised two tablet of Lorazepam 2 mg per oral without mentioning in patient file without considering the prior high deses of Nelbuphine. Consequently, due to the additive effect of the concurrent CNS depressants patient collapsed, and after an attempt of unsuccessful cardio-pulmonary resuscitation (CPR) patient expired. This was violation of ethical principles of beneficence and non-maleficence. Moreover, the doctor’s intention was not to harm the patient however, he bypassed the nurse, did not indicate the order in patient’s file, and handed over written prescription to the father of the patient. The poor father brought the medicine and gave to the patient, which resulted in fatal consequences. It was breach in his duty toward his patient and violation of Hippocratic Oath (Cruess Cruess, 2014). It is also evident from the scenario that doctor wanted to just keep the patient calm and get rid of his pain complain. So, he prescribed a high dose of another sedative medicine for the sake of his ease. Though his intentions was not to harm the patient and was also over loaded with too many responsibilities but, my question is, does work overload justify negligence which cost a human life? Discussion Malpractice is negligence on part of an individual within a professional capacity. According to Beauchamp and Childress (2001) negligence is the absence of due care either intentionally imposing risk of harm or unintentionally but, carelessly in a given situation. Principle of beneficence is central to healthcare and healthcare professionals are expected to be beneficent toward their patients in any circumstances. According to Mustafa (2013) â€Å"Beneficence refers to the promotion of welfare, denoting acts of mercy, unstinting love and selfless humanity† (p.2). However, in this case the doctor not only failed to be beneficent but also committed such an act which resulted in sentinel event. He prescribed the CNS depressant beside he knew that the patient had already received 40 mg of nelbuphine since morning. It was the commission of a maleficent act on his part which, resulted in loss of a precious human life (Beauchamp Childress, 2001). Being in the professional boundary of a doctor, he was trusted upon by the patient and family and was expected to be beneficent toward patient in any case. On contrary, it could be argued that, his intention was not to harm the patient. He just wanted to keep the patient in rest and pain free. In Addition, doctor was overburdened with other responsibilities. He had to take care of other patients so, on the bases of utilitarian theory he was justified to take into consideration the care of other patients as professional obligation. Additionally, it was not only the patient but also the worried family members and other patients in the ward who were disturbed due to his cries and complains. So his decision of prescribing sedative pills was for the benefit of large number of people (Beauchamp Childress, 2001). Though, his workload was more than usual, and he had to fulfill too many responsibilities at a time. However, it neither allows him to be negligent in patient care, nor permit him to violate Hippocratic Oath in which, he had promised that â€Å"he will lead his life and practice his art with integrity and honor by using his power wisely† (Zafar, 2006). His action was deficient as compared to a reasonable and prudent professional under given circumstances (Burkhardt and Nathaniel). Moreover his act was a serious carelessness and maleficent in nature for the client which cost his life. Such negligence is not justifiable on the basis of any legal or moral grounds. Secondly, he bypassed on duty nurse who was responsible for the administration of the medication. It was breach of duty on his part to fail to enter the order in patient’s file. Being responsible for patient’s care, and employ of the institute, he was supposed to follow due course of actions of patient care. Moreover, the concurrence of opiates and sedatives would not have occurred if the doctor had followed proper procedure of prescription. On other hand, it could be claimed that, the ultimate goal of his decision was to relieve suffering of patient. Violating proper procedure of prescription and administration was probably intended to provide prompt relief. However, the nurse could have moved with the doctor in his visit to the patient to argue on the dosage about concurrence. Furthermore, the doctor might have thought about giving prescription to the patient’s attendant will take less time and so prompt relief; he therefore broke the chain of flow of proper protocol. The society expects professionally and morally sound decisions from the doctors. As a part of healthcare team, they are supposed to follow the policies and abide by the rules of the institute they work in. furthermore, â€Å"patients have the right to a quality of care which is marked both by high technical standards and by a humane relationship between the patient and health care providers† (Exter, 2009). In the scenario, the doctor’s noncompliance regarding proper procedure of prescription was below the acceptable standards and violation of his professional obligation. According to American medical association the doctor’s responsibilities include to be ever vigilant for the benefit of patient, and to bear their part in sustaining its institutions and burdens† (Cruess Cruess, 2014). A large number of doctors’ misjudgments and medication errors are corrected by dispensing pharmacist or medication nurse if proper protocols are followed (Al-shara, 20 11). Finally, his request to the nurse about covering the incidence was a professional misconduct as this was a sentinel event. However, the nurse properly followed the virtue of veracity and dared to report the incident. Resultantly, the inquiry revealed that the additive effect of the concurrent CNS depressants was due to negligence in clinical judgment and careless behavior of the doctor. It could be argued that the incidence occurred unintentionally, and its reporting could endanger the doctor’s carrier. In addition, reporting of the incidence could have cost his job and even his license of practice. Is it acceptable to take such risks in a country like Pakistan where there is already shortage of doctors? The negligent behavior of the doctor cost a precious human life, even though he requested the nurse not to uncover the incident. This could be measured a serious misconduct and makes his trustworthiness and moral integrity questionable. According Pakistan medical and dental council the physicians need to attempt highest level of competence and all necessary skills and knowledge, and they will be responsible for their actions (Zafar, 2006).Considering the nature of the event, it was the moral and professional obligation of the nurse to report the incidence promptly. Proper reporting system could prevent future mishaps. Nurse was right in her decision to report the incident on the basis of utilitarian theory for benefit of long number of prospective patients (Burkhardt and Nathaniel, 2008). Recommendation Healthcare providers need to be competent, skillful, and vigilant to provide efficient care to the patients. They should comply with the Hippocratic Oath and trust and expectations of the society. Sound knowledge of bioethics and Islamic ethics can make a difference and should be the part of curricula across the disciplines of healthcare. Proper policies, procedures and protocols need to be implemented and monitored for compliance at institutional, provincial and country level. The government must consider the establishment of new institutions and policy for staffing and scheduling of healthcare professional to cater the needs of growing population and minimize work overload. The proper reporting and analysis should be carried out following an incidence. Conclusion In the conclusion, malpractice on the basis of work overload could not be justified on any moral or legal grounds. Healthcare professionals should comply with the entrusted expectations of patients and society. They are expected to demonstrated optimal level of clinical and professional competencies and skills to meet challenges of the respective professions. Human life is precious and should always be respected. References Al-Shara, M. (2011). Factors contributing to medication errors in Jordan: a nursing perspective. Iranian journal of nursing and midwifery research, 16(2), 158. Barach, P., Moss, F. (2001). Delivering safe health care: safety is a patients right and the obligation of all health professionals.BMJ: British Medical Journal,323(7313), 585. Beauchamp, T. L., Childress, J. F. (2001). Principles of biomedical ethics. (5th ed.). New York: Oxford University Press. Burkhardt, M. Nathaniel, A. (2008). Ethics and Issues in Contemporary Nursing (3rd ed.) Australia: Delmar Cruess, R., Cruess, S. (2014). Updating the Hippocratic Oath to include medicines social contract. Medical education, 48(1), 95-100. Exter, A. (Ed.). (2009). International Health Law and Ethics: Basic Documents. Maklu. Scheffler, R. M., Liu, J. X., Kinfu, Y., Dal Poz, M. R. (2008). Forecasting the global shortage of physicians: an economic-and needs-based approach. Bulletin of the World Health Organization, 86(7), 516-523B. WHO (2007).Global Health Observatory Data Repository. Retrieved from World Health Organization website: http://apps.who.int/gho/data/node.main.A1444?lang=en Zafar , M. H. (2006). Pakistan Medical Dental Council: Code of Ethics. Retrieved April 8, 2014, from http://www.pmdc.org.pk/Ethics/tabid/101/Default.aspx#6

