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Nursing Case Study

Louise is a registered nurse working on medical ward in the local hospital. She is caring
for Sam, an 18 year old, who has been admitted with unstable blood sugar levels. Sam has
a history of type 1 Diabetes Mellitus, which he was diagnosed with at the age of 5.
At 5pm Louise takes Sam his insulin to administer just prior to his dinner. Sam however,
refuses to take the insulin and tells Louise he is not hungry and is sick of being in this
stupid hospital. Louise tells Sam he must take his insulin but he tells her to get lost. Upset
by Sam’s comments, Louise leaves the room and does not come back to see Sam for the
rest of the shift. Louise hands over to the night shift that Sam is non-compliant and
The next day Louise comes in for day shift and is called to the Nurse Unit Manager’s
(NUM) office. The NUM informs Louise that Sam has been transferred to the Intensive
Care Unit (ICU) overnight with a diagnosis of diabetic ketoacidosis (DKA) and is very
unwell. The NUM asks Louise why Sam was not given his evening does of insulin.
When Louise gets home from work that afternoon she is upset and makes a post to her
Facebook© page. Whilst Louise has not mentioned any names in her post, many of her
Facebook© friends know where Louise works and are colleagues of hers.
Louise Smith Can’t believe I got called into the office today because my stupid patient
refused their insulin & ended up in ICU. How is that my fault?!?!
10 minutes ago Like Comment
1. What are the legal issues in this case?
• If legal action is taken by Sam or his family is it likely that Louise will be found
to be negligent? Consider the four (4) actions that must be met to be considered
• Is Louise’s post on Facebook© a breach of Sam’s privacy? Consider the
legislation, hospital policy and the NMBA codes and guidelines in your
2. Are Louise’s actions ethical?
• Define the bioethical principles commonly utilized in healthcare and use these to
argue for or against Louise’s actions.
3. What should Louise have done differently in this scenario?
• In your response outline the fundamental patterns of knowing in nursing and
explain how she could improve her knowledge on EACH of these to improve her
• Justify you response with supportive evidence including reference to the NMBA
codes and guidelines.
Headings to be used:
• Introduction
• 1. Legal Issues
• 2. Bioethical Principles
• 3. Recommendation
• Conclusion

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