Nursing Assignment On The Case Of Registered Nurse

Question

Task: Identify a case from the NSW Nurses and Midwives’ Board or HCCC, Caselaw or AHPRA website which involved a registered nurse(s) who had their registration cancelled or suspended for greater than 6 months due to their involvement in an adverse event for a patient in their care.

Access the following websites and choose a case that fits the description above (see highlighted terms) and that interests you.

https://www.hccc.nsw.gov.au/Hearings---decisions/Default

https://www.nursingmidwiferyboard.gov.au/News.aspx

https://www.ahpra.gov.au/Publications/Tribunal-Decisions.aspx

https://www.caselaw.nsw.gov.au/browse-court/54a634063004de94513d828a

NB: You need to provide the reference number and link to the case (the full case not a summary) – your assessment cannot be marked without it

Answer

Introduction:
The present nursing assignment is focused on a case of registered nurses who are governmental nursing staffs and provided license by their respective states in order to provide medical assistance, care and treatment regardless of their age, gender, caste, community or any other factors (Nursing and Midwifery Board of Australia 2020). These nursing staffs are trained in every field of healthcare as well as critical thinking and patient counseling. The nurses need to go through the National Council Licensure Examination and RN training to become a licensed registered nurse (Smyth 2019).

The nursing assignment focuses on a registered nurse Miss Kah Tam who has been registered by the National Law. She has been declared guilty for misconducting her work under the section 139B of unsatisfactory professional conduct as well as under section 139E for professional misconduct of the National Law. She has been under the complaint of low standard treatment and care giving in the practice of Nursing. Miss Kah Tam has a complaint of delivering unethical, unprofessional and improper treatment and care to the patients. There is more than one complaint where she has been charged for unsatisfactory conduct which is of serious nature that justifies suspension and cancellation of her registration as a nurse (New South Wales, 2020).

1. What actions/omissions on the part of the Registered Nurse(s) contributed to the adverse outcome for the patient?

The record of the St George Hospital where she was employed states that she was rostered for night shift on 13 to 14 November 2017 along with three other registered nurses in the Mental Health Unit. The time duration of the shift was from 2130 till 0700, but Miss Kah Tam was found seated in the nurse’s station from 1200 till 0440. She was found busy with activities other than work. The readings of the case considered to prepare this nursing assignment signifies that she was allocated with 10 patients those were admitted in the acute chamber of the Mental Health Unit. Also, there was CCTV installed in the acute chamber to observe the patient’s performances. But because of her not getting engaged to work, she failed to attain accurate and simultaneous observations of the patients. She did not continuously observe the behaviors, activities and responses of the patient from the CCTV footage and thus had a false observation.

There were total 25 patients present in the Mental Health Unit during the night shift, out of few were allocated to Miss Kah Tam. Out of the total patients allocated to her, 4 patients were in the need of level 2 care where they needed 10 minutes of observation. There were 4 patients in need of level 3 care with 30 minutes of observation time and 2 patients for level 4 care with hourly observation. Out of 25, 10 patients were under her observation and needed her assistance for specific time duration. But due to her careless behavior and misconduct of her responsibilities, she did not provide care and treatment to her patients during her shift hours.

As she was busy with other activities, she failed to conduct any observation in the duration of 1200 to 0620. She did not check the admitted patient’s respiratory rate.

Another major sever misconduct illustrated in this section of nursing assignment that she performed was that she documented false recordings and observation without even conducting any rounds or assistance. She notes a standardized report for every patient without focusing on the acute behavior of the patient. Her careless behavior and misconduct of her responsibility lead to severity in the patient’s health admitted in the acute ward. As these patients are admitted to the acute chamber, it defines the severity of their health. Careless behavior and lack of assistance towards these patients may lead to sever fall in their health condition and may lead to death of the patient.

2. Were there any other factors (e.g. systems-based) that contributed to the adverse outcome for this patient?

In the field of healthcare, collaboration plays a major role in delivering treatment and appropriate care to the patients in need. It is important that every individual who is a part of a health care service gets into collaboration to ensure that no patient receives deprived treatment as well as avoid any type of responsibility (Romero, Fry and Roche, 2017).

According to the case scenario of nursing assignment, there were three other nursing staffs that were allocated night shift with Miss Kah Tam. It would have been much beneficial, if they would have been working in collaboration. As there were total 25 patients where one of them needed 24/7 nursing assistance. 8 patients were in the need of level 2 care where they needed 10 minutes of observation. There were 9 patients in need of level 3 care with 30 minutes of observation time and 7 patients for level 4 cares with hourly observation. If the work was equally distributed among the four nurses as a team, the work load would have been decreases. Also, it would have ensured that, every work has been conducted. Working in collaboration would have not provided Miss Kah Tam with the opportunity to escape from her work and do other activities other than care and treatment.

It is important to have a supervisory in every shift in a healthcare whose role will be to take routine rounds after every time period. It will ensure that no registered nurse is wasting their time elsewhere other than their work, and misconducting practice (Furst and Salvador-Carulla, 2019).

As they were appointed at the Mental Health Unit of the hospital, the role of these nurses along with Miss Kah Tam becomes more critical and important. Handling and treating patient in such units requires greater knowledge and the nurses needs always to be alert. As there was no one to check and remind Miss Kah Tam about her duty, she did not bother to get out and look after the patient. She left them unaddressed throughout the shift hour and at last reported a false note about their health readings. If the routine rounds were conducted, Miss Kah Tam would have a fear of getting scolded for her misconducted and have conducted her shift with full loyalty and consideration. It is important that the registered nurses should have better communication and coordination which each other and patient to ensure safe and effective treatment for the patients (Ashley et al. 2018).

