Professional Conduct And Misconduct In Nursing Practice: A Case Study Analysis

Choose one, two or all three ofelder abuse, child abuse, and domestic violence and discuss,explaining the legal and professional issues that occur when a health care worker comes into contact with a person who has disclosed that they have been harmed.

The term professional conduct is referred to the manner in which an individual behave while acting in a professional ability. It is expected from each and every employees of the healthcare industry that they will uphold exemplary standard of conduct which is commonly taken to mean standards which is not generally expected from lay people (Bryce, Foley & Reeves 2017). In Australia, the code of professional conduct for nurses in Australia is supported by the code of ethics for Nurses in Australia. According to the latter, there prevails a set of ethics which needs to be followed by a set of professionals in order to ensure the ‘good standing’ of the nursing profession.  A breach of this code is considered to be either professional misconduct or unprofessional conduct. Professional misconduct conducted by a nurse chiefly involves the erroneous and wrong conduct of a healthcare service provider outside the domain of his or her domain of professional practice. This may include activities like theft, sexual assault, drunk and disorderly conduct in the public place. on the other hand, unprofessional conduct is referred to the conduct which is contradictory to the agreed and accepted professional standards. This may include breaching off the professional principles, violation of the confidentiality of the healthcare service users as well as other coworkers (Terry et al. 2017). In this report, analysis of a scenario where professional misconduct has been performed by a nurse has been performed by raising both legal as well as professional issues. Along with that, with the help of the given scenario, a better understanding of professional standard as well as professional misconduct will be gained.

A tribunal on the behalf of NMBA has been reprimanded on a nurse named Ms. Jodi Laughlan whose registration has been suspended for three months for performing professional misconduct concerning medication administration.  The mentioned healthcare service user was a registered nurse at a aged care faculty and she has been accused of performing the following misconduct. Firstly, she had failed to account 7 ml of morphine. It is suspected that the healthcare service provider has taken without lawful authority.  Not only that, in order to keep her theft a secret, Ms Jodi Laughlan had replaced the morphine which she had taken with water (Pickles, de Lacey & King, 2017).  Apart from that, she had conducted other unethical at as well. She had thrown away the post it note in which the medication discrepancy was written down and had also influenced or tried to  influence, another registered nurse in order to prevent reporting the discrepancy. Thus it can be clearly understood that being a nurse, Ms. Jodi Laughlan did not performed keeping accordance to the NMBA’s professional standards.  While making the decision, the tribunal had found all the allegations against Ms. Jodi Laughaln proven except the allegation that Ms. Laughan had taken the morphine as well as self administered it.  The allegations that has been proven are considered to be enough by the tribunal to suspend her registration for three months, reprimanded her as well as placed circumstances on her registration, requiring education on schedule 8 medications (Gill et al., 2017).

Analysis of Professional Standards and Code of Conduct

Nurses and midwives should be registered with the Nursing and Midwifery Board of Australia also known as NMBA (Maier, 2015). The NMBA imposed some rules, regulations and ethical issues in the professional healthcare and nursing practices in Australia are known as Professional Standards. NMBA professional Standards are divided into three subsections namely codes of conduct, standards of practice and code of ethics (Heale & Rieck Buckley, 2015). Code of conducts are comprise the do’s and don’ts of the nursing practices that involve both the patients and the healthcare system and authority. Any breach of these rules can cause serious legal consequences up to cancelation of license or imprisonment. The standard of practices are collection of care giving medical procedure that should be maintain by a registered nurse to be considered as a standard nursing practitioner (Kangasniemi, Pakkanen & Korhonen, 2015). Ignoring or violation of this standards may initiate legal procedures depending on the severity of the situation. The code of ethics are group of ethical considerations which should be implemented in nursing practice in order to be a ethically clear and transparent nurse or caregiver.

RN or Registered Nurses who have the nursing license should maintain the following standards in their regular professional practice:

• Critically thinking and analysing the executed practice by following roles and regulation, ethical consideration and quality management
• Conducting comprehensive assessments of patient condition and executed procedure
• Maintaining the capability for effective practice considering the lifelong learning and improvement practice (Hannon, 2017)
• Engaging in the Therapeutic and Professional relationship by establishing healthy and effective relationship with patients as well as other caregivers
• Developing and executing a planed nursing practice including pre development blue print, framework based approach and risk analysis
• Providing safe, appropriate and responsive quality nursing practice using scheduled direction, supervision, diagnosis and care giving services (Martyn et al., 2017)
• Evaluating the outcomes sincerely to inform the executed nursing practice  by monitoring the progress, implementing effective changes and documentation

RN or Registered Nurses who have the nursing license should follow the following code of conducts in their regular professional practice:

• Complying with legal procedures and policies regarding the diagnosis and treatment while maintaining lawful behaviour (Bryce, Foley & Reeves, 2017)
• Aligned the nursing practice with person cantered approach with adverse events and open disclosure
• Developing mutual respect for all cultures and making respectful relationship with patients and co-workers
• Maintaining professional behaviour by promoting the legal practices (Cashin et al., 2017)
• Teaching, supervising and assessing the students and subordinates
• Conducting research in health to improve the self nursing practice as well as the existing practice in nursing
• Maintaining the own health and the wellbeing of the colleagues by executing health advocacy

 RN or Registered Nurses who have the nursing license should take care of the following code of ethics in their regular professional considerations:

• Health of other nurses and co-workers and non-health related workers and professionals (Snelling, 2016)
• Cooperative and collaborative relationship with the colleagues with mutual respect considering ICN Code of Ethics for Nurses
• Sharing the values and ethics of healthcare with the society
• Keeping the own privacy and the privacy of the patients, co-workers and subordinates through information handling
• Keeping personal health considering mental, physical, social and spiritual wellbeing maintained

 Considering all the above mentioned factors the following legal codes should be imposed as per the relevancy and tangibility.

