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The Responsibilities of Nurses According to the Nursing and Midwifery Council, New South Wales

Describe about the Being Professional Nurse for Medical Practitioners and Consequently.

1: Nursing and Midwifery Council, New South Wales is a regulatory board that keeps a register of all the nurses, midwives and students eligible to practice in New South Wales; reviews and manages the notifications (complaints) against the medical practitioners and consequently, aims to protect public health by certifying the fitness and competence of the registered practitioners. A complaint regarding three distinct issues, Conduct, Health or Performance can be made against a practitioner. Conduct Issues include unacceptable or inappropriate behavior or communication between the practitioner and the patient and their family. Any health impairment suffered by the practitioner rendering him/her unfit to practice can be notified to the council. Failure to meet satisfactory performance standards can be reported as well (Making A Notification (Complaint), 2016). Conduct matters are classified into two categories, Unsatisfactory Professional Conduct, which is of relevance to this case study and Professional Misconduct. Unsatisfactory Professional Conduct includes a wide array to issues. Any deviation from the expected standards of knowledge, skill, judgment or care provided by the practitioner is considered as an unsatisfactory professional conduct. Violation of the health Practitioner Regulation National Law (NSW) ("NSW Legislation", 2016), that aims at protecting the health and safety of the public, failure to abide by the decision or order of the Committee or Tribunal, accepting or providing a benefit from or to a health service provider or a person who sells health products are all covered under unsatisfactory professional conduct. Other matters related to Unsatisfactory Professional Conduct are criminal convictions and criminal findings, assisting unregistered practitioners and failing to provide urgent attention. In the Nursing discipline-specific case, Heather Conyard has been rightly accused of unsatisfactory professional misconduct.

2: The nurse, Heather Conyard after commencing his afternoon shift was concerned about the patient’s worsening condition and was aware that the treating doctor of the patient was unavailable. The nurse was repeatedly informed about the patient’s continual diarrhea and other deteriorating symptoms, in spite of which she decided to wait for the locum doctor to arrive to see to the patient, which was a poor conduct judgment in account of a registered medical practitioner. She did not document her final observations, however she admitted of no improvement in the patient’s vital signs. His failure to raise an alarm about the condition of the patient to a doctor relates to her professional accountability.

Consequences of Unsatisfactory Professional Conduct

Mitigating factors in law are any information or evidence in support of the defendant that may result in reduced changes. The afternoon shift was a very busy shift and she was engaged in Diazepam (a schedule 4 drug) to a patient that required her absolute attention, when she was informed about the concerned patient’s deteriorating condition. She was in charge of both the emergency department and the nurse in charge, which can be an overwhelming responsibility for one person. Antibiotics that were prescribed by the doctor were to be administered one hour prior to her shift, which was only commenced after her shift started. The patient’s regular doctor as well as the locum was unavailable to the knowledge of the nurse during the occurrence of the incidence. The emergency department doctor was the only available doctor at that time.

3: The Nursing and Midwifery Board of Australia (NMBA) has set certain competency standards for registered nurses and midwives. The proposed standards are grouped under different domains. Professional Practice, Critical Thinking and Analysis and Provision and Coordination of Care are of utmost interest in the context of these two case studies (About Us, 2016).

These standards were violated in this case. The rationale for choosing mentioned standards in this context are discussed in the following part. The nursing actions that led to the violation of the standards are: the nurse did not provide nursing intervention based on recognized standards and assessments. She failed to comply with the relevant legislation, regulation, policies, guideline or standards when making decisions. She did not maintain accurate documentation patient assessments, planning, actions and evaluation. Assessments were not conducted comprehensively to collect accurate data and information and available resources were not assessed for planning actions. She failed to recise her plans based on current evaluations.   (Professional standards, 2016).

According to Chang and Daly (2015), the most important aspect of becoming an efficient practitioner is reflective practice i.e. learning from ones' own experiences and actions. Theory-knowledge building and action-oriented reflective practices are considered to be the most efficient method in evolving into a professional practitioner. Reflective practice based approach while nursing could have improved the core competencies of the nurses and successfully avoided such detrimental situations (Chang & Daly, 2015). Extra care regarding hygiene should have been the priority for patients suffering for an extended period, as it makes them more susceptible towards secondary infections (Pomerance, 2014).

Nursing Competency Standards Set by the Nursing and Midwifery Board of Australia


4:
Considering the case study, instead of a disease-centered or clinician-centered approach, a person-centered approach in nursing is an absolute necessity for quality health-care delivery (Morgan & Yoder, 2012). It focuses on individual patient need, preferences, and values. Antecedents i.e. events that have occurred previously provide information regarding the health conditions and surrounding setting which a primary influencing factor for personalized care giving. The organizational attitude and behavior and shared governance are key factors in this context.

