During the night shift, a nurse forgot to administer an injection at 2 a.m. due to sleeping. What is this act called according to ethical principles?

Appeared in: AIIMS Raipur NO - 2017 (Shift-1)

Explanation

Negligence is the failure to provide the level of care that a reasonably prudent nurse would under similar circumstances.
Forgetting to administer a scheduled medication due to sleeping is a classic example of an act of omission, which falls directly under the definition of negligence.
This act represents a breach of the duty of care that the nurse owes to the patient, regardless of whether harm occurred.

Option B: Malpractice is incorrect because it requires that the nurse's negligent act directly caused harm or injury to the patient. The scenario does not provide any information about the patient being harmed.
Option C: Leadership is a management function related to guiding, motivating, and directing a team. It is not a term used to describe a clinical error or professional misconduct.
Option D: Supervision is the act of overseeing, directing, and evaluating the work of others, such as a registered nurse supervising a student nurse. It does not describe a personal failure to perform a duty.

Visual 1: Flowchart: Elements of Malpractice. A visual showing the four components required to prove malpractice: 1. Duty Owed to Patient, 2. Breach of Duty (Negligence), 3. Causation (the breach caused the harm), and 4. Harm/Injury. This clarifies that negligence is a necessary component but not sufficient on its own for a malpractice claim.

Clinical Relevance

Nursing practice connection: Knowing Differentiating between negligence and malpractice in nursing ethics and law helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Accurate and timely medication administration is a fundamental nursing responsibility. Errors of omission, like forgetting a dose, can seriously compromise patient safety and treatment efficacy.
All medication errors, including those without apparent harm, must be documented and reported according to facility policy. This is crucial for patient safety, transparency, and for system-level analysis to prevent future occurrences.
What if? If the missed injection was a critical antibiotic for a patient with sepsis, and the patient's condition subsequently deteriorated into septic shock, the act of negligence could then be classified as malpractice because the element of harm would be present and directly linked to the omission.

How to Approach the Question

First, identify the core action or inaction in the scenario: a nurse failed to give a medication because they fell asleep.
Next, analyze the provided options. Recognize that 'Leadership' and 'Supervision' are management roles and are not terms used to classify clinical errors.
Then, focus on differentiating between the two remaining legal/ethical terms: 'Negligence' and 'Malpractice'.
Recall the key distinction: Malpractice requires proof of harm or injury to the patient as a direct result of the action/inaction. Negligence is the failure to act as a prudent professional, which is the act itself.
Since the question does not mention any harm to the patient, select the term that describes the breach of duty itself, which is Negligence.

Concept Tested & Keywords

Concept Tested: Differentiating between negligence and malpractice in nursing ethics and law.
Stem keywords: night shift, forgot to administer, injection, sleeping
Lead-in keywords: what is this act called

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