Critical Analysis of an Incident Essay -- Nursing Reflective Practice

Introduction The intention of this written essay is to demonstrate an understanding of my views on the art and science of reflection and the issues surrounding reflective practice. It is based on a significant incident from my own area of clinical practice as a state registered paramedic within the U.K. There is a discussion appraising the concept of reflection both generally, and in my particular area of practice. This is followed by an analysis of the incident using The What ? Model of Structured reflection suggested by Driscoll (2000). A rationale is given for the selection of this particular incident and also for the selection of the chosen model as a framework. It will show how the model has been used to reflect on the incident, what has been learnt, and the outcome on both current and future practice. Reflection is an active process of witnessing one’s own experience so that we can take a closer look at it. It has its foundations in the discipline of experiential learning. Dewey (1939 cited in Rolfe, Freshwater, & Jasper 2001) claimed that we learn by doing, and realising what came of what we did. â€Å"Reflective practice is something more than thoughtful practice. It is that form of practice which seeks to problematise many situations of professional performance so that they can become potential learning situations and so the practitioners can continue to learn, grow and develop in and through their practice† Jarvis P. (1992) pp174 -181. Johns, C (2000a) pg 34, describes reflection as a window through which the practitioner can view and focus self within the context of his own lived experience in ways that enable him to confront, understand and work towards resol... ...pman, C.M. (1988) Professional and Ethical Issues in Nursing: The Code of Professional Conduct: Chichester; J. Willey & Sons Ltd. Jarvis, P. (1992) Reflective practice and nursing, in Nurse Education Today, Vol 12, No.3 pp 174 - 181 Johns, C (2000a) Becoming a Reflective Practitioner; Oxford: Blackwell Science Ltd. Chapter 3 pg 34 Johns, C. (2000b) Becoming a Reflective Practitioner: Oxford: Blackwell Science Ltd. Chapter 3 pg 36 Procter, B. (1986) Supervision: a co-operative exercise in accountability: Routledge U.K. pg 23 Rolf, G., Freshwater, D. and Jasper M. (2001) Critical reflection for nursing and the helping professions: a users guide. Basingstoke: Palgrave Macmillan Roth, P.A. (1989) What is reflective practice? (Internet) Available from http://www/lovehealth.org/tools/reflection2.htm (accessed on 21 December 2006)

