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NURS3002 Advance Decision Making and Practice Assignment Sample

Length: 1500 words

Curriculum Mode:

There is a word limit of 1500 words. Use your computer to total the number of words used in your assignment. However, At not include the reference list at the end of your assignment in the word count. In-text citations will be included in the additional 10% word count. If you exceed the word limit by more than 10% the marker will stop marking at 1500 words plus 10%.

Aim of Assessment:

The Aim of this assessment is to develop your understanding evaluating the professional conduct of a nurse/midwife in the case study provided.
The case study provided is a decision statement selected from Decisions of the Professional Standards Committee from the Nursing and Midwifery Council New South Wales - The Health Care Complains Commission (HCCC). You are to identify professional practice issues from the case study and then draw on the professional frameworks and regulatory legislation, to develop sound and appropriate responses to the clinical incident that will inform your future practice.

Details for Assignment Help

This assessment requires you to identify and summarise the professional practice issues in the case study from either a nursing or midwifery practice perspective. You need to identify and evaluate relevant professional errors identified that potentially contributed to the incident happening. Finally, discuss on how your future practice might change and develop as a result of this learning.

Students are to draw on the National Safety and Quality Health Service (NSQHS) Standards, NMBA professional practice documents and NSW Health policy documents (where appropriate) to develop informed responses.

Students must refer to and use the case studies located on vUWS under Assessment 2 tab for this assessment. There is one nursing case study and one midwifery case study to choose from. Submission requirements: -

The total word count is 1500 words. - Electronic copy only.

- This assessment is marked online; no paper copy will be accepted. Marks, comments, and the marking criteria will be released online. If you do not receive your marked assessment when all others have been returned, it is your responsibility to contact the Subject Coordinators for assistance.

Solution

Introduction

The professional code of conduct of a nurse embodies an ethical blend of rules and norms that is designed to direct the nurse in providing care to the patients found in critical care situations. The code of ethics comprises veneration for beneficence, autonomy, non-maleficence and justice. The essay consists of three sections. The first section discusses the professional practice issues from the perspective of a nurse. The second section points out the relevant professional errors of two nurses from the case study. In addition, the NSW Health policy documents mark the guidelines to be followed by the nurses rendering service to critical care patients. Finally, the third section discusses the reflection on how the suggested practices might amend and mitigate the issues found in the incident of the case study. The essay identifies the relevant professional errors from the case study and shows that the professional code of conduct followed by the nurses can help to resolve issues.

Section 1

The incident in the case study points out the complaint that has been launched against Ms Nelly Youssef who is a registered nurse. The complaint was launched against Ms Nelley Youssef by the Health Care Complaints Commission before the Administrative Tribunal and NSW Civil.

This complaint was lodged after an inspection of all the allegations charged against her on 13th January 2021 (Gillespie & Reader, 2018). All the allegations were proven, and she was charged with professional misconduct and unsatisfactory professional conduct. The case was filed against her after the Commission noticed an unprofessional act. They alleged her after they found an 80 year patient with a laryngeal stoma unresponsive. Ms Nelley Youssef reluctantly agreed with the junior colleague to dress the stoma and provided the dressing to the patients without proper instruction (Joo & Liu, 2021). Later, the patient was found not responding, thus it was tough for her to remove the dressing. When asked, she provided wrong information stating that she noticed the patient was not responding and the stoma was not covered. When found that the information provided was irrelevant, it was decided that strict actions would be taken against her. She misled her junior colleague (Gillespie & Reader, 2018).

Section 2

The incidents in the case study point out two professional errors committed by two nurses, Ms Nelley Youssef and RN Mc Arthur. Nelly Youssef was accused of unsatisfactory professional misconduct as she improperly responded to a request from a junior colleague who sought advice from her (Caselaw.nsw.gov, 2022). The former stated that it will cause no harm if Meplix occlusive dressing to the stoma of Patient A. By this, she portrayed inadequate knowledge that stoma is the only airway of patient A, covering which will lead to more harm than good. Moreover, the dressing was forgotten to be removed from the patient until he was found unresponsive in the shower. When she was accused of unprofessional conduct under 139B(1), she said she did not find Mepilex border dressing on the stoma. However, later on, she admitted that she lacked knowledge regarding Patient A's anatomy (Caselaw.nsw.gov, 2022). Moreover, she stated that she did not know that the laryngeal stoma was the only airway for the patient.

RN McArthur was also accused of the unprofessional code of conduct under 139B(1)(a). The concerned person also improperly applied a Meplix dressing on the patient's laryngeal stoma before he started to take his shower. Moreover, he also lacked adequate knowledge about the clinical history of the patient (Halcombet al. 2020). He also failed to know that the only airway of the patient is the laryngeal stoma which was unknowingly covered. He further stated that she stayed with the patient for five minutes after applying the dressing. This was falsely stated by the person in a letter sent to HCCC. He had further satiated that at the time of dressing he lacked the information about the underlying anatomy of patient A (Caselaw.nsw.gov, 2022). To everyone's utter surprise, he denies is not guilty of whatever has happened with the patient.

NSW health organisations monitor the incorporation of Policy Documents and guide the implementation as an essential aspect of strong governance, audit formulation and performance. The policy document consists of guidelines, policy directives and information issued by the NSW Ministry (NSWhealth, 2022). Besides encompassing protocols and procedures, it also lays down guidelines that should be strictly adhered to by the health service unit within the local health district. The policy documents formulate superior clinical practices along with the clinical and non-clinical functions. The guidelines are issued by the NSW policy systems and adopted in the NW health units. The components of the policy document are the information bulletin, NSW health organisation and the NSW ministry of health (NSWhealth, 2022). The policy document clearly explains the information bulletin, policy directive and essential guidelines issued by the NSW health organisation.

