- Discuss the benefits of the advanced practice nursing (APN) and nurse practitioner (NP) roles
- Discuss the legal and professional regulatory aspects of the role of the APN and NP roles
- Explain and critically discuss the concepts of accountability and ethical practice and their application in clinical nursing practice
- Describe the health care system in your country as it relates to advanced nursing practice
- Identify potential issues and challenges associated with these roles in the health care system in which you work, currently and in the future
Imagine that you have to address a group of people, to explain the APN or NP role.
How would you address the following?
What are some of the key issues you would raise in the meeting to present a positive view of the APN/NP?
What would be your key messages to the community?
How would you promote your new role to someone who opposed it?
What key messages would you want to convey to other health professionals?
Accountability in Clinical Nursing Practice
According to the health and safety legislative framework, professional misconduct is referred to an unsatisfactory professional conduct of a sufficiently serious nature for justifying suspension of cancellation of the registration of the practitioner. In this context, the professionals need to follow the legislative framework along with the professional conduct standards for nursing professionals (Katsikitis et al., 2013). In this context, this assignment has been focused upon a particular case of professional misconduct by a nursing professional and the decision of Civil and Administrative tribunal and the effect of their decision upon the nursing professionals. The assignment would also include the responsibilities of the facilities to reduce these kinds of misconduct further.
Prior analyzing the specific case, it is important to have an insight of professional accountability in the clinical nursing practice, aligning it with the professional codes and standards of practice. Both individual as well as collegial accountability is required in clinical practice. While discussing about the accountability of a registered nurse, it is important to align the practices with the professional standards of registered nurse. For instance, RN standards guide an RN to meet individual accountability, therefore promote the nurse to think critically and analyze the nursing practices, being performed; maintain the capability of practice, developing appropriate nursing plans in practice, conducting appropriate assessment in practice, being able to give appropriate, safety and quality service in the care framework (Masters, 2015). On the other hand, regarding the collegial accountability, the nurse should engage in therapeutic and professional relationship and should be able to evaluate the outcomes to inform nursing practice. Therefore, being an experienced nursing professional, Mr. Andrew should be aware and consist the competency to meet all of the above mentioned standard guidelines, to ensure the maximum compliance with the professional responsibility.
Here, the key concern is the professional dispute of Mr. Andrew Simonsen, who is a registered nurse. The Health Care Complaints Commission prosecuted the RN due to breach of his professional conduct. On July 3rd, 2011, Mr. Andrew, who have been recently joined the organization, Chesalon Aged Care. Initially, he allowed one of his friends, person A, instead of knowing that the person is addicted to heroin. Moreover, during night shift, he failed to provide pain medication ‘morphine’ to patient B, instead of checking the patient’s medication chart. He further was claimed to self administer and abuse the drug in the premise’s toilet. His colleagues have also reported wired and unusual behaviour of the practitioner. After the termination of his employment at Chesalon old age home, the practitioner, he joined Sir Moses Montefiore Jewish Home, where he did not conveyed regarding his previous professional history to his new employer (Caselaw.nsw.gov.au, 2016). In addition, he did not comply with the conditions imposed upon him regarding the safe usage of drugs, during his employment at Montefoire. Therefore, it can be interpreted that Mr. Andrew did not comply with standard 6 of professional nursing practice, which depicts that nurses should ensure that a safe, appropriate and responsive quality of nursing practice is being promoted.
Professional Misconduct by a Nursing Professional
According to standard 7, he also failed to evaluate the consequences of his misconduct and the impact of his behaviour upon his patient or his own profession. In addition, the practitioner have also breach the ethical code of nurse practitioner as well as registered nurse (Nursingmidwiferyboard.gov.au, 2017). According to the code statements of the nurse practitioner, it is important for the nurse professional to ensure nursing ethics is followed, which include appropriate professional behaviour, respect and dignity towards the care users and colleagues as well as aligning the professional practices with the legislative framework of health and safety. However, Mr. Andrew did not comply with these code statements.