Position Paper- Rene Descartes Essay

Rene Descartes was known as a modern philosopher who questioned everything unable to be proven true, a type of thinking called skepticism. He also was intrigued by reason and opinions of people and how they created the opinions from society and their surroundings. His ideas have evolved into modern philosophy all around the world. People are born with the natural sense of reason (the instinct to determine right from wrong). This natural sense is what creates opinions. No two people have the exact same opinion, because no two people reason the exact same way. The distinction between right and wrong is an opinion itself, therefore, reason is just a subject of opinion. Opinions are becoming a problem. Many people are either open minded or close minded based on society and their surroundings. Descartes’ was neither here nor there about how someone thinks, but the best lesson he learned during his life was â€Å"not to believe too firmly anything of which I had learnt merely by example. † This basically means to caution yourself from making opinions based on a set example, which implies the greatness of an open mind rather than a closed mind. Another subject of opinion is acceptance. Take the average Joe for example. He has an opinion, he accepts it, and that opinion is true, no question. But what about the other millions of people in the world who accept something different than Joe? Won’t they think Joe’s opinion is not true and he’s accepting something wrong? In the grand scheme of things, no one really knows what is true and what’s not. That’s why everyone should have an open mind and be willing to accept more than what’s in their zone of comfort or belief. Our society has a bad habit of manipulating the human mind and forcing it to believe what’s popular. This has become a controversy all over the world. Descarte would not appreciate what society has done to many of its citizens because more people than not are obsessed with their own belief and aren’t willing to think outside of the box. Everyone needs to remember what Descarte talked about in this document and create a balance of what they currently believe in and what beliefs they would like to explore.

Nelson mandela Essay

in India, discriminatory attitudes towards men and women have existed for generations and affect the lives of both genders. Although the constitution of India has granted men and women equal rights, gender disparity still remains. There are limited opportunities for women in sectors which traditionally demand for men to participate, such as armed forces. Although women also have mostly off-front job opportunities within the army. There is specific research on gender discrimination mostly in favour of men over women. Due to a lack of objective research on gender discrimination against men, it is perceived that it is only women who are suffering. The research often conducted is selectively sampled, where men are left out of the picture.[1] Women are perceived to be disadvantaged at work, and conclusions are drawn that their capabilities are often underestimated. Discrimination towards Women Infancy to childhood Both women and men are important for reproduction. Sex is very important between a male and a female to ensure continuity of human species on the earth. The cultural construct of Indian society which reinforces gender bias against men and women, with varying degrees and variable contexts against the opposite sex,[3] has led to the continuation of India’s strong preference for male children. Female infanticide, a sex-selective abortion, is adopted and strongly reflects the low status of Indian women. Census 2011 shows decline of girl population (as a percentage to total population) under the age of seven, with activists estimating that eight million female fetuses may have been aborted in the past decade.[4] The 2005 census shows infant mortality figures for females and males are 61 and 56, respectively, out of 1000 live births,[5] with females more likely to be aborted than males due to biased attitudes. A decline in the sex ratio was observed with India’s 2011 census reporting that it stands at 914 females against 1,000 males, dropping from 927 in 2001 – the lowest since India’s independence.[6] The demand for sons among wealthy parents is being satisfied by the medical community through the provision of illegal service of fetal sex-determination and sex-selective abortion. The financial incentive for physicians to undertake this illegal activity seems to be far greater than the penalties associated with breaking the law.[7] Childhood to adulthood and education Education is not widely attained by Indian women. Although literacy rates are increasing, female literacy rate lags behind the male literacy rate. Literacy Rate Census of India 2001 and 2011 Comparison Literacy for females stands at 65.46%, compared to 82.14% for males.[8] An underlying factor for such low literacy rates are parents’ perceptions that education for girls are a waste of resources as their daughters would eventually live with their husbands’ families and they will not benefit directly from the education investment.[9] Adulthood and onwards Discrimination against women has contributed to gender wage differentials, with Indian women on average earning 64% of what their male counterparts earn for the same occupation and level of qualification.[10] Discrimination against women has led to their lack of autonomy and authority. Although equal rights are given to women, egality may not be well implemented. In practice, land and property rights are weakly enforced, with customary laws widely practised in rural areas. Women do not own property under their own names and usually do not have any inheritance rights to obtain a share of parental property.[1] D

