Question:
In May 2016, two Registered Nurses (RNs) were subject to an inquiry by the Professional Standards Committee.
A six month old baby was taken to a rural hospital’s emergency department. The nurses provided care.
The baby was diagnosed with gastroenteritis upon his arrival at the hospital.
Later, medical staff determined that the baby had suffered from a bowel obstruction. They decided to transport him by ambulance to a secondary hospital. Unfortunately, the infant passed away shortly after.
According to the complaint, nurses failed in their duties to communicate effectively with paediatricians and respond to patients’ needs. They also failed to keep appropriate clinical records.
Two practitioners were found to have unsatisfactory profession conduct. This was in response the the allegations that arose from the circumstances of the infant’s passing.
A separate PSC hearing saw a paediatrician charged with unsatisfactory conduct.
The hearing concluded that the practices of the nurses did not show the required knowledge, skill, judgement, and care.
This was significantly below what can reasonably be expected from nurses with the same level of experience or training. There were also serious questions about clinical reasoning.http://www.hpca.nsw.gov.au/home/publications-and-policies/case-studies/performance-pathway/case-study-importance-in-responding-and-communicating-appropriately-to-patient-deterioration
Analyze the above case study and consider the professional and legal implications.
Answer to Question: SNPG923 Legal And Professional Issues
The paper will cover the conduct of two (RNs), registered nurses after the death in childbirth of a six-month-old boy.
The complaint against the nurses was that they did not properly manage the patient’s condition and communicated with the pediatrician.
They also failed keep appropriate records of patient observation.
First, let’s examine the key terms that will be used to analyze the case.
The nurse’s professional code of ethics (also known as the nurse’s code of nursing) is a collection if existing ethical rules designed to assist nurses in making informed decisions in difficult patient care situations.
Technically speaking, the two RNs in this case study did not follow the nurse’s code.
On the other side, professional responsibilities of nurses include ethical and moral obligations in the nursing profession.
The standards apply to patient care, integrity, ethics, morals, as well as responsibility for social changes.
A professional nursing environment is vital for achieving a healthy work atmosphere. This is technically possible because of the practice context.
Technically, this paper will be an in-depth examination of both professional misconduct and ethical breaches committed by the two RNs.
Special attention will be paid to both the professional and legal issues raised in the complaint.
The paper will also examine the notion of good practice by medical providers and how they apply the NMBA ethics codes and general ethics.
Cho & Kim (2014), p. 550.
Codes typically outline the roles and responsibilities of the nursing profession, such as their commitment to patient care, promotion, protection, as well the upholding of the fundamental rights of all recipients of health-care services.
Relatively speaking, the purpose for the code of ethics for nurses in Australia is: to give nurses somewhere to refer to in terms how they should conduct themselves; to indicate to people the ethical standards and human rights standards that nurses must adhere to and, finally, to guide the ethical decision making process for registered nurses. (Daly Speedy & Jackson 2017 p. 170).
One of the value declarations that were broken by the two nurses is value seven for nurses. It states that nurses should respect ethical information management.
The Importance Of Registered nurse Standards
RNs have the responsibility and accountability of NMBA, Australia’s Nursing and Midwifery Board of Australia.
These Registered nurses standards should be apparent in their practice, using a combination NMBA code, standards, and guidelines (Perry et.al 2016, p.60).
As a professional work area, RN practice should reflect a continuous mindset and encourage the creation of mutually beneficial relationships.
RNs are responsible to coordinate and provide quality, safe nursing.
Parahoo 2014 at p.170. The practice of quality nursing involves providing comprehensive assessments and developing effective plans as well as evaluating the outcomes.
As such, it is important that RNs ensure that they are accountable for delegating and supervising nursing activities.
This should not be limited to providing clinical care.
This is where the nurses failed. They should have taken on every responsibility that was given to them and utilized their nursing skills.
This extended care included providing patient care. It also included maintaining a relationship with the parents as well as the pediatrician.
The management, research advisory, and other roles that can impact the effectiveness of service delivery are some examples.
Technically, it’s the responsibility of RNs that they can autonomously practice in the dynamics systems. This includes the relationships with other healthcare professionals.
There are seven standards that define registered nurse standards.
The main responsibility for professional standards is to create and maintain safety, as well as clinical competency, in the field.
How the registered nurse standards for practice are applied.
Technically, these are the standards:
You should think critically about the nursing profession and analyze it.
Assessments are conducted in depth
Engages and maintains professional and therapeutic relationships
Make a plan to help with nursing
The outcomes can be used to inform your nursing practice
Nursing practice that is safe, appropriate, and responsive to patients
It is important for everyone to understand that the standards have interconnectedness and that each standard should be treated with the respect it deserves.
Some standards can be referred to as one another while others are applicable to different dimensions of practice.
This is why it is essential for hospitals to make sure that all RNs are familiar with the standards.
Consider, for example, that each standard includes a criterion describing how the standard should operate.
To give an example, all nurses work as partners and are able to delegate their responsibilities.
For all RNs, the registered nurse standards of practice are not common.
It is vital that they be read in conjunction with applicable NMBA documents like codes and standards.
These codes include the codes of ethics of nurses, code to professional conduct for nurse, national frame for development of decision-making for midwifery practice and midwifery, guidelines and mandatory notifications, as well as supervision guidelines and guidelines for nursing and Midwifery (Watkins 2015).
In this case, there is accountability because the established standards have been met.
In the interest of accountability, the two RNs in this case can be accused of having a lack of professional ethics.
Accounting in nursing is the responsibility of nurses to the patients they are caring for, their employers, the nursing regulatory authority, and their patients.
They should also be accountable to their decisions, actions and behaviors, as well the responsibility that comes with their nursing role, such as documentation.
Accountability cannot be delegated.