In the context of collegial accountability, all the employees need to contribute equally in the professional role for achieving their own responsibility objectives as well as to maximize the quality of service provided by the organization. It has also been revealed that the practitioner was addicted to drug, which led to the development of some impairment and thee practitioner was guilt for his misconduct. Doyle, Hungerford and Cruickshank (2014) argued that collegial relationships with other members of the healthcare team are an important requirement for the NP to negotiate role delineation and to educate others about the role as their skill set is increasingly recognised. Therefore, in context of collegial accountability, the other staffs of the health care team should discuss the issue with the applicant, after identifying his misconduct or inappropriate behaviour at the first glance. Identifying his guilt at the initial step and promoting his positive thinking through positive communication and strong relationship building may help the practitioner to adopt coping skills, for reducing or eliminating his drug addiction. Moreover, the security staffs should be more prone and active, while allowing an individual in the institution; they should thoroughly assess the person’s capability and need for entering into the organization.
On the other hand, a counselling may be helpful for Mr. Andrew, at the initial stage for dealing with his substance abuse nature. Is colleagues should be more prone to identify the inappropriate behaviour and should advise him regarding his professional misconduct and the possible consequences. The care home authority should also consider his condition, impairment and should undergo a thorough discussion with the practitioner and should show empathy and respect, while making him understand regarding the potential negative consequences of drug abuse upon him, patients as well as the organizational image. In the above ways, collaborative collegial accountability may prevent the misconduct or repetition of professional misconduct by the nursing professional (Schneider & Whitehead, 2013).
In addition to the individual and collegial responsibility, the professional misconduct can also be prevented with the help of organizational accountability to eliminate these kinds of incident in the organization. For instance, the health facilities should implement strict safety standards and penalty should be imposed on any kinds of such misconduct. The organization should implement a risk assessment system to identify any kinds of risky behaviour by staffs or patients, which is harmful to the organization. The organization should arrange significant training and promotional sessions, for individual nursing professionals, for motivating and giving value to their work. In addition, these professional training helps nursing staffs to be more familiar with the organizational legal and ethical policies. Potential policies, like zero tolerance policy, which impose high penalty for professional misconduct or unprofessional behaviour can limit these kinds of misconduct and empower professional standards in the organizational environment (Caselaw.nsw.gov.au, 2016).
In conclusion, it can be said that professional conduct and standards are the guidelines for the nursing professionals, for meeting their professional objectives. In this context, the case of Mr. Andrew included significant misconduct and breach of professional standards in his practice, which should be prevented significantly, from the current practice in health and social care sector. For ensuring the elimination of these kinds of misconduct, the employees as well as employers should strictly follow the professional competency standards and legislative framework, thereby maximizing both the quality of service provided to the service users as well as the quality of their lives in the care homes.
Caselaw.nsw.gov.au. (2016). Simonsen v Health Care Complaints Commission - NSW Caselaw. Caselaw.nsw.gov.au. Retrieved 6 June 2017, from https://www.caselaw.nsw.gov.au/decision/577b49d6e4b058596cb9d1a8
Doyle, K., Hungerford, C., & Cruickshank, M. (2014). Reviewing Tribunal cases and nurse behaviour: Putting empathy back into nurse education with Bloom's taxonomy. Nurse education today, 34(7), 1069-1073.
Katsikitis, M., McAllister, M., Sharman, R., Raith, L., Faithfull-Byrne, A., & Priaulx, R. (2013). Continuing professional development in nursing in Australia: Current awareness, practice and future directions. Contemporary nurse, 45(1), 33-45.
Masters, K. (2015). Role development in professional nursing practice. Jones & Bartlett Publishers.
Nursingmidwiferyboard.gov.au. (2017). Nursing and Midwifery Board of Australia - Registered nurse standards for practice. Nursingmidwiferyboard.gov.au. Retrieved 6 June 2017, from https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx
Schneider, Z., & Whitehead, D. (2013). Nursing and midwifery research: methods and appraisal for evidence-based practice. Elsevier Australia.
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