Anna Registered Nurse Employed Secondary School Queensland Adolescent Mental Health

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Assignment Details

Nurses, midwives and other health professionals have legal and ethical responsibilities and accountabilities in practice. The goal of this assessment is to apply your understanding of ethical and legal principles and requirements to the roles and responsibilities.

Within your response to each case you must consider:

  1. The ethical principles and how they apply to the case.
  2. The legal requirements for students and registered health professionals.
  3. How the professional, ethical codes (code of conduct and code of ethics) apply to the specific details of the case.

Case Study one

Anna is a registered nurse employed full-time at a large secondary school Queensland. Anna is experienced and well-regarded by staff and students. She has recently completed professional development in adolescent mental health and culturally responsive communication. Anna is supporting Samir, a 17-year-old Year 12 student who recently arrived in Australia with his family on a humanitarian visa. Samir is fluent in English and academically capable but has expressed experiencing high levels of stress and difficulty adjusting to the Australian school system. He оссаsionally visits the school health and wellbeing centre to talk with Anna about strategies for managing stress and homesickness.

Over time, Samir begins attending more frequently, and Anna provides informal emotional support beyond physical health concerns. During one session, Samir mentions feeling isolated and says Anna is one of the only adults he feels comfortable talking to. Moved by his honesty, Anna begins to check in with him between classes and allows their appointments to extend well beyond scheduled times. She also shares personal experiences of living abroad and struggling with belonging, believing this helps to "normalise" Samir's feelings.

One afternoon, Anna drives Samir home after school when his sibling forgets to pick him up. She does not inform the school or document the interaction, believing it was a simple favour. Samir later emails her on her work address, thanking her and saying he hopes they can "catch up like that again." A member of the school leadership team sees the email and expresses concern, prompting a review of the case. An audit reveals limited documentation of Samir's visits and no formal referrals made to appropriate mental health or settlement services. Anna is asked to explain her actions and reflect on the implications of crossing professional boundaries, despite her good intentions.

Note: Please analyse the ethical and legal issues in this case study, using relevant ethical principles, professional codes, case law and legislation.

Case Study Two

Lisa is a registered nurse with 12 years of experience, currently working in a busy metropolitan emergency department in Queensland. During a night shift, Lisa is working alongside Tom, another registered nurse and long-time colleague. Lisa notices that Tom appears distracted, and smells faintly of alcohol. At one point, he nearly administers the wrong dose of IV medication before Lisa intervenes. She asks if he's okay, and Tom discloses quietly that he's been "having a hard time" and has been drinking alot but he "won't let it affect his work"

Lisa is concerned but feels torn. She knows Tom has recently gone through a divorce and has been under financial pressure. She also worries that reporting him might destroy his career. After their shift, she advises Tom to take some leave and "get help." He agrees but continues to work, calling in sick intermittently.

A week later, a graduate registered nurse approaches Lisa to say she found Tom asleep in the staff room during his shift, with a half-empty water bottle that smelled like alcohol nearby. Still unsure, Lisa speaks to some of the other senior nurses privately warning them to look out for Tom's behaviour, but does not submit a formal notification to AHPRA or the hospital.

Two weeks later, a serious medication error occurs on Tom's shift. The hospital's internal review uncovers concerns raised by staff, and further investigation confirms Tom had presented to work multiple times under the influence of alcohol. AHPRA is notified by the hospital as part of the investigation.

When questioned, Lisa admits she suspected Tom had been intoxicated on shift but felt conflicted.

Assessment Requirements Summary

This assessment required nursing students to critically analyse legal and ethical responsibilities of health professionals through two case studies. The key tasks included:

  • Applying ethical principles (such as autonomy, beneficence, non-maleficence, justice, and professional boundaries) to each case.
  • Identifying the legal obligations of both students and registered nurses under Australian health law and professional regulations.
  • Demonstrating understanding of the Nursing and Midwifery Board of Australia (NMBA) Code of Conduct and Code of Ethics, and how they apply in practice.
  • Referencing relevant case law, legislation, and professional guidelines.
  • Critically evaluating the implications of actions or omissions by the nurses involved.
  • Providing a well-structured, objective legal memorandum-style analysis for each scenario.

Step-by-Step Approach by the Academic Mentor

The academic mentor guided the student through the process in a systematic way:

Step 1: Understanding the Task

  • The mentor clarified that the assignment was not about giving personal opinions but providing a predictive, evidence-based analysis.
  • Emphasis was placed on balancing both ethical considerations and legal frameworks in each case.

Step 2: Structuring the Response

  • The student was advised to adopt a legal memorandum-style structure with clear headings for each section:

    • Case overview
    • Ethical issues
    • Legal issues
    • Application of codes and standards
    • Implications and conclusion

Step 3: Analysing Case Study One (Anna and Samir)

  • Mentor helped the student identify ethical boundary issues: over-involvement, dual relationships, and lack of professional distance.
  • Discussed legal requirements around documentation, duty of care, and mandatory referral pathways.
  • Guided the use of NMBA’s Code of Conduct to show breaches of professional boundaries and accountability.
  • Encouraged citing case law and examples where nurses faced disciplinary actions for similar boundary crossings.

Step 4: Analysing Case Study Two (Lisa and Tom)

  • Mentor guided student to explore the ethical dilemma of loyalty to a colleague versus duty to patient safety.
  • Discussed legal obligations to report impaired practice under the Health Practitioner Regulation National Law.
  • Analysed how Lisa’s failure to escalate concerns formally contributed to patient risk and professional accountability issues.
  • Applied the NMBA standards to show that safeguarding public safety outweighs personal loyalties.

Step 5: Integration of Ethical and Legal Frameworks

  • Mentor reinforced the importance of showing interconnection between ethics, law, and professional codes.
  • Encouraged critical evaluation of consequences of actions/inactions rather than just describing them.

Step 6: Final Drafting and Referencing

  • Student was guided on incorporating legislation (e.g., National Law, privacy requirements), NMBA codes, and academic references.
  • Mentor emphasized clarity, objectivity, and a balanced conclusion in both cases.

Final Outcome and Learning Objectives Covered

By the end of the process, the student successfully:

  • Produced a structured legal memorandum analysing both case studies.
  • Identified ethical principles and boundary issues in professional practice.
  • Applied legal requirements and understood obligations under the NMBA standards.
  • Recognised the serious consequences of failing to report or document appropriately.
  • Learned to balance compassion with professional accountability.
  • Developed skills in critical thinking, legal research, and application of ethical frameworks to real-world healthcare scenarios.

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