Assignment On Advanced Health Care System

Running head: NURSING
Nursing
Name of the student:
Name of the University:
Author’s note

1NURSING
Introduction:
Australia as an advanced health care system and with the increase in modern
complexities of health care system, there is high expectation regarding registered nurses to
achieve highest level of skills to maintain international standards of care. Because of this
demand, many registered nurses are taking up specialist nursing role (Shields, 2013). Critical
care nursing is also a specialist role where nurses are responsible for providing care to patients
who are critically ill. The key difference between the skills of a critical care unit (CCU) nurses
compared to a registered nurse is that they CCU nurse are nurses who take specialist education
and training to respond to patient with life threatening illness in critical care setting. Specialist
nurse also have certain specific safety and legal responsibility during care delivery (Jokiniemi et
al., 2012). This reflective paper aims to describe issues of safety or legal responsibility in relation
to the experience of providing care to a patient in the specialty area of critical care nursing. The
paper will identify issues specific to the speciality area by review of current practice standards
and key role and responsibilities in the role.
Patient safety issues in the specialty area:
During one of my clinical placement in a CCU unit, I was assigned to the care of a 75
year old patient with advanced stage of dementia. However, she was admitted to the hospital for
knee replacement surgery after she fell in the bathroom and fractured her knee. According to my
role and responsibilities as critical care nurse, I followed the handover report for the day and
completed vital sign assessment. I communicated with the patient regarding her state of health
now and any issues she faced. I gave her the medications prescribed and took permission to
leave. Then I moved on to inspect and assess others patients in the CCU. However, one mistake

2NURSING
that I did during my clinical practices as a CCU nurse was that in the handover report, it was
written in bold ‘hourly round in pathway’. However, I ignored it and did not go to see the patient
again. In addition, while documenting patient’s progress on the ‘patient care pathway’ form, I
wrote that the patient was asleep during last round. Meanwhile, the issue that took place was that
the patient had a fall from his bed. I was called for disciplinary action because of involvement in
patient safety and legal issues.
On analysis of my action, the incident is a patient safety issue because ignorance of the
patient care pathway resulted in clinical deterioration of patient. As part of my role and
responsibilities as a critical care nurse, I had the responsibility to adequately assess patient,
monitor their progress and report about any changes to the physician. In accordance with my
specialist role, I had the duty to provide round the clock care and monitoring to ensure that
patients are safe and at no risk of clinical deterioration (Chamberlain, Pollock & Fulbrook,
2018). However, I was involved in disciplinary action because I failed to complete my
responsibility of round the clock care and monitoring. In addition, I violated my responsibility of
completely following patient care pathway and my assigned duties during shift. Jakimowicz and
Perry (2015) explains that for critical case nurse, it is extremely important to keep patient safe
and perform task exactly as instructed to them. They need to continually monitor the care
provided to patient. They have the responsibility to work quickly in stressful conditions and stay
alert even after many hours of work. However, my action of ignoring hourly round proved costly
for me. By ignoring hourly round, I missed to identify that the patient was dosing off and there
was no bed rail that could prevented fall. If I had visited patient on an hourly basis, the same
situation could have been avoided.