“Let’s Talk About Sex” Documentary Essay Essays

â€Å"Let’s Talk About Sex† Documentary Essay Essays â€Å"Let’s Talk About Sex† Documentary Essay Essay â€Å"Let’s Talk About Sex† Documentary Essay Essay Essay Topic: Talk James Houston put together the docudrama â€Å"Let’s Talk About Sex† that highlights the differences between American’s attack to arouse instruction and that of other states like the Netherlands. The stereotypes. contention. and irony all related to sex is put out in the unfastened and discussed. Throughout the movie. it is obvious that America’s ways of sex instruction and attitude towards sex has created a negative intension. The Europeans have a much more unfastened attack when it comes to the treatment of sex and started sex instruction at an early age. American’s. on the other manus. have a really closed attack to arouse treatment and salvage sex instruction for later ages. This negative intension and attack to instruction has resulted in the States holding much higher rates of adolescent gestation. adolescent birth. and sexually familial infections when compared to European states. One could state that it’s clip the United States changes its attack and sentiments sing sex. gender. and the instruction behind it. Throughout the film. there was a commonalty between those who held a colored sentiment on the subject of sex. Those who believed abstention should be enforced and were against an unfastened treatment of sexual dealingss were frequently times from the older coevals. It’s the parents of teens. most instructors of sex instruction. and even people within the churches that held a prejudice. They believed that teens should non be involved in sexual activities and that it should be saved for matrimony. Along with that. they stood behind the thought that the teens should non be educated about sex until later in high school and the unfastened treatment of sex and gender was non proper. Kelsey’s female parent was one of these biased people. She was strongly against the thought of Kelsey taking portion in sexual activities until she got married and did do it easy for Kelsey to openly pass on with her about her sexual dealingss. For those teens that do take portion in sexual activities. they are looked down upon in the greater part of American civilization because of the negative intensions that have been established here in the United States. With these prejudices. it has put sex into a negative class non merely for the minority. being the teens. but most Americans in general. In America. sex is non something people openly talk about nor is it something that teens are â€Å"suppose† to take portion in. The thought of teens taking portion in sexual dealingss prior to matrimony is greatly frowned upon and the stigma of transporting a rubber has scared them off from it. An illustration of this. which was shared in the film. is that in the Netherlands. transporting a rubber get downing in their teens is really common and bucked up. Where as in the provinces. if a adolescent were to be caught with a rubber. others would see that as a mark of person who is really promiscuous. In the film. females thought males who carried rubbers wanted nil but sex from a miss while males thought that adult females who carried rubbers were easy and considered slatterns. This negative impact in the States has generated these stereotypes environing sex. The effects of these stereotypes have negative results. For illustration. if a cat is afraid to transport a rubber because of the stereotype and when it comes clip for him to take portion in sexual activities. he won’t be decently prepared. Without the protection. he is at hazard for STIs and possibility of gestation in misss. This is besides true frailty versa with misss ; they excessively should transport rubbers. but are afraid due to the negative association. There is besides a negative thought behind the treatment of sex in an unfastened scene. Most parents in the US are afraid to speak about sex with their teens sharing both their sexual lives and discoursing their teens. Because the parents are non unfastened to it. the teens are afraid to near their parents with sex related inquiries or state them they have taken portion in sexual activities. Because of this. many teens go with out proper direction and right information in respects to sexual activities. Where as if the parents were more unfastened and accepting of the thought of their teens taking portion in sexual activities. it would open an avenue for better cognition and possibly even assist prevent STIs. gestations. and other sex related issues. The minority group in â€Å"Let’s Talk About Sex† stood as US teens. These teens faced the favoritism of senior groups and negative stereotypes. but throughout the class of the film. it showed how things are easy altering. Several people who are frequently viewed as community leaders are working to decently educate teens. An illustration was sublime Williams. who created an unfastened country to discourse sex related things and offer proper instruction. Some instructors besides voiced their sentiment on how they believe sex erectile dysfunction. should be more about sexual dealingss and non about human anatomy. They besides believe the instruction should get down at younger ages when childs are traveling through pubescence and developing sexually developing. This is one manner these teens are acquiring the upper manus on favoritism. Another is that opening the thought of household treatments about sex and the thought of teens being involved in sexual dealingss. Interrupting the premise that abstention is the lone reply and opening the door to treatment. utilizing the Netherlands as an illustration. By the terminal of the film. Kelsey. whose female parent originally frowned upon sex before matrimony. was able to alter her female parents mind and even speak about her sexual dealingss. These are merely a twosome of the ways the teens easy made alteration. there is still a batch more to be talked about and changed. When reflecting back. I excessively can associate to the US teens in the docudrama. I have noticed the closed door in footings of the treatment of sex and human gender every bit good as the stigmas associated with teens’ engagement in sexual activities. I do believe there is something to be said about the Netherlands attack to human gender and sex. particularly when looking at the figure of adolescent gestations and transmittal of STIs compared to the much larger figure in the US. We. as the United States. could profit from a alteration in the ambiance environing adolescent sex. and sex in general. Sexual activity is a natural thing.

