State Regulations and Nursing Standards in Practice

Regulations affect nearly all professionals from various fields including nurses and their practice, licensure and education; these regulations are always either external or internal. External regulations include laws, rules and standards formulated by legal authorities to govern the entire nursing body, while internal rules refer to the or principles that govern a nurse.

This case study portrays a direct violation of the HIPAA privacy regulation rules since Dr. G discloses patient Es personal health information (PHI) to Mr. H who has no permission by the patient to access his PHI. This rule states, covered entities should not use or disclose individually identifiable health information to any party unless authorized by the individual or permitted under the regulations (George et al, 2008).

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According to the 13th rule of the New York State Public Health Laws (PHLs), the patients PHI and records should be kept private and confidential but this was violated. The patient acted within the law by refusing to be put in ventilator (rule 11). Dr. G also violated rule 10 by allowing Mr. H who is not a legal signatory to the patients medication records to sign against his wishes and to authorize him to be put in a ventilator.

In as much as we witness a typical violation of HIPAA privacy regulation rules, in this case, Dr. within the nursing code of ethics that emphasizes on the value of a patients life, protection from pressure and proper decision making over the strict observance of nursing regulations (Tschudin, 1992). This means that in a situation where strict observance of the rules might lead to fatal impacts; it is advisable for the doctor or registered nurse (RN) in-charge to execute decisions that would save the patients life at all costs. To save his brothers life, Mr. B was justified to go against the details of the agreement he signed and to authorize the use of a ventilator. However, the impacts of such decisions on a RN could be devastating because they should document and report all occurrences to the administration according to the stipulated regulations.

The state where registered nurses have the liberty to make essential decisions in line with their extent of practice and readiness to act is referred to as nurse autonomy. This area of practice largely clashes with the Board of nursing regulations, but they both work for the greater good of the patients. Moreover, Stewart & Dock (2006) verified that Nightingale Florence supported autonomy by quoting her vow that

I will do all in my authority to maintain and raise the level of my work, and will hold in self-belief all private matters committed to my custody and all family issues coming to my understanding in the practice of my vocation. With faithfulness, I will attempt to assist the physician, in his work, and dedicate myself to the wellbeing of those devoted to my care.


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