Jill is a physical therapist and Director of Rehabilitation Services in a Skilled Nursing Facility (SNP). Mary is a 75-year-old female who was admitted to the facility for the continuation of rehabilitation secondary to a total hip replacement. After treating Mary one Sunday afternoon, Jill wheeled her back to her room. She documented the treatment performed, and then went to another facility to treat a few more patients.
The following day, Jill received a call from Edith, the Director of Nursing Services in the facility. Edith stated that a few minutes after Jill left, Mary evidently tried to get up from her wheelchair to turn down the volume of the television and fell, hitting her head on the floor. When asked why she tried to get up on her own despite previous instructions not to do so, Mary stated that Jill did not put her call light within reach and that there was no one around to call. Edith relayed that Mary’s condition deteriorated over a 12-hour period, and she was subsequently sent out to the acute hospital (immediately after the incident Mary’s physician was called and he ordered them to keep Mary in the facility for observation). Mary suffered an intracranial hemorrhage and died early the following day.
That same day, Jill, Edith, and Betty (the facility administrator) met to review Mary’s chart. When asked if she made sure Mary had her call light, Jill stated that she was not sure if she did. Jill admitted to being preoccupied that day because of her heavy caseload and other personal problems. However, Jill stated that she had always placed the call light within reach of her patients in the past. Edith and Betty then asked Jill to revise the PT note that she did the day before to reflect that she had given Mary the call light. Edith, who was also the charge nurse on the day of the incident, had already “reconstructed” her chart entries accordingly. Betty was afraid of a big lawsuit coming from Mary’s family, so she ordered everyone involved in Mary’s care to “strengthen” their documentation to reflect that the facility was not responsible for her injury and consequent death.
Jill was pressured by Betty to change her documentation, implying that she might be terminated if she did not agree to make the revisions. Betty wanted Jill to completely revise the whole note. Consequently, Mary’s family sued the facility for negligence. Provide an ethical and legal analysis of this case. Ensure each of the following components is included in your analysis:
Definition of the problem(s)
Identification of ethical, legal, and professional principles/standards that were violated in the case
A plan to:
Right the identified ethical, legal, and/or professional principles/standards that were wronged in the case.
Minimize the suit that Jill and the hospital now face.
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