Analysis Of Unsatisfactory Professional Conduct In Nursing

Nursing Competency and NMBA Professional Code of Conduct

Question:

Discuss about the Professional Conduct of Nurses According to NMBA.

Nursing competency can be described as the combination of knowledge, attitude, skills, and values one possesses. Every healthcare clinic needs competent nurses to carry out the hectic process of care to the patients. In Australia, the NMBA professional code of conduct provides the nurses with some clauses, which would help the nurses to provide the patient the best possible care. The aim of the essay is to analyze the provided case study, which describes how a nurse Ms. Heather Conyard has been accused of unsatisfactory professional conduct. The nurse was unable to understand the graveness of patient’s health and the lack of the skill and judgment costs the life of the patient. The respondent nurse Heather Conyard acted such a way, which cannot be regarded as professional at all.

The nurse could have done many immediate activities to save the patient. Firstly, when the nurse started her duty, the nurses made her aware of the deteriorating condition of the patient. However, she decided to wait for the locum (Dr. Vallentino), despite of calling the attending medical officer of Patient A. If she called the doctor on time, the patient could have been saved. Moreover, the respondent nurse did not check the availability of the doctors in the hospital.

Secondly, the respondent nurse did not red-zoned the patient’s condition immediately after she was informed about the deterioration of the health of the patient. When the respondent nurse considered the patient as critical, it was very difficult for the patient to survive. According to the between the flags policy of the hospital the patient needs immediate care within 10 minutes. If the respondent nurse could have critically analyzed the situation and then could apply the proper intervention, the life of the patient could have been saved.

Thirdly, the respondent nurse needed to contact the family of the patient immediately after the patient was considered as red-zoned, as the present policy of nursing is to include the family of the patient into the process of care giving.

Fourthly, Ms. Conyard did not inform anyone about the condition of the patient including the nurse manager Ms Jones, who was present at the ward. She could have saved the patient, if she informed the authority about the condition of the patient. The nurse manager could have contacted the authority and decided to move the patient to another hospital with special facilities.

Immediate Actions that Should Have Been Taken

Finally, the nurse acknowledged that she was well aware of the fact that the hospital does not have the proper infrastructure to take care of such a patient. However, she did not bother to call the doctors and to share her concern. If she had shared her concern with anyone of the hospital authority, the transfer of the patient to another hospital would be faster and the patient should have got the proper treatment in time.

Coordination amongst the coworkers ensures the competent and safe care of the patient. A hospital situation is tough and error-prone (Anderson, & Thorogood, 2015). Coordination amongst the healthcare providers is the only key to avoid the number of errors. In this provided case study, the respondent nurse did not coordinated with anyone present in the ward, including the other nurses, physicians and the nurse manager. The nurse could have reduced the accountability by improving the coordination amongst the coworkers.

The nurse breached many of the NMBA professional code of conduct during the course of action. The primary work of a nurse is to assist all of the patients and provide them with proper care according to their needs (Koutoukidis, Stainton, & Hughson, 2016). . The nurse ignored the patient, which subsequently led to the death of the patient. This inaction of the nurse, led her to breach many of the NMBA standards.

To begin with, The NMBA standard two states, all the registered nurse have to provide all the patients with safe care. The process caring should be patient centric. It means, the nurse should provide care to the patients according to their wellbeing (Marquis, & Huston, 2012). ). The nurse has to critically analyze the situation and decide the action, which can be considered as the best condition for the patient (Nursingmidwiferyboard.gov.au, 2008).

Secondly, the NMBA standard three states, all the nurses have to be familiar with all the professionally relevant laws (Nursingmidwiferyboard.gov.au, 2008). The nurse is accused of breaching the NSW law 139B (Unsatisfactory professional conduct). Her inactions about patient A clearly shows that she was not familiar with the relevant laws regarding healthcare, albeit she worked as a nurse for more than a decade (Anderson, & Thorogood, 2015).

