legal responsibility in peroperative care

Read each module and assessment task Given at the end and write on it in relation my
speciality area which was perioperative. And u need to cite whatever u write with peer
reviewed articles or references

Module 1: legal responsibility in perioperative care

Personnel in the perioperative settings have numerous responsibilities in relation to the legal
and ethical responsibilities. This is because their duty of delivering care is deep seated core
within the nursing principles and code of conduct. In this context, the documentation of nursing
care is a legal responsibility during perioperative care. This is the only proof they can use in their
defense that they are not negligent (Litwack, 2010). The documentation process must meet the
established practice of documentation. The records must indicates patients preoperative
assessment, care provided by the surgical team, the outcomes and evaluation plan conducted as
they are used to indicate the procedures that should be used in primary care settings. One of the
most important documentation processes in perioperative care is the informed consent (Lim et
al., 2010).
The main element of quality care in perioperative department is the issue of informed consent.
The general legal principle of perioperative care is that the healthcare provider must obtain a
valid informed consent from their patient, before any treatment intervention is put in place. This
principle is put in place to ensure that the patient enjoys the right to their health, and to decide
what health care practice that takes place in their body. This right is entitled to every patient
including the children, but the laws have specific rules that should be followed for these minors,
or patient under critical care (Litwack, 2010).

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Additionally, patient have right to confidentiality, unless they have allowed their health
condition be shared in the consent form. This implies that the patient have a legal right that must
be obeyed by the healthcare providers in the perioperative care, if the patient refuses presence of
visitors during this phase. The healthcare providers have a legal responsibility of informing all
the patient’s visitors and the contractors that the perioperative environment is a very confidential
department, and that it is only chaperoned by the staff members assigned in these departments
only. If the visitors are present for any reasons, it must be recorded in the theatre record for
referencing purposes (Tilse and Wilson, 2013).

Module 2: Dilemma of providing patient information to carers
Patient privacy is important as it upholds patient’s dignity, which is a core nurse principle and
fundamental aspect of care. The physicians are often face challenges as patients health
deteriorates, especially when they have to deliver relevant information that can be used at home
care. More often, doctors face criticism from family relatives and carers for not giving patients
adequate information. This is because it is the physician legal obligation to respect and to protect
patient information. Traditionally, patient privacy philosophy argues that patient identify the
person who can be informed about their health condition, and including if the information can
be shared with the friends or the family (Gold et al., 2009).
This theoretical model, which focuses on patient centered care, is not always the clinical reality.
The legal obligations demands that such information should be provided is there is explicit
permission. This can create huge debate if a relative who have been at the center of delivering
care of patient is denied the patient information. On the contrary, if the patient condition does
not permit them to make decisions for themselves due to severe illness or dementia, then the

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family or carer can be integrated in the decision making process. These two scenarios indicate
divergent positions in the communication between the patient’s carers and the physicians. This
indicates that the culture of patient centered care in some cases can create tensions in healthcare
(Atkinson & Coia, 2012).
In reality, the family members and carers are always concerned about the patient health. This is
especially important during transition of care from acute settings to homes. In this context, the
patients discharged from the hospital are weak and will rely on caregiver for their daily activity.
Research indicates that providing patient information to carer is beneficial because it reduces
carer anxiety, improve competency, and improve the coping strategies that will facilitate the
decision-making processes. These findings have been supported by one studies conducted in
cancer patients. From this perspective, then it is true that the carers work is often unrecognized,
and often overlooked due to the way the medical ethics and law protects the patient’s
information. These individualistic ethics dominating the healthcare practice could be hindering
quality care (Gold et al., 2009).
Therefore, it is important to empower the carer with clear and effective communication about the
essentials as they undertake the quasi-nurse role. This is because the patient carer knows the
patient best. The carer is the constant support in patient’s life, and over time, the patient builds
trust. Research indicates that the carer are encouraged and feel appreciated when integrated in
decision making processes, as they become aware of the patients physical and psychological
demands than when denied access to patient information (Atkinson & Coia, 2012).
Module 3: Reflection
Patient perspective about illness, disease, dying and death is best explained by the Spoon theory
developed by Christine Miserandino. According to her, illness especially those diagnosed with

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chronic illness such as systemic lupus makes the patient have limited expendable energy. This is
because even a small activity makes a patient loose a spoon (energy), which is very difficult to
retrieve back. Her perspective about systemic lupus and all chronic illnesses are that patients are
weak to even to undertake simple daily activities such as taking birth, walking and feeding. This
is similar to the daily incidences that we deal with at the perioperative care. Most of the
perioperative patients lack the exact words to explain the way they feel or their worries. This
narration has helped me in understands the needs, the struggles and the services needed by the
patients, especially those under perioperative care (Wagner et al., 2010).
From this narration, I have learnt that the most affected individuals during illness, dying and
death are friends and the close relatives. From the narration, it is evident that healthy people are
usually distressed and have unimaginable fear about illness, especially in chronic illness such as
lupus. For instance, the narration indicates that the patient friend got confused and may felt
helpless during the treatment regimes. However, as indicated in Maggie’s case study of hope in
recovery, it is important for the family to understand, and to find ways they can meaningfully
participate in their patient’s recovery, and to understand that their acceptance positively impact
the response of their loved ones. The family have crucial role especially in hospital settings.
They must a way to advocate for quality care for the loved ones (Atkinson & Coia, 2012).
As indicated in Maggie’s story of hope in recovery case study and Christine’s story of the
twelve spoons, the healthcare role in managing patients goes beyond offering quality care alone.
I have learnt that the healthcare providers have additional role to care giving which includes
educators, advocates, and counsellors. The healthcare staffs have the responsibility of helping the
patients to understand the disease they are suffering from, and to ensure they understand and
accept the management of their condition. This activity is important as it builds the gap between

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the healthcare providers and the patient. Additionally, it offers emotional support that will help
the patient cope with the illnesses (Bennet et al., 2010).

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Atkinson,J.M., & Coia, D.A. (2012). Responsibility to carers — an ethical dilemma. Psychiatric
Bulletin 11/1989; 13(11):602-604. DOI: 10.1192/pb.13.11.602
Bennet, A., Coleman, E., Parry, C., Bodenheimer, T., and Chen, E. (2010). Health Coaching for
Patients With Chronic Illness. Fam Pract Manag. 2010 Sep-Oct;17(5):24-29.
Gold, M., Philip, J., McIver, S., & Komesaroff, P. A. (2009). Between a rock and a hard place:
exploring the conflict between respecting the privacy of patients and informing their
carers. Internal Medicine Journal, 39(9), 582-587. doi:10.1111/j.1445-
Litwack, K. (2009). Clinical coach for effective perioperative nursing care. F.A. Davis
Company. Philadelphia
Lim, J., Bogossian, F., & Ahern, K. (2010). Stress and coping in Australian nurses: a systematic
review. International Nursing Review, 57(1), 22-31. doi:10.1111/j.1466-
Tilse, C., & Wilson, J. (2013). Recognising and responding to financial abuse in residential aged
care. The Journal of Adult Protection, 15(3), 141-152.
Wagner, G., Lorenz, K.A., Riopelle, D., Steckart, M.J., Rosenfeld, K. (2010). Provider
Communication and Patient Understanding of Life-Limiting Illness and Their
Relationship to Patient Communication of Treatment Preferences. Journal of pain and
symptom management  ; 39(3):527-34.

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