Being A Professional Nurse: Conduct, Mitigating Factors, Standards, And Professional Behaviors

Conduct Pathways

Discuss about the Being Professional Nurse.

The unsatisfactory professional conduct definition applies to the case study since the conduct of a nurse practitioner failed to meet of the reasonable standards that is accepted by the laws. According to New South Wales consolidated Acts, unsatisfactory professional conduct of registered health practitioner refers to the conduct demonstrated in skills, care excised or knowledge ether in omission or act that is below the reasonable professional standard. In the case study, the nurse shows unsatisfactory professional conduct. Firstly, nurse in case study failed to recognize the worsening health condition of the patient, failed to document assessment and plan of action despite the critical health condition of the client (Savage, 2015). The applicable law was National Laws section 139B meaning of unsatisfied professional conduct of Registered Health Practitioner Law (NSW).

Conduct pathways notifications are notifications received that relates to the conduct of professional health practitioner. Factors in the case study that make case to fit the conduct pathway criteria include the misconduct of practitioner and omissions. Case involved misconduct of nurse that failed to provide medical assistance, escalation and document assessment despite client medical condition. Furthermore, practitioner failed to escalate the declining health issue to the health service manager. The practitioner exhibited unsatisfactory professional character and numerous omissions that are not in line with their professional training leading to death (Nursing and Midwifery Board of Australia 2008).

Nurse needed to have done emergent medical review, provided immediate assistance, provided faster clinical assessment of the patient for accurate diagnosis and escalates the worsening health condition Health Service Manager to obtain immediate medical intervention. Firstly, the nurse is would have done emergent medical review due to patient’s blood pressure and respiratory rate examination result. Secondly, nurse need to have provided immediate assistance due to continuous abdominal pain which indicate deterioration in health. Thirdly, as a professional nurse there was need for faster clinical assessment by medical doctor as the patient was in red zone which require assessment with 10 minutes to prevent worsening health condition of patient. Finally, nurse would have escalates the worsening health condition of the patient to Health Service Manager for immediate medical assistance of the patient (Pairman and Pincombe et al 2015).

Medical doctor, laboratory personnel and pharmacist needed to be involved in the coordination of care. Medical doctor would be administering the necessary treatment for the patient. Medical laboratory personnel need for blood and other required medical diagnosis for the patient. Blood diagnosis would have provided the immediate conclusion on the nature and identity of the disease. Finally, pharmacist would obtain the recommended medications for emergent treatment of the patient. The three health care team officers were needed since septicemia is life threatening diseases that need emergency identification and treatment (Andre and Heartfield 2011).

Mitigating Factors

There are a number of mitigating factors that reduced the individual’s accountability in the case. Firstly, nurse was busy the afternoon when the patient’s condition was worsening. Secondly, nurse was attending and administering medicine to another emergency patient. Thirdly, patient had been given antibiotics by medical doctor and therefore hoped patient will improve. Fourthly, the regular doctor was not available and was to arrive later. Fifthly, there was lack of clear policies for emergency doctor to attend other patient. Finally, nurse was not aware that at time of “red zone” policy a doctor should be called to provide medical assistance despite training on the “Between the Flag” policies (Nursing & Midwifery Board of Australia 2010).

According to NMBA Codes and standards, Standard 1 statement 1:1 part requires one to assess complex unstable health care need of patient. This was not the case since the practitioner shows minimal concern on the continuous unstable health condition of the patient. Furthermore, the nurse did not asses the impact of co-morbidity and interprets assessment information correctly. This would have help change the plan of action to have the patient transferred to well equipped facility on time and therefore breach the expected standard of practice of nurse (Nursing and Midwifery Board of Australia 2006).

Standard 1 statement 1:2 requires timely use of diagnostic investigation for clinical decision making. In the case study, nurse did not exhibit timely response and effective communication of the patient deteriorating health. Furthermore, escalation of the issue to the health care officer in charge was not done in time. The transfer of patient to another better health facility also failed despite several attempts.

Standard 2 Statement 2:1 indicates the need to translate evidences into plan of care which was not the case as the nurse ignored the medical examinations evidence of worsening patient health. The nurse did not do the medical review despite unstable blood pressure and respiratory rate and continuous diarrhea. In addition, the nurse was supposed to take personal responsibility to evaluate medical examination findings for correct decision making.

Standard 4 Statement 4:1 is based on evaluating outcomes of personal practice. Nurse was required to document treatments or interventions accordingly yet the practitioner asses the patient but fail to document the result. It was also expected that the nurse on duty should apply evidence available to identify appropriate outcome measures. The declining health of patient was placed patient at red zone as described in the between flag policy yet the practitioner did not document this result (Chang and Daly, 2016). 