Lastly, the NMBA standard seven states that all the registered nurses should have the competency to make the best clinical decision in response to the wellbeing of the patient (Nursingmidwiferyboard.gov.au, 2008). From the case study, it can be clearly seen that the respondent nurse was not competent enough to properly analyze the situation and decide the best for the welfare of the patient (Kangasniemi et al., 2015). The lack of ability of the nurse is another vital reason that the patient lost his life (Butts, 2013).

Breaches of NMBA Standards

The nurse should have behaved professionally to handle the situation. The most important part of patient’s welfare is the nurse patient interaction (Cheng & Daly, 2016). This solves a big problem regarding the medical diagnosis of a patient. The interactions between the nurse and the patient help the nurse to diagnose the proper condition, which can resolve the problem the patient is currently facing. From the case study, it is clear that the nurse did not properly interact with the patient (Cheng & Daly, 2016). However, the condition of the patient was so critical that the nurse was able to understand the patient’s condition (Chiarella, 2014). Nevertheless, the nurse misjudged the patient’s health, which led to the death of the patient.

From the action of the nurse, it is clear that the nurse did not reflect the situation. Reflection of a situation is very important for the nurses as it gives them insight in the present situation (Pincombe et al., 2015). The nurse can imply unbiased clinical judgment by reflecting and evaluating a situation. From the case study, it is very clear that, the nurse did not show any evidence of proper clinical judgment.

From this case study, I learnt about the fact that, the best policy to provide a patient best possible care is through professionalism. It is very important that, to be a nurse, I know everything about my role as nurse, according to the NSW body. There are many aspects of this case study, the student nurses including me have to learn. One is the proper documentation of the case. I learnt that, it is very important to understand the patient’s needs to be sure that they are properly assisted. If I am sure about the needs of the patient, I can coordinate with the other ward members and the physicians to give the patient the best possible care. As I am to be a graduate nurse, it is very important for me to have knowledge and skills to know and determine the type of the medical attention the patient requires before their condition deteriorates. There will be many critical cases, which I have to face in my upcoming career. It is also true that, if a patient is suffering from different complex aliments, it is often very hard to determine and to provide the needed care to the patient. Nevertheless, it is my duty to ensure that the patient is getting the best case possible, which will drive them further to a road of recovery. During my upcoming tenure as a nurse, I have to make sure that, I am coordinating properly with the other staffs like the other nurse, nurse manager and the physicians. This is because, in nursing, it is necessary to have a proper coordination with the other staffs to ensure the best care for the patients. This is one of the biggest mistakes, the respondent nurse made during her duty. As a newly graduate nurse, I have to make sure that I never make any of the mistakes the respondent nurse made. I also have to make sure that I know about the principles of “Between the Flag” policy to make a instant framework of managing the health of the patients who are in the critical condition. As a nurse, I also have to make sure that, I have access to all of the emergency medical equipments when needed.

To conclude with, the patients can die if the nurse provides unsatisfactory professional conduct. In this context, the nurse provided inappropriate care to the patient, misjudged the condition of the patient and failed to show the ability of clinical judgment, which was necessary. It is the responsibility of the nurse that all the patients receive the best possible medical attention and care, which is necessary for the overall improvement of the patients. Moreover, the nurse has to be professionally accountable; as in, the nurse has to make sure that the patients are receiving the best possible care.

References:

Anderson, L., & Thorogood, C. (2015). Ethical frameworks for practice. Midwifery-E-Book: Preparation for Practice, 339. Retrieved from https://books.google.co.in/books?id=oFqmBgAAQBAJ&lpg=PA339&ots=PueHf0ruFR&dq=Moving%20from%20codes%20of%20ethics%20to%20ethical%20relationships%20for%20midwifery%20practice.%20Nursing%20Ethics%2C%209(5)%2C%20522-536.&lr&pg=PA339#v=onepage&q&f=false

Butts, J. B. (2013). Ethics in professional nursing practice. Retrieved from https://books.google.co.in/books?id=9R_ET0JLvEwC&lpg=PA69&ots=faCfLSes_H&dq=professional%20code%20of%20ethics%20nursing%20australia&lr&pg=PA91#v=onepage&q=professional%20code%20of%20ethics%20nursing%20australia&f=false

