A Reflection Paper Submitted in Partial Fulfillment of the

Requirements in NCM 107

Catingub, Cherrielyn C.
Name of Student

Mr. Danilo Pilanga

Clasroom Instructor

Ateneo de Zamboanga University

La Purisima Street, Zamboanga City, 7000 Philippines

This is the moment when an agency nurse working for the NHS turned off her patients
life support machine by mistake.
Her devastating actions, captured on a camera Jamie Merrett had installed by his own
bed, left the 37-year-old with severe brain damage.
He was starved of oxygen as the untrained agency nurse panicked and struggled to
work basic resuscitation equipment.

Caught on camera: Nurse Violetta Aylward switches off Mr Merritt's ventilator - it was 21
minutes before a paramedic helped turn it back on

Ms Aylward has been suspended while the incident is investigated by the Nursing and
Midwifery Council
Footage from the camera, which he had put in to guard against poor care, shows her
grabbing the resuscitation machine and shouting, What do I do with this? before
paramedics were called to save him.
Last night, critics warned that the plumbers case showed how the NHS was repeatedly
failing to ensure patients were looked after by trained staff.
Violeta Aylward is a Filipino learning disabilities nurse who had not worked in intensive
care and was not trained to manage a ventilated patient.

And Mr Merritt, who needed round-the-clock care at his home in Devizes, Wiltshire,
after being severely injured in a car accident in 2002, had already had concerns over his
care.
Although he was paralysed from the neck down and dependent on a ventilator, he could
operate a wheelchair and remained mentally alert, using a voice-activated computer to
manage his own affairs and study languages.
He had warned NHS Wiltshire, which funded his care, that staff twice previously failed
to connect his ventilator properly.
When he had the camera installed in January 2009, Mr Merrett needed 24-hour care
from nurses trained to look after a ventilated patient with intensive care experience.
A notice stuck beneath the camera read: This is my webcam. It is for my family to see
that I am safe. It is recording.
Footage shows Miss Aylward approach the ventilator and push a button once which
starts an alarm beeping and a red light flashing.

Mistreated: Jamie Merrett with his sister, Karren Reynolds (centre), and her daughter,
Lauren
She then pushes the button again, switching off the machine and cutting off the oxygen
supply. Mr Merrett, who cannot speak as he is starved of air, clicks his tongue against
the roof of his mouth a warning sound ventilated patients are told to make in an
emergency.
Miss Aylward eventually realises something is wrong and calls for the care assistant on
duty, who asks: What have you done?, before calling 999.
Miss Aylward is seen floundering with the resuscitation equipment. Instead of
connecting it to the hole in Mr Merretts neck she puts it in his mouth.
She calls out: How do you do this? She then urges her patient: Jamie breathe please.
Paramedics restarted the machine after 21 minutes but by then Mr Merrett suffered
severe brain damage.

His sister Karren Reynolds, who discovered the footage on his computer, said: He
doesnt have a life now. He has an existence but its nowhere near what it was before.
Referring to the footage, she told the BBCs Inside Out programme: The point at which
the carer gives the nurse the Ambubag [resuscitation equipment] and she says, What
do I do with this?.
You know things are going to go really wrong from then on in. I cant imagine what
Jamie must have been thinking. He said to me later, Did you see me praying?.
Katherine Murphy, of the Patients Association, said: The NHS has been warned
repeatedly about ensuring the staff it hires, agency or otherwise, were suitably trained to
look after their patients.
A confidential report by Wiltshire social services, leaked to the BBC, concluded the
agency was aware it should supply a nurse trained in ventilator care, but had no system
for ensuring this happened.
Seamus Edney, Mr Merretts solicitor, said: In my experience this is the worst case of
negligence on the part of a nurse.
Miss Aylward has been suspended while the Nursing and Midwifery Council
investigates.
Ambition 24hours, the agency which supplied her, said it was not able to comment as
an internal investigation was ongoing.
NHS Wiltshire Primary Care Trust said it had put in place a series of actions to ensure
such an event will not occur again.

SOURCE:
HOPE, J. & Bentley, P. (2010). Pictured: The moment paralysed man was left braindamaged after bungling nurse 'turned off his life-support machine'. Retrieved:
http://guides.library.ualberta.ca/content.php?pid=51541&sid=380592

REFLECTION PAPER

Negligence as evident in the article is a component in cases of injury, proving

that a company, person, or any other entity failed to act in a competent way and thus
caused harm by lack of expected or reasonable action to obtain damages for the victim.
If a nurse fails to provide competent care and consequently the patients condition gets
worse or results in severe impairments or death, the nurse will be indeed negligent. In
cases where a nurse fails to pay attention to his or her tasks or has inadequate skills, it
may lead to a suit of negligence to one who does not give approved care standards
(Helm, 2003).
When a nurse cares for patients, he or she takes on the duties and
responsibilities to care for the patient in a skilled and thorough manner. This reflection
paper would like to bring to light the following ethics : Non-maleficence and
beneficence.
The first one is the duty of Nonmaleficence which means to do no harm. Nurses must
maintain competent practice level to avoid causing injury or suffering to clients. In the
above mentioned article, the nurse failed to provide competent care because she let the
patient starve off oxygen on her watch by removing the support machine by mistake,
she also failed to perform CPR as if she was not trained and lacked the knowledge to
perform it and because of her failure to perform her duty well, her patient became
paralyzed.
The second duty, is the duty of Beneficence. For instance beneficence can be seen as
working above and beyond for the patients. The nurse on duty failed to realize how she
can best help the client. Being the nurse on duty, she should have been knowledgeable
about the effects it would take if she turned off the supporting machine and anticipate
the preventive measures that would help the client. Good nurses know their obligations
and communicate well with their patients and physicians. Such nurses are aware of
board practices and regulations within legal guidelines. Most nurses have no issues with
committing negligent acts provided and they adhere to the confines of required
practices, protocols, and legal hospital guidelines.