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The Council and its mandate

Question:

Discuss About The Journal Of The Australasian Nurses Association?

The council is a governmental organization that was formed in the year 2010 after the dismantling of the Nurses and Midwifes Board. The board’s mission is to protect public safety and maintain professional standards through the effective regulation of nurses and midwives and the development of collaborative relationships. To achieve its mission, the organization is responsible for assisting and managing around 14 professional councils in NSW. The council also works hand in hand with the NSW Health Care Complaints Commission to manage any complaints reported about the NSW health practitioners as well as the registered students in the health practitioner program. According to Scanlon et al, 2016, the council helps the health nurses and midwifes to implement the laws, work ethics and quality standards in their profession as much as possible. The main objective of this council is to increase the nurses’ or midwives’ trust and confidence in their work areas.

Some of the activities that the nurse on duty from 1700HRS on 11 January 2013 should have done are:

To make frequent check-ups on the patient’s health condition. This would have helped the nurse to realize the immediate changes of the patient’s condition. According to the nurses rules and laws, there should be thorough, frequent but regular and effective patient check-ups (Benton et al, 2013).

The nurse should not have taken too much time to check patients A’s condition. For instance, patient A’s condition worsened after 20minutes but it took almost one hour to notify the nurse. The longer it took, the worse the conditions became.

The nurse should have recorded and documented the patient’s condition after observation (Kingwell et al, 2017). This means that the nurse had no point of reference if she were asked to provide evidence or if she wanted to refer the patient to the doctor.

The nurse failed to notify the doctor about the patient’s condition early enough (Foley et al, 2017). This was against the rules and laws governing the hospital especially the shifts that take place from 1720HRS that states that a doctor should be notified when a patient’s health condition worsens especially from 1720HRS and beyond. The Nurse therefore failed to notify patient A’s doctor which against the hospital rules.

The patient failed to make a plan of action for patient A, even after observing that her condition was worsening. The lack of plan to improve patient A’s health condition led to its deterioration and later death. The nurse should have come up with a plan to manage the patient’s health condition to avoid it from deteriorating (Ross et al, 2017).

Importance of professional standards

During her shift, the nurse decided to wait for the doctor to arrive even when she knew that patient A’s condition was becoming worse. The nurse knew that it would be long before the doctor arrived to check on the patients (during his normal working hours) but she still waited until he arrived. The doctor did not have any idea about the patient’s condition at that time, courtesy of the nurse on duty. Apart from failing to notify the doctor, she did not try to make the patient’s condition better. She failed to make the patient feel comfortable and better which is one issue that led to further and faster deterioration hence death.

Just like any other profession, the Nurse and Midwife practice has created and implemented some work ethics and standards that govern their profession. These standards are however made by the NMBD organizations. These standards are meant to guide and direct the nurses and midwives towards effective and proficient practice and competency (Fisher, 2017). The following are some of the standards that were breached in the case study:

This standard relates to the ability of a nurse to develop a plan of action during the practice to help the patient get better. The plan is supposed to focus on ways and methods to improve the health condition of the patient. Also, the standard expects this plan to be documented and communicated to other people responsible e.g. doctors or other nurses. The nurse on duty from 1700HRS on 11th January 2013 failed to create a plan for patient A, even after she observed her condition deteriorating. This was a breach of standards which later led to the death of the patient.

The purpose of this standard is to ensure that patient assessment and observations are frequent and regular. The nurse should ensure that patient check-ups are comprehensive and right. The assessments made by nurses should be used to create a plan to improve the patient’s health before the doctor’s assessment (Cashin et al, 2015). However, in the case study, the nurse failed to make frequent and regular check-ups for the patient. Additionally, there was a situation where the nurse was informed about the condition instead of her observing it on her own. By failing to do this, the nurse missed out on the progression of the patient’s condition hence poor judgment.

This standards are responsible for ensuring that the nurse is capable of thinking critically during her working hours. This standard values a nurse’s level of appraising and developing herself professionally as well as her value for providing practice evidence (Cashin et al, 2017). It certainly revolves around ensuring that every nurse’s activities, observations and assessments are recorded and documented. In the case study, the nurse failed to document her observations on the patient when she assessed her. The nurse failed to create a plan to improve her condition. All of these things should have been documented for reference in future or as evidence that the nurse did all she could.