Ethical Information Management: How Was the Value Statement Breached
The creation and management, as well as the maintenance of relevant records, should be done with integrity and professionalism (Cherry & Jacob 2016, p.155).
This is the place where professionalism becomes a topic.
The information to be processed must be accurate, nonjudgmental and relevant for the health, treatment, and care of the patient.
Two nurses, Catalano (2015), p.97, did not follow this value statement because they mismanaged the information.
The health record can only be altered in specific circumstances, such as when there is an urgent need for more information.
It is extremely powerful because it can be used to communicate with healthcare professionals.
The ethical management information must respect patient privacy, confidentiality, and not compromise patient safety or well-being.
This applies to all relevant data. It includes research and clinical data.
Self
The legal rights of nurses are the same as those of other patients.
A nurse also has the right to protect their own information as they do their patients.
Person
In this case, the person is called the health consumer.
Nurses must be aware of the conditions under care that information about patients (includes children and persons who may not have the ability to read or speak) can be shared.
Black 2016, p. 60). It is essential that nurses adhere to all regulations and privacy laws as well as the reporting requirements.
However, ethical information management can also require RNs create and maintain the records that are necessary to provide quality nursing care.
The nurses appear to have revealed the required information to the toddler to someone not necessary authorized to use the data.
Coworkers
The regulation effect under the section for colleagues was not handled in a proper manner.
Consider, for example, one of the nurses involved in the case.
Technically the case would have been different, if either of them had taken the initiative to disclose concerns about their professional practice.
The code of ethics states that nurses must ensure that all colleagues are provided with accurate and complete information regarding the risk to the patients they are providing healthcare.
However, these information are subject to the approval of policies and relevant privacy laws.
Community
The community is key to the success of systems of information management.
The information management system should conform to the community’s expectations (Katsikitis and colleagues 2013, p. 40).
This includes measures that protect and support patients’ privacy rights.
It is important that nurses are sensitive to, and also respect, the legal requirements that govern the communication or sharing of information with cultural significance.
The nursing and midwifery Board of Australia states that nurses are required to adhere to certain codes of ethics.
Nurses should be open to accepting the differences of all people
Nurses care about promoting health and wellbeing in an environmentally, socially and economically sustainable world.
No matter what age or social status, nurses value providing quality nursing care to all patients.Nurses value well-informed decision making
Nurses place great importance on ethical information management
Nurses value a culture that is grounded in safety in healthcare.
Two-nurse breached Conduct three of the code for professional conducts for nurses Australia. This states that nurses should follow the established standards of their profession and the wider healthcare system.
There are two possible ways to breach the code of professional conduct: professional misconduct and unprofessional conduct.
Professional misconduct is when a nurse acts in an erroneous manner outside of the scope of her or his practice. Examples are disorderly conduct, theft and assault.
Unprofessional conduct is the conduct that is in violation of the accepted standards for professional conduct (Karimi et. al 2014, page190).
Technically, the misconduct described in this case can be considered unprofessional.
Nursing is a profession that requires nurses be professional and maintain confidentiality.
The case involved two nurses who were required to care for the child. They failed to do so together with the pediatrician.
Two conduct statements will be reviewed to see what the nurses did right.
Conduct Statement Six
It is the duty of nurses to give impartial, honest, and accurate information on nursing care and other healthcare products.
The exploitation, misrepresentation and misinformation of nurses regarding nursing care and healthcare products should be avoided.
As in the case study, mistakes will occur in the provision of healthcare if nurses present a negative image of their services.
A nurse should have a variety of roles beyond their professional duties.
This includes caring for friends and family, as well as the community.
The nurses should take all steps necessary to ensure that both the patient and their possessions are safe and secure.
Conduct Statement Three
Nurses must follow the laws that apply to their profession and practice nursing.
All registered nurses know the rules and regulations of their profession.
It is essential that registered nurses understand the rules and regulations of their profession.
As stated above, it’s important to make sure that nurses fully understand that reporting any misconduct they see to the relevant authorities is their responsibility.
In this way, the required authority will take the appropriate precautions and address the problem to protect the patient’s best interests.
If a nurse reports an unprofessional or illegal conduct to their supervisors and employers, but the employers fail provide the necessary response, she is required to report the matter to an external authority.
An advocate is an individual who can help the patient make informed decisions.
The case study showed that the infant’s parents should have been granted the primary responsibility to make decisions (Arnold & Boggs 2015 p.37).
The relevant head bodies must ensure that Australian RNs can provide accurate and honest information regarding nursing care and healthcare products.
To aid the parents and pediatrician in making an informed decision, the nurses must have thoroughly explained the advantages and disadvantages to alternative care products.
Ethics refers to the standards of moral judgement and professional conduct.
In this context, nurses are responsible for patients, employers, the general public, and the nursing profession.
It is vital that RNs fully understand and analyze all ethical, legal, as well as professional issues they face in their profession.
Important is the Australian Health Care System, and the factors that influence healthcare delivery.
According to the findings, there was unsatisfactory professional behavior against the two RNs as a result of the circumstances that led the infant’s suicide.
The pediatrician was not a willing participant in the unsatisfactory professionalism.
The two nurses are not entirely to blame, but the pediatrician played a second row role in the case. (Griffith &Tengnah 2017 p. 203).
The reasoning behind this is that they were not conducted by the expected knowledge and judgment of a nurse.
Technically, it was below the expected standards. This despite the fact that practitioners are qualified and have the required experience in this profession.
Also, the case study raised serious questions regarding the level of clinical reasoning ability among Australian Registered Nurses.
Nursing should be understood as a caring profession. In this case, caring includes empathy and connection.
In this context, core nursing values are vital in clinical practice.
In this case, both nurses should be tried as they violated the law and were not professional.
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