NMBA Codes and Standards

Professional behaviors such as faster response, personal concern, observational skills, medical assistance and good communication skills would made the situation different. Firstly, the worsening health of the patient required faster response in attending the patient (Nursing & Midwifery Board of Australia, 2010). Secondly, continuous pain would attract the nurse to personal concern that is necessary for patient care.  As professional nurse immediate plan of action was required to reduce complications of the septicemia due to delayed treatment. This professional behaviour would attract different plan of action for instance, severe septicemia require patient admission into the medical emergency facility. Thirdly, good observational skills during examination, assessment and provision emergent plan of action or medical assistance would have further change the situation. Based on nurse experience it was important to communicate deteriorating health to health service manager (Stein-Parbury, (2014). Moreover, due to the declining of patient’s health condition the nurse was supposed to have close interdisciplinary engagement to ensure emergent assistance. Fourthly, provision of faster medical assistance to the client due to the continuous diarrhea and back pain was critical since there was no time for delay. Septicemia required quick administration of broad spectrum antibiotics as medical assistance. 

I have learned to prepare to adequately to provide all the required care to patient during my professional practice. Firstly, it is my responsibility to provide medical assistance to patient depending on the urgency need of those clients (Pairman and Pincombe et al 2015). Secondly, as a professional nurse my response in time of emergency case is highly required because this is necessary for life threatening diseases. Thirdly, documentation of medical assessment and examination result of patient is importance during my professional practice. Finally, escalating patient’s declining improvement to the required health care officers is important. This implies that I have to learn both communication and organization polices of hospital.

Communication of the patient medical progress as an aspect of care is vital for new graduate nurse. According to Chang and Daly (2016), personal communication skills for graduate nurse is important for facilitating care plan between patient and other health care team officers. Professional nurse is accountable for effective communication of patient progress, deteriorating health and any medical assistance needs to health care officer in charge or to the medical doctor. In addition, nurse is accountable for documentation of patient’s medical assessment or examination. New graduate nurse need to learn the necessary organization culture and for ease of communicating patient condition to other health professionals.

Reference

American Psychological Association (2010), Publication manual of the American Psychological Association (6th ed.). Washington, DC: American Psychological Association.

Andre, K. and Heartfield, M. (2011), Nursing and midwifery portfolios: Evidence of continuing competence (2nd ed.). Chatswood, Australia: Elsevier Australia.

Chang, E. and Daly, J. (2016), Transitions in Nursing: Preparing For Professional Practice (4th ed.). Chatswood, Australia: Elsevier.

Dempsey, J., Hillege, S., and Hill, R. (Eds.) (2014), Fundamentals of Nursing and Midwifery: A Person-Centred Approach to Care.  Sydney, Australia: Lippincott Williams & Wilkins.

Duchscher, J. (2008). A process of becoming: The stages of new nursing graduate professional role transition. The Journal of Continuing Education in Nursing, 39(10), 441-450.

Ebert, L. and Gilligan, C. et al (2014), They have no idea what we do or what we know”: Australian graduates’ perceptions of working in a health care team. Nurse Education in Practice, 14(5), 544-550.

Fry, S. Johnstone, .J. and the International Council of Nurses. (2008). Ethics in nursing practice: A guide to ethical decision making (3rd ed.). Oxford, UK: Blackwell Publishing.

Nursing & Midwifery Board of Australia (2010), A nurses' Guide to Professional Boundaries. Canberra, Australia: ANMC

Nursing & Midwifery Board of Australia, (2010), National framework for the development of decision-making tools for Nursing and Midwifery Practice, 2007. Canberra, Australia: ANMC

Nursing and Midwifery Board of Australia (2008), Code of professional conduct for nurses in Australia.

Nursing and Midwifery Board of Australia (2006), National competency standards for the registered nurse (4th ed.).

Nursing and Midwifery Board of Australia, Australian College of Nursing & Australian Nursing Federation (2008), Code of ethics for nurses in Australia.

Nursing and Midwifery Board of Australia (2010), A midwives' guide to professional boundaries. Canberra, ACT: ANMC

Pairman, S. and Pincombe, J. et al (2015), Midwifery: Preparation for practice (3rd ed.). Chatswood, Australia: Churchill Livingstone.

Savage, P. (2015), Legal issues for nursing students: Applied principles (3rd ed.). Frenchs Forest, Australia: Pearson Australia.

Staunton, P. J., and Chiarella, M. (2013), Law for nurses and midwives (7th ed.). Chatswood, Australia: Churchill Livingstone.

Stein-Parbury, J. (2014), Patient and person: Interpersonal skills in nursing (5th ed.). Chatswood, Australia: Churchill Livingstone.