Activities for nurses on duty

Every nurse should always be well updated and aware of their patient’s condition. This can be achieved by ensuring that there are frequent and regular observations, assessments and check-ups made. However, the nurse in the case study failed do any of these and instead, she made just one observation.

The nurses should ensure that their patients are well engaged but in a professional way. They should use their skills and knowledge to create some conversation with patients. This is proven to be an indirect way to improve a patient’s health and could have worked for the patient in the case study.

Whenever an observation, an assessment or a check-up is done, the nurse should ensure that they record and document the details or results for future reference or as evidence. This was done by the nurse in the case study which showed poor or ineffective clinical reasoning.

Every nurse or midwife is supposed to have certain personal and interpersonal attributes that help them cope during in their work. Most of these attributes should involve skills like sympathy, accountability, critical thinking, innovative skills and ability to solve problems among others (Casey et al, 2017). The nurse in case study failed to reflect on her actions or even sympathize with the patient which led to her failure to act effectively.

From the case study, I have learnt that it is important for a nurse or midwife to be well prepared about the profession and the responsibility that is to be installed on his/her shoulders. The nurses are the ones entirely responsible for taking care of the hospital patients after they are treated by the doctors. This means that they are the people to determine whether the patient’s condition improves or not (Vogt, 2015).

The care aspect of my choice is to conduct patient observations and check-ups. I will be able to evaluate and understand a patient’s progress and condition with every observation. In this aspect, I will be able to interact with the patients professionally by making small talks. Through this, I will be able to achieve other aspects like engagement and therapeutic relationships with patient’s, come up with a plan to help improve the patient’s condition as well as record the patient’s results and document them. Generally, I can say this is the best care practice option because it will help me achieve most of the other care activities of a nurse.

Conclusion

In the case study, the nurse failed to implement her skills and knowledge effectively and efficiently, i.e. she failed to carry out most of the crucial activities of a nurse on duty. The nurse did not observe patient A as she should, failed to record and document the results from the one observation made and failed to inform the doctor about the patient’s condition. This indicates that there was malpractice which led to the patient’s death. Such incidences may also lead to court or legal conditions to be followed which may lead to jail sentence. Therefore, it is clear that every nurse or midwife should follow and adhere to the standards set by their organizations from them to be successful in their profession.

References

Benton, D. C., González, Jurado, M. A., & Beneit, Montesinos, J. V. (2013). A structured policy review of the principles of professional self-regulation. International nursing review, 60(1), 13-22.

Casey, M., Cooney, A., O'Connell, R., Hegarty, J. M., Brady, A. M., O'Reilly, P., ... & O'Connor, L. (2017). Nurses', midwives' and key stakeholders' experiences and perceptions on requirements to demonstrate the maintenance of professional competence. Journal of advanced nursing, 73(3), 653-664

Cashin, A., Buckley, T., Donoghue, J., Heartfield, M., Bryce, J., Cox, D., ... & Dunn, S. V. (2015). Development of the nurse practitioner standards for practice Australia. Policy, Politics, & Nursing Practice, 16(1-2), 27-37.

Cashin, A., Heartfield, M., Bryce, J., Devey, L., Buckley, T., Cox, D., ... & Fisher, M. (2017). Standards for practice for registered nurses in Australia. Collegian, 24(3), 255-266.

Fisher, M. (2017). Professional standards for nursing practice: How do they shape contemporary rehabilitation nursing practice? Journal of the Australasian Rehabilitation Nurses Association, 20(1), 4.

Foley, M., & Christensen, M. (2016). Negligence and the Duty of Care: A Case Study Discussion. Singapore Nursing Journal, 43(1).

Kingwell, E. L., Butt, J., & Leslie, G. (2017). Maternity high-dependency care and the Australian midwife: A review of the literature. Women and Birth, 30(2), e73-e77.

Ross, K., Barr, J., & Stevens, J. (2013). Mandatory continuing professional development requirements: what does this mean for Australian nurses. BMC nursing, 12(1), 9.

Scanlon, A., Cashin, A., Bryce, J., Kelly, J. G., & Buckely, T. (2016). The complexities of defining nurse practitioner scope of practice in the Australian context. Collegian, 23(1), 129-142.

Vogt, T. (2015). Life after graduation–Professional issues and registration 101. Women and Birth, 28, S6.

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