Nursing practice essay

Case Study One:

Kate is 17 years old, having just been admitted to hospital following a collapse at work (exact cause unknown). The accident and emergency staff recommended hospitalisation as she was found to be mildly dehydrated and hypoglycaemic. At handover the A&E nurse mentioned a referral to psychiatry had been made as the registrar suspected Kate might have an eating disorder.

Kate is a rather remarkable young lady in that she lives independently whilst studying for two A- Levels at night school. She tells you that she was an adoptee given back to foster care, and then abused by her carer. She is now an independent minor who works 30 hours per week in the local supermarket to support herself. Kate has absolutely no family support.
Kate is scared, stating that she doesn’t want to see the on-call psychiatrist and that she will discharge herself from care if he arrives on the ward.


Whilst you are completing your admission paperwork with Kate, the psychiatrist walks onto the ward.
Explore your professional, ethical and legal obligations towards Kate.

Case Study Two:

As a first year student nurse you are shadowing the ward sister whilst she is caring for six patients on an acute medical admissions ward. It is a bank holiday Monday and the ward is severely short staffed with the agency unable to fulfil the shortfall (it is a sunny day).

Two of your patient’s Mr. Arnold and Mr. Ahmed require their pain medication of Oramorph. As this is a controlled drug, the ward sister asks a colleague to assist.

Two hours later, Mr. Arnold who has mild learning disabilities is shouting at his visitors that the nurses are withholding his pain medication. Mr. Arnold informs you that his syringe of Oramorph was only half full.

Mr. Ahmed who is receiving palliative care has been unusually quiet all afternoon.

You find the ward sister to inform her about Mr. Arnold’s pain and Mr. Ahmed being sleepy all afternoon. The ward sister initially looks horrified but then states “the syringes must have got mixed up; I’ll top up Mr. Arnold’s pain relief, no harm done”.


Explore your professional, ethical and legal obligations towards Mr. Arnold and Mr. Ahmed.


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