Professional Issues in Nursing Practice: A Case Study

Background of the Case Study

You are expected to comprehensively discuss professional aspects of nursing practice and draw to conclusions covering all learning outcomes of the module.

’Bola is a newly qualified mental health nurse who works on an inpatient mental health hospital word and is assigned to work along with a senior nurse Yemi, a senior nurse as part of her preceptorship for twelve months. Bola is in the third month of her employment when a 45-year-old Jamal, a patient/service user who was a refugee from a war-torn country and who spoke limited English was admitted to the ward with psychosis, post-traumatic stress disorder, and was underweight.

The care plan included close 15 minutes observations to monitor Jamal’s mental health and also his nutritional and fluid balance intake was agreed to be monitored as part of the care plan to ensure every time Jamal ate food or was given a drink that this was recorded by the nurses on the fluid balance and nutritional intake charts. Mark, a mental health nursing student on placement who was working with Bola and was supervised by Yemi, noticed that Bola did not speak to Jamal during the shift and that she was not completing the nutritional and fluid balance intake charts accurately about Jamal’s actual amount of fluid and food intake.

She appeared to be guessing the amount that she was recording on Jamal’s nutritional and fluid balance intake charts, so the charts looked complete when this was not accurately observed, measured and recorded. Following the incident, Mark spoke to Bola and expressed concern about her recording not being accurate to which she replied: ‘’You are just a student nurse are you going to teach me how to do my job’’? Bola told Mark to keep his head down, to finish his practice placement and to focus on getting a good evaluation for his practice placement if he wanted to continue with his student nurse training.

Mark kept quiet because he did not like confrontations and wanted to avoid conflicts with the newly qualified mental health staff nurse Bola. Mark had two days off over the weekend and when he returned to the ward on the third day, he noticed that Jamal’s nutritional and fluid balance charts were not kept up to date over the weekend and when Mark spoke to Jamal, he told him that he was hungry and thirsty and that he has not eaten for two days. Jamal was confused and appeared dehydrated.

Mark escalated his concern about Bola’s behaviour to Yemi his Practice Supervisor and Service Manager and expressed concerns about Jamal’s deterioration, confessional state and dehydration, and that Bola has not kept the nutritional and fluid intake charts accurately.

The manager acted immediately by investigating why the patient had become confused and the ward doctor was called to review the patient/service user who confirmed that Jamal needed an intravenous infusion for the dehydration. The nurse manager also ensured that Jamal was given regular drinks and food and that this was recorded on his nutritional and fluid balance chart accurately. Jamal recovered from the confusional state and the intravenous infusion was stopped the following day and his family were informed’’.

Consider the current NMC Code, relevant legislation, policies, guidelines, ethical principles. Identify, discuss and analyse the appropriateness of behaviours of the nurses involved in the scenario.