Chang, E., & Daly, J. (2016). Transitions in Nursing: Preparing for Professional Practice (4th ed.). Chatswood, N.S.W.: Elsevier. Retrieved from https://ezproxy.uws.edu.au/login?url=https://www.clinicalkey.com.au/nursing/#!/browse/book/3-s2.0-C20140009604

Chiarella, M. (2014) (pp. 5-11). University of Sydney. Retrieved from https://www.commonwealthnurses.org/conference2014/Documents/MaryChiarella.pdf

Kangasniemi, Mari & Pakkanen, Piiku & Korhonen, Anne. (2015). Professional ethics in nursing: An integrative review. Journal of advanced nursing. 71. . 10.1111/jan.12619. Retrieved from https://www.researchgate.net/publication/271139792_Professional_ethics_in_nursing_An_integrative_review

Koutoukidis, G., Stainton, K., & Hughson, J. (2016). Tabbner's Nursing Care: theory and practice. Elsevier Health Sciences. Retrieved from https://books.google.co.in/books?id=yeMCDQAAQBAJ&lpg=PP1&ots=TutiKEsJuA&dq=nursing%20care%20according%20to%20the%20nmba%20standard&lr&pg=PP1#v=onepage&q=nursing%20care%20according%20to%20the%20nmba%20standard&f=false

Marquis, B. L., & Huston, C. J. (2012). Leadership roles and management functions in nursing: Theory and application. Lippincott Williams & Wilkins. Retrieved from https://books.google.co.in/books?id=38mzZLwcOe0C&lpg=PA1&ots=aKDK2KeRQQ&dq=Marquis%2C%20B.%20(2012).%20Leadership%20roles%20and%20management%20functions%20in%20nursing%3A%20Theory%20and%20application.%20(7th%20ed.).%20Philadelipha%2C%20PA%3A%20Wolters%20Kluwer%20Health%2F%20Lippincott%20Williams%20%26%20Wilkins&lr&pg=PA1#v=onepage&q&f=false

Nursingmidwiferyboard.gov.au, (2008). Codes of Professional Conduct & Ethics for Nurses in Australia 2008. Nurses Board of South Australia. Retrieved from https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx

Nursingmidwiferyboard.gov.au. (2008). Codes of Professional Conduct & Ethics for Midwives in Australia 2008. Nurses Board of South Australia. Retrieved from https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx

Nursingmidwiferyboard.gov.au. (2016). Nursing and Midwifery Board of Australia - Registered nurse standards for practice. Nursingmidwiferyboard.gov.au. Retrieved 7 October 2017, from https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx

Pincombe, J., Thorogood, C., Tracy, S. K., & Pairman, S. (2015). Midwifery-E-Book: Preparation for Practice. Elsevier Health Sciences. Retrieved from https://books.google.co.in/books?hl=en&lr=&id=oFqmBgAAQBAJ&oi=fnd&pg=PP1&dq=Pairman,+S.,+Tracy,+S.+Pincombe,+J.,+Thorogood,+C.+%26+Tracy,+S.+(Eds.).+(2015).+Midwifery:+Preparation+for+practice.+(3rd+ed.).+Chatswood,+NSW:+Churchill+Livingstone+Elsevier&ots=PueHf0puFU&sig=TuzjC8ffRRlgFN4eg9togNC4S9Q#v=onepage&q&f=false

Scanlon, Andrew & Cashin, Andrew & Watson, Ngaire & Bryce, Julianne. (2012). Advanced nursing practice hours as part of endorsement requirements for nurse practitioners in Australia: A definitional conundrum. Journal of the American Academy of Nurse Practitioners. 24. 649-59. 10.1111/j.1745-7599.2012.00761.x. Retrieved from https://www.researchgate.net/publication/232609308_Advanced_nursing_practice_hours_as_part_of_endorsement_requirements_for_nurse_practitioners_in_Australia_A_definitional_conundrum