3. With reference to the evidence-based literature (including relevant NSW policies) outline the actions that should have been taken by the Registered Nurse(s) to prevent adverse outcome for this patient considered in the case of nursing assignment.

There are several policies and ethics that are developed by the national law which will guide the nursing staffs and the healthcare professionals to deliver proper care and treatment to the patient in need. The ethics guides them to provide case and treatment without any discrimination and equality based on race, gender, caste, social group or economic condition (Nursing and Midwifery Board of Australia, 2020). For the nursing staff, it is important to develop a better interprofessional relationship with their patients. It helps the nursing staff to better understand them and their needs; it builds a trustful and comfortable environment for them which helps in curing the patients (White, 2017).

The New South Wales have their different policies and nursing guideline which guides the healthcare professionals and nursing staffs to conduct a fair and beneficial treatment process for the people in need. The Nursing and Midwifery Board of Australia has their nursing ethics and guidelines which are followed by every health care setting to educate and train their nurses (Nursing and Midwifery Board of Australia, 2020). One of the essential guidelines for the registered nurses outlined in the nursing assignment is Standard 2 which states engaging in therapeutic and professional relationship. It believes in establishing and sustaining a professional relationship with the colleague and patients. It ensures effective communication and sustains the dignity of an individual and the culture, beliefs, values and rights they belong to. Miss Kah Tam involvement with her patients and employees would have developed a trusted professional relationship. Developing an interprofessional relationship would have provided Miss Kah Tam about her duty, she did not bother to get out and look after the patient. She left them unaddressed with the understudying and sincerity related to her work and would have stopped her from conducting such unsatisfactory act in her profession.

According to Standard 6 of the nursing guideline, it is important to provide safe, accurate as well as responsive quality of care to the patients in need (Nursing and Midwifery Board of Australia, 2020). It helps the registered nursing staffs as well other healthcare professionals to provide a quality of care which helps them to attain their acquire healthcare goals and patient’s safety. Miss Kah Tam neither needed to focus on the standards of the nursing guideline to ensure that nor is patient left unaddressed and untreated. It provides the under testing about the standards of the care delivery and the importance of reporting and identifying a person’s risk factors which may lead to death.

According to the standard 7 of the nursing guidelines considered in this segment of nursing assignment, it is the role of the registered nurse to evaluate the priorities, health care goals and outcomes for their respective patients (Nursing and Midwifery Board of Australia, 2020). It is necessary to evaluate and monitor the heath progress and effectiveness of the treatment that is delivered to the patients. It was the role of Miss Kah Tam to examine accurately every patient she was provided with. She has a major role in observing their behaviors and condition as well as reading the respiratory rate. Neglecting her role as registered nurse and performing such sever misconduct demonstrated a sever outcome in the patient’s health. It was important for her to follow the nursing’s guideline s and ethic during her work hours to ensure that no harm was done to her patients. It would have also helped her to maintain her dignity as a registered nurse and would not have pledge guilty for risking lives of so many patients.

Conclusion:
In order to conclude the study build in the nursing assignment, it can be stated that the registered nurses have a very important role in a healthcare facility. They are registered and trained in order to ensure advanced care and treatment delivery to every patient admitted in a health care organization. The nursing ethics guides these nurses to give equal, advanced and effective care to the patients. Whereas the National Law has a chief role in ensuring that no misconduct or unsatisfactory actions are performed by these nursing staffs. The case study analysis done on this nursing assignment provided a detailed understanding about the role of a registered nurse and the severity it may cause due to their careless behavior.

Reference:
Ashley, C., Halcomb, E., Brown, A. and Peters, K., 2018. Experiences of registered nurses transitioning from employment in acute care to primary health care—quantitative findings from a mixed?methods study. Journal of Clinical Nursing, 27(1-2), pp.355-362.

Furst, M.A.C. and Salvador-Carulla, L., 2019. Intellectual disability in Australian nursing education: Experiences in NSW and Tasmania. Nursing assignment Journal of Intellectual & Developmental Disability, 44(3), pp.357-366.

New South Wales, 2020. Health Care Complaints Commission V Tam - NSW Caselaw. [online] Caselaw.nsw.gov.au. Available at:<https://www.caselaw.nsw.gov.au/decision/5e7a9fd6e4b0529762cf0789> [Accessed 21 April 2020].

Nursing and Midwifery Board of Australia, 2020. Nursing And Midwifery Board Of Australia - Registered Nurse Standards For Practice. [online] Nursingmidwiferyboard.gov.au. Available at: <https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards/registered-nurse-standards-for-practice.aspx> [Accessed 21 April 2020].

Romero, B., Fry, M. and Roche, M., 2017. The impact of evidence?based sepsis guidelines on emergency department clinical practice: a pre?post medical record audit. Journal of clinical nursing, 26(21-22), pp.3588-3596.

Smyth, D., 2019. Exploring undergraduate nursing students' knowledge and attitudes of the management of patients with a drug and/or alcohol substance use disorder: An Australian perspective. Australian Nursing and Midwifery Journal, 26(6), p.63.

White, E., 2017. Claims to the benefits of clinical supervision: A critique of the policy development process and outcomes in New South Wales, Australia. Nursing assignment International journal of mental health nursing, 26(1), pp.65-76.