Major Tom Tillison Case Study - Law Assignment Help

Assignment Task

Preamble:  As citizens, we are obligated to uphold the law.  As nurses, we are also obligated to follow and adhere to the Nursing Standards of Practice.

This assessment will allow you to understand -

Standard 1: Thinks critically and analyses nursing practice;

Standard 2: Engages in therapeutic and professional relationships and

Standard 3: Provides safe, appropriate and responsive quality nursing practice.  

Details of task:
Identify and discuss three (3) legal issues from the case study provided. 

Introduction: should clearly introduce the assessment task and provide an outline of your essay

CASE STUDY
Major Tom Tillison is an 88-year-old war veteran recently admitted to the Green Acres Repatriation Hospital in suburban Melbourne after a recent fall. Major Tillison had been diagnosed with metastatic bowel cancer in 2017 and underwent a hemicolectomy, right lung lower lobectomy, chemotherapy and radiotherapy over the last 2-3 years. He had recently been diagnosed with new tumours on his liver and been given a terminal diagnosis by his treating cancer specialist Dr. Brodski. Major Tillison had otherwise no other remarkable medical history but was taking 100mg of aspirin each morning, because his general practitioner said it was a good prophylactic. About 4 weeks prior to the fall, Major Tillison requested access to the Voluntary Assisted Dying (VAD) substance.

Dr. Brodski in his assessment, agreed that Major Tillison met the criteria to access the VAD medication and organised a full body CT to be undertaken and a second opinion, per the legislation, by Dr. Rodriguez. Major Tillison at the time, spoke with his only relative, Mx Sarah Moore, who was previously listed as his next of kin and person responsible on his advanced care plan. They had agreed to be his medical treatment decision maker and the appropriate paperwork was completed. Major Tillison was appreciative that Sarah was willing to support him in this role and expressed to Dr Brodski his confidence in them undertaking the role of person responsible. As Major Tillison was heading to his CT, he slipped over and hit his head on the concrete. The fall was witnessed by Mrs Meg Connery, a personal care attendant (PCA) who had recently completed her first aid training. She rushed to assess and assist Major Tillison. Meg noted he was unconscious, and she couldn’t determine breathing sounds.

She called 000 and was told to commence CPR. Meg did this and on her first compression on Major Tillison’s chest, she heard a crunching sound and Major Tillison groaned loudly in pain. She stopped her CPR as she assumed that he was breathing. The ambulance arrived quickly and took Major Tillison to the hospital. He underwent a CT Brain which showed a brain mass but no bleeding; and a chest x-ray which showed proximal 4 th& 5th right sided rib fractures. Major Tillison was admitted for observation and pain management.

The “Not For Resuscitation” paperwork was completed at the same time, as Major Tillison was adamant on not being “A burden to the health system”. When Sarah was visiting their uncle two days after admission to Room 2 on the 4th floor, they noticed that he was having difficulty breathing and he sounded wheezy.

They told the nursing staff on duty and said that they were upset about the fact that Major Tillison had fractured ribs in no thanks to Meg’s efforts, and asked if this was the cause of the wheeze. While Sarah was with him, he had a second chest x-ray on the ward that showed he had pneumonia to the right lung. Although stoic, Major Tillison asked Sarah to get the medicine he needed to die as he was in a lot of pain and “over it all” saying “It’s time for me to pass on”.

On leaving that afternoon, Sarah mentioned this to the Nurse Manager Fatima, who told Sarah that she would speak to the doctors and Sarah thanked her for doing so. Sarah also asked Fatima to arrange some pain medication for the Major, as he seemed to be in pain but probably wouldn’t have asked of his own volition. Major Tillison had been ordered 1mg/min morphine PRN IV until pain free with a maximum dose of 40 mg in a 24-hour period.

RNs Petty and Dean entered the room and asked Major Tillison if he wished to have morphine for the pain. Major Tillison stated “I was in the war; this is nothing compared to the pain I had on the front line! But um, sure, if you think it will help, I will take the morphine”. RNs Petty and Dean administered 1mg doses to a maximum of 10 mg IV over 5 minutes which relieved Major Tillison’s pain and allowed him to sleep. At 0745hrs the following morning Sarah received a phone call from Nurse Fatima and was informed that Major Tillison had deteriorated and was not expected to survive the day. As Sarah stepped in the lift to go up to his room, they overheard two nurses discussing what appeared to be lack of capacity in the hospital.

One nurse said “I have another patient for Room 2 when he goes. He’s had 20mg in the last hour… I can’t believe he’s still with us”. Sarah was shocked to hear this, and, speechless, stepped out of the lift and entered Major Tillison’s room, staying with him for the next 40 minutes as he slowly passed away in peace. As Sarah left the hospital, they went to see Nurse Manager Fatima who offered her condolences on behalf of the ward staff. Fighting back tears, Sarah repeated the conversation they had heard in the lift and explained that they were going to report the hospital to the police for “killing” their uncle and was suing the hospital and nurses for the “pain and suffering” they and their uncle have been through. Sarah also advised that they were lodging a complaint to the Health Complaints Commissioner and AHPRA as they were appalled with the unprofessional conduct of the staff. Nurse Manager Fatima offered an apology, but as Sarah walked away saying “Your apology means nothing. It’s too late”.

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