Lubbe & Roets in their studies have shown that competency of nurses are key to provide optimal care to patients. Nurses should abide by the laws that restrict different categories of nurses to regarding their scope of practice. Responsibilities and capabilities should be conspicuous to a certain nurse category and the importance of interprofessional teamwork should be realized in providing quality care of the patients. Failure to assess the patient condition and potential risks factors may result in individual and organizational liability (Lubbe & Roets, 2014).

According to Walker & Campbell, work outcomes in graduate nurses are hypothesised to be related to multidimensional work readiness that includes organizational acumen, clinical competence, social intelligence and personal work characteristics (Walker & Campbell, 2013). It has been proposed that development of skills concerning various levels of work readiness may contribute to long-term performance and competency of nurses.

 The judgment, knowledge or skill of the nurse was below standard. However, she did not document her observations, failed to recognize the adverse consequences and take necessary actions. He did not notify a doctor about the patient’s condition. 

Heather Conyard was registered as a nurse in 1989, was appointed in the Hospital from 2008 and has performed the role of ‘nurse in charge’ from 2009. She had training for ‘First Line Emergency Care’. Considering her expertise and experience, she needed to call a doctor as soon as she became aware of the patient’s vital signs, as they indicated the patient ‘red zone’ and required immediate response. The nurse could have avoided the situation by making a difference in her professional behavior.

She should have ensured to maintain the expected professional standards she is accountable to. The authority should have been informed about the circumstances as it compromised with the professional standards.

She was unaware of the policies and standards of the hospital relevant to the situation. She did not follow a reflective nursing practice. The experience she gathered from a very similar kind of situation in the past was not reflected in her actions  (Professional standards, 2016).

5: Krautscheid in her studies addresses the ambiguity regarding the definition of nursing accountability and aims to provide a consistent definition of the same. BFrom extensive revirew of literature the author concludes that accountability can be identifies with various terms like professional socialization, professional values, virtue ethics, professional identity, professional behaviors and ethical behaviors to mention a few. Accountability has been widely defines as being answerable to self and to those who are associated to one’s actions (Krautscheid, 2014). A comprehensive definition of accountability aids the nurse educators and researcher to elucidate every related aspect to the nurses and consequently assist nurses to evaluate their duties and restrictions.

In this context, as a graduate student a very unambiguous understanding of the aspects of nursing accountability, nurses are liable to are an absolute necessary. In clinical practices, nurses are accountable for their nursing actions, behaviors and decisions within the scope of their role. Knowledge of legislative laws relevant to the scope of practice is mandatory. In future practices, I will always aim at a reflective approach while providing care for an inpatient. The maintaining of standardized protocols has no alternatives. Reacting to emergencies and opting for professional assistance wherever there is a possible confusion or doubt about the health complications of a patient, is crucial for delivering quality care and avoid furthur complications (Battié & Steelman, 2014). 

References

About Us. (2016, September 7). Retrieved from www.hpca.nsw.gov.au: https://www.hpca.nsw.gov.au/Nursing-and-Midwifery-Council/About-Us/About-Us/default.aspx

Chang, E., & Daly, J. (2015). Transitions in nursing: preparing for professional practice. Elsevier Health Sciences.

Health Practitioner Regulation National Law (NSW) No 86a. (2016, September 9). Retrieved from www.legislation.nsw.gov.au: https://www.legislation.nsw.gov.au/#/view/act/2009/86a/part1/sec3

Krautscheid, L. C. (2014). Defining professional nursing accountability: A literature review. Journal of Professional Nursing, 30(1), 43-47.

Lubbe, J. C., & Roets, L. (2014). Nurses’ scope of practice and the implication for quality nursing care. Journal of Nursing Scholarship, 46(1), 58-64.

Making A Notification (Complaint). (2016, September 7). Retrieved from www.hpca.nsw.gov.au: https://www.hpca.nsw.gov.au/Nursing-and-Midwifery-Council/Making-A-Notification/default.aspx

Morgan, S., & Yoder, L. H. (2012). A concept analysis of person-centered care. Journal of Holistic Nursing, 30(1), 6-15.

NSW Legislation. (2016). Legislation.nsw.gov.au. Retrieved 12 September 2016, from https://www.legislation.nsw.gov.au/#/view/act/2009/86a/part1/sec3a

Pomerance, B. (2014). Arbitration over Accountability: The State of Mandatory Arbitration Clauses in Nursing Home Admission Contracts. Fla. Coastal L. Rev., 16, 153.

Professional standards. (2016, September 7). Retrieved from https://www.nursingmidwiferyboard.gov.au: https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx

Walker, A., & Campbell, K. (2013). Work readiness of graduate nurses and the impact on job satisfaction, work engagement and intention to remain.Nurse education today, 33(12), 1490-1495.

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