The organisation found in the case study does not follow the guidelines laid down by the National Safety and Quality in Health Service Standards (NSQSH). So, the company can opt for Safety and quality systems with the help of governance processes so that they can improve and manage the safety and quality of health care for patients (Australian Commission on Safety and Quality in Health Care, 2021). In addition, the NMBA guidelines are not ingrained in the mentioned health care unit of the case study. The NMBA states that nurses shall adhere to professional commitment and abide by the respective law (NMBA, 2022). Thus, the nurses are expected to act with professional obligation for the sake of the patient's recovery and well-being. As a result, the convicted nurses are placed under S139B (1) for conducting unprofessional behaviour (NSWhealth, 2022). The Health Care Complaints Commission (HCCC) has done justice to the complainant by identifying the accused and taking legal measures.

The implementation of the NSW policy documents gives an overview of the roles and responsibilities to incorporate the policy directives (Taylor et al. 2020). The policy documents comprise the codes of conduct that medical professionals are expected to follow. It provides a framework of actions with respect to ethical conduct. Breaching the code of conduct mentioned in the policy documents will be held responsible by law (NSWhealth, 2022). In addition, it leads to disciplinary actions and the punishment is decided by the severity of the crime.

Section 3

Reflection

I have been through both the cases and understood that the first case was related to Ms Nelley Youssef, against whom a case was filed due to her unprofessional negligence towards the dressing of stoma for an 80-year-old patient who was found not responding. At the same time, the second case deals with two professional misconducts by Ms Nelley Youssef and RN McArthur for reluctantly applying Meplix dressing to a patient with a laryngeal stoma (NMBA.gov., 2022). All I understand is that both cases are completely careless, or the nurses are not being provided with proper training. As per my understanding, an individual might own a degree and be an official nurse, but they can still be expected to make mistakes. In both cases, the situation could have been controlled if the nurse had asked for help from their other senior colleagues before conducting the method on the patients (Taylor et al. 2020). Both the patients have been found to act unprofessionally, first for misguiding their junior colleagues and second for showing a lack of adequate knowledge.

After summarising the cases, I had been through the NMBA Standards for Practice documents for Nurse and NSQHS or National Safety and Quality Health Service. I learnt about the patients' professional expectations and the nurse's authority. I can conclude that if I had been in place of Ms Nelley Youssef, I should have taken the responsibility and correctly instructed my junior colleague for the dressing of the laryngeal stoma firstly because the patient had not been responding and second because it was 80 years of age. This is not only the main reason but the main because, as a senior nurse, it is my responsibility to take care of the patients and properly guide the juniors (NMBA.gov., 2022). Thus, this would not have led me to any problems like Ms Nelley Youssef had. As per the case of RN McArthur, firstly, I would have strictly followed NMBA and NSQHS and still, if I was unclear about the procedures, I would have consulted someone, maybe a doctor or an experienced nurse. I would not have reluctantly applied Meplix on the patient's stoma before their bath. It is very unprofessional and showcases carelessness to state a lack of adequate knowledge about the wound (NMBA.gov., 2022). Even if that had happened, I would not have just strongly accepted that it was not my fault, even after knowing it was.

Conclusion

This study is concerned with summarising a case study that had been provided related to the issue or complaints that had been launched against the nurses for misleading or misconducting and performing unprofessional techniques of giving medication to the patients. Here the summary has been provided of the patient's complaints. The study has been divided into an introduction to the nursing case study talking about the professional code of conduct in nursing. Sections 1, 2, and 3 highlights the issues and summarise what the problems had been, under what act they have been taken, and what accusation points have been pointed at the nurses and how they had reacted to it. Reflection is the place where the cases have been heightened with the problems that the patients have faced due to the unprofessional acts of the nurses.

References

Australian Commission on Safety and Quality in Health Care (2021). National safety and quality in health service standards (2nd ed.). Retrieved 27th August 2022, from https://www.safetyandquality.gov.au/sites/default/files/2021-05/national_safety_and_quality_health_service_nsqhs_standards_second_edition_-_updated_may_2021.pdf.

Gillespie, A., & Reader, T. W. (2018). Patient?centered insights: using health care complaints to reveal hot spots and blind spots in quality and safety. The Milbank Quarterly, 96(3), 530-567. https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/1468-0009.12338

Halcomb, E., Williams, A., Ashley, C., McInnes, S., Stephen, C., Calma, K., & James, S. (2020). The support needs of Australian primary health care nurses during the COVID?19 pandemic. Journal of nursing management, 28(7), 1553-1560. https://doi.org/10.1101/2020.06.19.20135996
HCCC v Youssef & McArthur [2021] NSWCATOD 2

Health Care Complaints Commission v Youssef; Health Care Complaints Commission v McArthur - NSW Caselaw. Caselaw.nsw.gov.au. (2022). Retrieved 27th August 2022, from https://www.caselaw.nsw.gov.au/decision/176ee7c5bee2c2cdb86225c8.

Joo, J. Y., & Liu, M. F. (2021). Nurses' barriers to caring for patients with COVID?19: a qualitative systematic review. International nursing review, 68(2), 202-213. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8013562/

NMBA.gov. (2022). Retrieved 29th August 2022, from https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards/registered-nurse-standards-for-practice.aspx

Taylor, E. V., Lyford, M., Parsons, L., Mason, T., Sabesan, S., & Thompson, S. C. (2020). "We're very much part of the team here": A culture of respect for Indigenous health workforce transforms Indigenous health care. PLoS One, 15(9), e0239207. https://doi.org/10.1371/journal.pone.0239207

Www1.health.nsw.gov.au. (2022). Retrieved 27th August 2022, from https://www1.health.nsw.gov.au/pds/ActivePDSDocuments/PD2016_049.pdf. 

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