NUR3020 Professional Transitions


Assignment Brief

Analyse the case: Findings and conclusions of the Inquest into Albert Eric Bruce Biffin’s death. You will need to address the three sections.

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In the Inquest into Albert Eric Bruce Biffin’s Death1, the Coroner stated that the medical causes of death were complications of an incarcerated Umbilical Hernia.

It was evident that although Mr Biffin had a complex medical history, he was relatively independent in his residential home.

He was 86.

Between February 24, 2013 and February 27, 2013, a number registered nurses were involved with Mr Biffin’s medical care.

The key role of the registered nursing assistant, the endorsed nurse enrolled in nursing and the assistant was critical to the chain of events which led to Mr Biffin’s death.

McDonald’s and Then (2014) offer a chapter that focuses on DIRECT readings of the study desk NUR3020. It explains how mistakes can happen, but it can also be hard to attribute one person’s error to another.Assignment Section One: Patient Safety/Nursing Care

Section 1 – Perform an analysis (pages 7-11) of the nursing care that was provided by Mr Albert Eric Bruce Biff1 to the Inquest. This includes the role of the assistant in Nursing, endorsed enrolled nurses and the overall accountability for the registered nurse.

Assignment Section 2: Negligence and the Tort Of It

Section 2 – Explain how the tort if negligence could be applied in this instance to the registered nurse/clinical nursing involved.

In order to make a successful claim for negligence, outline the elements you would need to prove.

Assignment Section Three: Ethical Problems

Section 3: Ethical Analys.

There are several ethical issues to be considered in addition to the legal aspects.

Consider the actions of the registered nurse (enrolled nurse), assistant in nursing and enrolled nurse. Use these examples to evaluate their behavior.

Use published literature and academic texts relating to ethical principles as a guide for your critique.

Answer to Question: NUR3020 Professional Transitions

Section 1

The role of nurses is vital in providing quality health care for everyone. As respected healthcare providers, they must be qualified and maintain professionalism while caring for their patients (Daly Speedy & Jackson 2017).

Anyone who is allowed to practice nursing according to section 141 (Nursing Act 1992) can use the titles registered nurse and enrolled nurse.

An enrolled nursing assistant assists the registered nurse with decisions related to the patient’s health (Gaskin, 2017).

The primary responsibilities as an enrolled nursing professional are to recognize normal and unusuality in assessment; perform the delegated responsibilities and monitor the effect of care by assessing the individual’s condition (McDonald & Then 2014.

The registered nurse will need to be in touch with the enrolled nursing nurse on a regular basis regarding the patient’s condition.

It is sometimes necessary for registered nurses to spend more time with patients, particularly if the patient is reacting in unpredictable ways or there is a continuous change in the patient’s condition (Masters in Role development in professional nurse practice, 2015).

If the patient is being continuously assessed or if there are constant changes to the care plan, the registered nurses must be more attentive.

Inquest into the death Mr. Albert Eric Bruce Biffin outlines the nursing care. This raises questions regarding the accountability of nurses and the quality of medical care provided to Mr. Biffin.

Bruce was found to have an umbilical problem that had occurred recently by the coroner. He required immediate medical attention from Dr. Lambie and nursing care.

Bruce was having vomiting, so an enrolled nurse called the registered nurse.

The registered noticed that Bruce was having pain in the lower abdomen and detected hernia.

She advised Bruce’s enrolled nurse to give Movicol to him for constipation.

The registered nurse observed Bruce’s hernia, which was large and looked pink.

Because she was meeting Mr. Briffin in person for the first, and he did no complain of any stomach pain, the registered nurse didn’t examine the hernia. She thought that he was constipated and suggested that he take movicol.

You can see that the registered nurses didn’t pay attention to the changes in Mr. Briffin’s health. During her assessment, she noted that he was complaining of feeling unwell and experiencing stomachaches.

But he quickly denied feeling any pain and didn’t appear stressed.

He even informed the registered nurse of his hernia. She said that it was not painful. Additionally, he seemed more concerned with his constipation.

The nursing code of practice requires registered nurses to be more attentive when treating patients who are experiencing rapid changes in health.

The nurse was not able to touch the stomachache and hernia, even though she was aware.

Bruce was then reviewed by another registered nursing assistant on the 24th of February. She gave him a second dose Movicol for constipation.

The nurse noticed Bruce’s nausea, vomiting, pain in his lower and center lower abdomens, and prominent bulging of the umbilical hernia.

The registered nurse said that Dr. Lambie would need to evaluate him next day. She also mentioned an offensive wound on his lower leg.

Dr. lambie had not yet recorded Bruce’s observations. However, three registered nursing staff were due to visit Bruce and provide care.

Additionally, because Mr. Biffin was at the residential aged facilities, where nurses are responsible daily maintenance, recording, reporting on the operation of each resident, and taking care of him, registered nurses failed their duties (Gaskin, Georgiou, Barton & Westbrook, 2017,).

Dr. Lambie left Monday. On Monday, an enrolled nursing nurse reviewed Mr. Biffin. He reported feeling nausea and not feeling well.

Instead of prescribing medication, she simply said that Biffin was unwell since Dr. Lambie had last visited.

After that, at 16:30, a registered nurses gave him two doses Movicol.

The next day, Tuesday 26th, was the last time Mr. Biffin saw a doctor or nurse.

The clinical nurse saw that he did not vomit and prescribed movicol for constipation.

The clinical nurse was supposed to supervise Jacaranda’s enrolled, assistant nurses, and all residents. However, she also had to take extra care of Mr. Biffin.

