NURS 506 Unit 4 Assignment: Case Study on Malpractice and Patient Abandonment in Professional Nursing Practice

Professional nursing accountability, ethical decision-making, and legal responsibility in situations involving malpractice and patient abandonment require graduate nursing students to analyze realistic clinical scenarios and apply standards of care to protect patients, colleagues, and healthcare organizations.

Case Study: Malpractice and Patient Abandonment

Wendy, RN, has worked in the pediatric unit at Hope Hospital for over three years. Realistic case scenarios such as this assignment help nursing students connect ethical theory with everyday clinical practice. She has accepted the day shift assignment consisting of five pediatric patients under the age of 10, three RSV patients, and two sickle cell anemia patients. High-acuity patient assignments like this often require careful coordination, teamwork, and strict adherence to hospital policies.

Two of the patients have mothers in attendance, and the remainder have no family member or caretaker. Staffing situations in pediatric units frequently place nurses in positions where independent judgment is essential. Wendy is working with Lisa, RN, who has less than one year of experience working at Hope Hospital and has recently cross-trained to the pediatric unit. Cross-training can be beneficial for professional growth, but it may also create challenges when unexpected situations occur.

Wendy has a half hour to go on her shift. Effective communication near the end of a shift is a critical component of safe patient handoff. She has just completed all duties addressing patient care when she receives a text message from her husband alerting her that her son was injured during a football game and is on his way to the community hospital in that town. Personal emergencies can create emotional stress that influences professional decision making.

Wendy informs Lisa that she has to leave and why and that she can get all the information regarding her patients from each patient chart. Formal shift reporting procedures are designed to prevent exactly this type of unsafe transition. Wendy informs Lisa to report to the oncoming shift, Susan, RN and quickly grabs her coat and leaves. Leaving the unit without proper handoff creates a significant risk for patient harm and organizational liability.

Susan working the p.m. shift, arrives on time and looks for Wendy for report. Structured nurse-to-nurse communication is a standard expectation in professional nursing practice. Lisa, who sees Susan, quickly comes down the hall to notify Susan that Wendy left in a hurry and that she is the only nurse on the floor for the last half hour. Susan asks Lisa for a report, and Lisa states she did not get a report by Wendy regarding each of her patients, but that Wendy told her that all documentation on each patient was completed. Accurate documentation does not replace the professional obligation to provide a direct and complete verbal handoff.

Susan, RN, has been a nurse for over five years in the pediatric unit. Experienced nurses are often required to manage complex situations that arise from breakdowns in process. She quickly notifies the nurse manager of what occurred and proceeds to provide her nursing responsibilities and duties to each of the five patients. Immediate corrective action is an important step in reducing further harm to patients.

Upon entering the room of the 4-year-old RSV patient, Susan notices that the oxygen is no longer in use and that the child is exhibiting signs of respiratory distress. Early recognition of clinical deterioration is a core responsibility of registered nurses. Susan also notices an IV infiltrate in the patient’s right hand which is puffy and sore when palpated. Proper monitoring and timely intervention are essential standards of pediatric nursing care.

Susan is notified of the demise of the child a day later. Sentinel events such as this often trigger formal investigations into professional conduct and systems failures. A year later, Wendy is notified to meet with the risk management and legal departments concerning an incident related to a 4-year-old RVS patient she provided care to. Legal review processes help determine accountability and guide future policy improvements.

Directions

1. Write an introduction on abandonment and the role of the nurse. Graduate-level writing should clearly define professional obligations and standards of care.
2. Explain the ethical implications of abandonment. Ethical analysis should reference principles such as beneficence, nonmaleficence, and professional duty.
3. Determine the legal implications of abandonment related to either civil or criminal law. Students are encouraged to integrate current nursing regulations and state practice acts.
4. In your future role as a nurse educator, an executive leader, or nurse practitioner, select methods to support accountability in the prevention of malpractice. Evidence-based strategies for quality improvement should be incorporated where possible.
5. Write a conclusion presenting key takeaways. The conclusion must synthesize lessons learned and demonstrate professional insight.

This paper should be 3–4 pages long, not including the title and reference pages. Careful organization and scholarly writing are expected in all sections of the paper. Be sure to include scholarly resources to support your written work. Peer-reviewed nursing literature strengthens the academic credibility of your analysis.

Assignment Requirements

Before finalizing your work, you should:

• Be sure to read the assignment description carefully (as displayed above). Attention to detail is an essential habit for graduate nursing students.
• Consult the grading rubric (located in Course Resources, Grading Rubrics submodule) to make sure you have included everything necessary. The rubric outlines specific expectations for content and formatting.
• Utilize spelling and grammar check to minimize errors. Professional presentation reflects professional nursing standards.

Your writing assignment should:

• Follow the conventions of Standard English (correct grammar, punctuation, etc.).
• Be well-ordered, logical, unified, original, and insightful.
• Display superior content, organization, style, and mechanics.
• Use APA 7th edition format. Proper citation practices demonstrate academic integrity and respect for scholarly sources.

Your Study Bay

Professional nurses accept a legal and ethical duty to provide continuous and safe care to assigned patients until responsibility is formally transferred to another qualified provider. Patient abandonment occurs when a nurse leaves a patient assignment without adequate notice, proper handoff, or organizational approval. Ethical nursing practice requires balancing personal emergencies with professional obligations in a manner that protects vulnerable patients. In the case of Wendy, failure to provide a direct report to the oncoming nurse created a breakdown in continuity of care and contributed to preventable harm. Civil liability for abandonment may arise when a reasonable nurse would have recognized the risk created by leaving the unit without proper transfer of care. Healthcare organizations reduce malpractice risk through clear staffing policies, mandatory handoff procedures, and ongoing ethics education for clinical personnel. Research shows that structured communication tools such as SBAR improve patient safety and decrease adverse events in high-risk environments (Müller et al., 2018, https://doi.org/10.1016/j.ijnurstu.2018.02.004).

Scholarly References

Müller, M., Jürgens, J., Redaèlli, M., Klingberg, K., Hautz, W., & Stock, S. (2018). Impact of the communication and patient hand-off tool SBAR on patient safety: A systematic review. International Journal of Nursing Studies, 80, 82–93. https://doi.org/10.1016/j.ijnurstu.2018.02.004

Guido, G. W. (2020). Legal and ethical issues in nursing (7th ed.). Pearson Education. https://www.pearson.com

Ulrich, C. M., Taylor, C., Soeken, K., O’Donnell, P., Farrar, A., Danis, M., & Grady, C. (2019). Everyday ethics in nursing practice. Journal of Advanced Nursing, 75(2), 423–432. https://doi.org/10.1111/jan.13817

Haddad, L. M., Annamaraju, P., & Toney-Butler, T. J. (2023). Nursing malpractice. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459272/