• Pursuant to s 196(1)(b)(iii) of the Health Practitioner Regulation National Law (Queensland) (National Law)

As per this act, if a medical practitioner or nurse be proven with adequate avoidance as a subject of clinical or nursing misconducts, the subject will be considered as guilty and will be liable for his or her activities. The further penalization and prosecution will be considered as a part of further verdict (Nursingmidwiferyboard.gov.au., 2016).

• Health Practitioner Regulation National Law (Queensland), s 3A

As per this act, a medical practitioner, nurses or caregivers must follow the NMBA code of conducts and they will be considered as completely liable for their misconducts and also will be responsible to show the causes of the executed violations (Cashin et al., 2017).

• 193(1)(a)(i) of the Health Practitioner Regulation National Law (Queensland) (National Law) (Snelling, 2016)

As per this act, during the professional duty hours, a medical practitioner or nurse will be completely responsible for their behavior and the authority will be also responsible to take adequate initiative to collect all the evidences regarding the violation and misconducts. Along with that, they must report to the national health authority for further procedure as per the severity of the outcomes.  

• Health Ombudsman Act 2013 (Qld) (HO Act)
• Queensland Civil and Administrative Tribunal Act 2009 (Qld) (QCAT Act) 

Legal Consequences and Penalties for Professional Misconduct in Nursing Practice

From the above case overview, it can be clearly understood that Ms Jodi Laughalan had conducted several breaches of professional standard as well as professional misconduct by conducting theft of morphine, replacing it by water, self-abusing the drug and attempt to eradicate all the evidence against her. According to code of professional conduct statement 1, Nurses are alleged to practice in a safe and competent manner. All the nurses, working under NMBA  are expected to be aware that undertaking activities within their scope of practice may result in compromisation with the safety of the healthcare service users (Murray et al., 2017).  According to the professional conduct statement 3, every healthcare service users should practice and beha accordance with laws relevant to the profession and practice of nursing (Murray et al., 2016).  Healthcare service users should be familiar with relevant laws and ensure they do not engage in clinical or other practices prohibited by such laws or delegate to others activities prohibited by those laws (Halcomb et al., 2017). Thus, it can be clearly understood that the mentioned nurse has breached both the codes of professional conduct. Firstly, by failing to account for the 7 mL of morphine without lawful authority, Ms Jodi had conducted an illegal act (Mitchell et al., 2015). Secondly, the fact that she had replaced the amount of taken morphine with water bear the risk of potential harm to the healthcare service user who will be injected the diluted morphine in future.

Through this, the subject ignored the nursing standards of Critical thinking and analysing the executed practice by following roles and regulation, ethical consideration and quality management. Besides that the fact that she had self-administrated the morphine during her working schedules I against the code of professional conduct statement 1 of NMBA (Wilson et al., 2018). According to the mentioned code, all the healthcare service providers should practice in a safe as well as competent manner that includes avoidance of compromising with their personal health limitation (Sidebotham et al., 2018). Through this, the subject ignored the nursing standards of Providing safe, appropriate and responsive quality nursing practice using scheduled direction, supervision, diagnosis and care giving services. This involves use of alcohols as well as other substances that has the potential to alter the capacity of the nurse to practice safely all the time (Fisher, 2017). The code further states that healthcare services providers, whose health threatens their capacity to practice competently as well as safely posses a responsibility to seek assistance to address their health requirements.  

Conclusion

When it comes to the NMBA professional standard it includes the code of ethics for nurses in Australia, The code of professional conduct for nurses in Australia and the ICN code of ethics for nurses. It will also comprise the NMBA Competency Standards for Nurse Practitioners, Registered Nurses and Enrolled Nurses and The NMBA National Framework for the Development of Decision-Making Tools for Nursing and Midwifery Practice. Apart from the above mentioned standards, nurses in Australia also need to abide by standards developed by professional nursing organizations (Scanlon et al., 2016). It can be said that Ms. Jodi has violated all the major mentioned professional standard. Apart from that, for this activity the subject is also accused for breaching the Pursuant to s 196(1)(b)(iii) of the Health Practitioner Regulation National Law (Queensland) (National Law). As per this act, the further penalization and prosecution will be considered as a part of next verdict.

Conclusion: 

From the above analysis of the case study of the nursing practice violation it can be concluded that the accused nurse can be penalised, her RN licence can be cancelled permanently and even she may a considered as a subject of imprisonment depending on the verdict of legal and procedural authority. Apart from that it can be said, Nurses and midwives should be registered with the Nursing and Midwifery Board of Australia also known as NMBA should maintain and comply with the NMBA rules, regulations and ethical issues in their professional healthcare and nursing practices while considering the professional standards as well.  

Reference List

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