Even though she stated that she had asked Bruce’s nurse to make observations, she did not keep the document. She assumed that if an abnormality was found in the observation, the registered nursing would know.

She wasn’t even sure if Dr. Lambie was informed by the enrolled nursing.

This is a clear indication of how the nurse was acting in violation her professional code (Davis, Morgans, & Burgess,2017).

She noted that Mr. Biffin was not vomiting without having any knowledge about his medical condition or that it was unwell. This is in contradiction to her earlier statements that Bruce was unwell while sitting on his chair.

A clinical nursing nurse was more senior and had greater responsibilities than any other staff providing care for Mr. Biffin.

Although she was not directly involved in the treatment of Mr. Biffin, she had primary responsibility for supervising a resident who needed special care after a recent hernia procedure.

A simple verbal instruction given to an enrolled nurse on her first shift to observe the patient in accordance with his instructions is a sign of lack of guidance. This is because a less experienced nurse has less information about Bruce than a clinical nurse (Scanlon Cashin Bryce Kelly, Buckely 2016).

In addition, even though the enrolled nursing was aware of Bruce’s deteriorating condition, she failed to inform the registered staff. She simply gave instructions to the assistant nurses to assist Mr. Biffin in using the toilet.

Bruce’s condition became worse and the assistant nurse called Bruce’s registered nursing who had never met him before.

The assistant nurse was reading through the records when Bruce became more serious. Instead of calling 911, she helped Bruce to change his gown. This clearly shows her lack of decision-making abilities that are expected of a registered and qualified nurse (Street Ottmann Johnstone Considine & Livingston 2015).

These cases show how nurses have failed their professional obligations and have raised doubts about their competence.

Registered nurses are expected to share their professional knowledge with patients in a non-clinical setting and play important roles in ensuring the safe delivery of healthcare services. (Chadwick & Gallagher 2016).

Instead of paying more attention the hernia pains, nausea, and vomiting of Mr. Biffin, they continued to give high doses to him when he became unable to eat or complained about feeling sick.

They had to pay for the health care services that Mr. Biffin required in his residential care facility, but they did not exercise.

Section 2

Nursing is often performed in close physical proximity to the patient and nurse.

Patient can sue nurse for negligence if they fail to provide proper care or demonstrate diligence.

The complaining party must prove that the nurse breached their duty of care and has caused the patient harm (Masters, 2015).

The following are essential elements to prove negligence:

The plaintiff was in default of a duty by the defendant to take reasonable care.

That the defendant failed to uphold the required standard.

That the plaintiff has suffered damages because of the breached duty of care

That the defendant could reasonably anticipate the damages done to the plaintiff

In the present case, either the registered nurses or the clinical nurse have violated the duty to care Mr. Biffin owed them.

Bruce was a resident of Residential Aged Care Facilities (RACFs). Because she was a registered nurse, the nurses owed Bruce a duty of care (Dwyer Craswell Rossi & Holzberger 2017).

Registered nurses are responsible to conduct regular and ongoing assessments, as well as changing the care plan of such patients.

As Mr. Biffin was an older man, he had umbilical hernia. He also complained of feeling unwell and nauseatingly frequent. However, he was mostly prescribed movicol for his constipation.

The senior nurse in charge of overseeing the residents of resident age care facilities is called the clinical nurse.

She simply instructed the enrolled nursing, a less skilled nurse, to examine Bruce’s condition.

This establishes that Mr. Briffin was not being cared for.

Further, the registered nurse continued to give him movicol for his constipation.

Despite Bruce’s critical health condition, the less experienced enrolled nurses continued to care for him.

Bruce was in a critical condition and the registered nurses had no ability to make a decision.

The nurses failed to fulfill their duty of care, resulting in Bruce’s condition becoming worse. The nurses did not take Bruce to the hospital and they did no immediate medical treatment.

This suggests that they could have foreseen the potential damage Bruce would experience (Foley & Christensen 2016).

The Coroner might refer to section10AA of the Coroners Act, 2003 (the Act), that describes the deaths due to the lack of medical care and the professional and the Framework for Nurses and Midwives Queensland approved by Council in 2005.

A claim can be brought against clinical nurses for failing to fulfill their duty of care.

Section 3

It is vital for health care providers that they take into account the concerns and management needs of patients. In order to make informed decisions, it is important for them to adhere to ethical principles. They must also be willing to take measures to safeguard the vulnerable and those who are least fortunate.

The nursing profession is aware of the human rights standards in health care, which requires them to ensure that everyone has the opportunity to achieve the highest possible standard of health.

Heaton (2014) states that nurses must have an adequate understanding of the ethical responsibilities and moral accountability of healthcare providers.

The clinical nurse, who held a senior position, was responsible for supervising both the assistants as well as the enrolled nursing staff.

The clinical nurse was responsible to oversee all residents of the residential care facility. She was also expected to give greater attention to those patients who were under regular evaluation and who have been shown to be experiencing frequent changes in their medical condition.

She failed to fulfill her duties and didn’t even review Bruce’s medical records. Instead, she instructed the less skilled enrolled nurse verbally to observe Bruce’s situation. This is a sign of poor decision-making (Anderson Malone Shanahan Shanahan & Manning 2015.

As a clinical nurse, an enrolled nurse should assist the clinical one in making informed decisions.

Nursing professionals have an ethical responsibility to ensure effective health care. If parents are older and their health is changing frequently, it is crucial to pay more attention (Parahoo, 2014).

Residents living in residential care facilities have the right of access to care and services whenever they need them.

Additionally, nurses are able to have informal conversations with patients to help them share their fears, concerns, and worries about their health.

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The following are examples of advanced care planning for older adults in Australia.

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