College Term Paper Topics

College Term Paper Topics College Term Paper Topics The modern system of education is getting broader every day expanding the stores of study information gathered as important knowledge and at the same time closing up as a mouse trap for the student, that desiring to learn, get tight deadlines and great load of homework. Among all of those study troubles homework is the most problematic assignment. First of all, unlike the work which you are to do at class, at home you are cut off the group study process and have to do it on your own. Moreover, there is no professor around to give you a helping hand. Homework is mostly assigned in form of written works which makes it even harder. Not only you have to know the material from the class but you are also supposed to put it on the college term paper with a fluent language to make your assignment readable. This can be all done at a more or less corresponding level since it all comes with experience and practice. Term papers are the most unfavored written assignments for students. Not because they are hard to write or can have different format, its just that it at times becomes very challenging to get a college term paper topic. Imagine that you are writing a college term paper as well as the other hundreds of students at your college. To make this assignment grade winning you have to find a delicious topic for it. Nevertheless, how can it be exclusive and appealing to the reader if the rest of the students are thinking about that, too. You dont get much space to move the thoughts around. Considering that selection of the topic is the most important in the writing of the college term paper it is sometimes better to get help from your professor, classmate, academic sources or professional online writing help. If you need custom college term papers, you can order them from our college paper writing service.

An Overview of MHRA Referencing

An Overview of MHRA Referencing An Overview of MHRA Referencing If you’re studying in the humanities, you may be asked to use MHRA referencing at some point. But what exactly is the MHRA system? And how does it work? Let us explain. What Is MHRA Referencing? The Modern Humanities Research Association is a UK-based organization that promotes study of the humanities, particularly literature and languages. It is best known for producing the MHRA Style Guide: A Handbook for Authors, Editors, and Writers of Theses. MHRA referencing, meanwhile, is the citation system set out within this guide. You can download [PDF] the third edition of the MHRA Style Guide for free if you want a full explanation. But since it is quite a big book, we’ll summarize the important points here. Citing Sources When people refer to MHRA referencing, they usually mean the footnote and bibliography version. This is where sources are cited in footnotes, indicated with superscript numbers in the text: These numbers usually appear at the end of a sentence, like this.1 The first time you cite a source, include full publication information. For a book, for instance, this means giving the following details: n. Author Name(s), Title (Place of Publication: Publisher, Year), page number(s). Repeat citations of the same source can then be shortened to save space. The MHRA style guide recommends using the â€Å"shortest intelligible form† for this, usually just the author’s surname and a pinpoint citation. Make sure to check whether your university has other rules, though. There is also an author–date version of MHRA referencing, but this is much less common. The Bibliography In MHRA referencing, you should list all cited sources in a bibliography at the end of your document. However, for a bibliography entry you should: Invert the first listed author’s surname and forename. Leave out pinpoint citations and final punctuation. You would format a book like this, for example: Surname, First Name, Title (Place of Publication: Publisher, Year) More generally, you should set out the bibliography as follows: List sources alphabetically by author surname. List anonymous works by title (ignoring articles for alphabetical order). If citing more than one work by the same author, sort them by title. You would then use two em dashes in place of the author’s name(s) for each entry after the first. Use italics for titles of longer works (e.g., books). Use inverted commas for shorter works (e.g., journal articles). You can abbreviate the titles of frequently cited journals. However, you must also give the full titles in a list of abbreviations earlier in your work. If you follow these rules, making sure everything is consistent, you should end up with a perfectly formatted MHRA bibliography. But if you want to be extra sure everything is in order, don’t forget to have your work checked by one of Proofed’s expert proofreaders.