Being a professional nurse or Midwife

Being a professional nurse or Midwife
Criteria 1. Case Summary: Summarises the case and presenting professional practice
issues.
Professional practice issues
A Nurse practices the profession underpinning the standards of the nursing profession. Team
work, communication, and professional improvement to ensure the quality nursing care are
the essential factors of professional practice in nursing. In the case scenario, the nurse has not
implemented professional practice. Nurses work as a team with doctors and technicians to
promote the health of the sick. But in the case scenario, the nurse makes a decision against
the standard of professional practice. She did not communicate the patient’s condition with
the medical professionals and the patient’s family. Communication is an essential aspect of
professional practice (Professional codes and guidelines, 2019). The nurse did not document
the patient’s condition and she neglected the oral communication and written communication.
The Nurse in the case was indecisive and lacks decision making quality. The patient was
clinically deteriorating but the nurse failed to make decision according to the need of the
patient. Lack of knowledge about the standards of professional practice caused clinical
deterioration to patient A (NSQHSS, 2012).
Case summary
Patient A is 81 years old presented to the GP clinic with the complaints of shortness of breath
and breathlessness. Lasix was administered to her. VMO advised imagining procedures and
blood tests to diagnose the disease condition. The patient was again visited by the VMO since
patient had diarrhoea and right side tenderness in the abdomen. The patient was undergoing a
condition called clinical deterioration which coincides with the atrial fibrillation, with the
heart rate of 120/mt. patient refuses the oral intake and she was very weak, suffering from

severe abdominal pain. VMO Assessed the patient and diagnosed that patient is anxious and
depressed. He advised mobilisation for the patient. Further investigation concluded the
patient was having UTI and started with IV antibiotics. When the patient was suffering from
various signs of clinical deterioration the respondent was waiting for the arrival of patient’s
doctor to treat her. At this time patient’s vital signs were not improved. The respondent hasn’t
informed the condition of the patient to any of the health professional who was involved in
the patient’s treatment. Finally, Dr.locum arrived when the patient A was critically sick.
Patient A was diagnosed to have severe dehydration. The effort made by the medical team t
to transfer the patient to the hospital failed. The patient died due to Septicaemia.
Criteria 2. Contributory factors: Identify relevant professional errors that potentially
contributed to the incident happening?
Medical malpractice
Medical malpractice was unprofessional conduct of the nurse which contributes the patient’s
clinical deterioration. In this case scenario, the nurse ignored that the patient’s condition was
declining and she did not implement the nursing process to improve the medical condition of
the patient. The nursing process includes five steps, assessment, planning, nursing
intervention, implementation, and evaluation according to the standards of Nursing and
Midwifery Board of Australia. Assessment of Patient A reveals that all her organs fail to
work and undergoing a condition called multiple organ failure due to dehydration. The nurse
did not plan the nursing interventions according to the objective and subjective data of the
assessment (Johansen, 2016). Because the nurses' medical malpractice and negligent
professional behaviour she was unable to manage the patient’s clinical deterioration (NSW,
2018).
Lack of knowledge and skill in clinical practice

Knowledge and skill contribute the holistic nursing care to sick. In the case scenario, nurse
was lacking knowledge about the clinical deterioration. She was not skilful enough to
identify and treat the worsening patient condition (NSW, 2018). When patient was
deteriorating, the nurse did not monitor the patient frequently and the patient’s condition was
not reported and documented (NSQHSS, 2012). The patient was refusing oral intake, but
nurse did not measure her vital signs to rule out the signs and symptoms of dehydration.
Instead the nurse was encouraging the patient to mobilise which is a contraindicated nursing
intervention for the specific condition. According to New South Wales health policy,
patient’s clinical condition need to identify and the appropriate nursing care has to be
provided (Boamah, 2017). The patient had atrial fibrillation and shortness of breath. Patient’s
vital signs were not monitored oxygen therapy was not started to meet the needs of the
patient. Patient A was continually complaining of abdominal pain and back pain. The nurse
did not inform the patient’s complaints to the VMO and she has not implemented pain
management measure to reduce the pain. As a result of nurse’s lack of knowledge about the
clinical deterioration and appropriate nursing skills, the patient’s medical condition was
worsening.
Criteria 3. Implications for future practice: Discussion that includes how your practice
might change and develop as a result of this learning. What professional behaviours
may have made a difference in this situation?
Improve knowledge and skill in clinical practice
Knowledge and skill are the two essential factors of clinical practice in nursing. In this case
scenario the nurse did not update her knowledge for the benefit of the patient she cared for. I
will improve my knowledge and skill based on the New South Wales health policy and
Nursing and Midwifery Board of Australia. I will use online library to enlarge my clinical
knowledge and implement for the health promotion of the patient. I will implement the

elements of nursing process for each patient I care for. I will improve my clinical knowledge
with the help of registered nurse and doctors. I will continue the learning process while caring
for the patient to improve my skill in clinical practice (Ryan, 2016). I will ensure safety and
quality nursing care. Appropriate knowledge and skill will help the nurse in prompt decision
making. I will modify my attitude to improve my decision making capability. I will work
towards my professional development which will help me to work efficiently in the
emergency situation (Decker, 2015). Professional development will improve my decision
making capacity which is an essential characteristic of a nurse in critical nursing care. I will
plan the nursing care according to the need of the patient and deliver in the prompt condition.
I will work for the dual benefit, both for the patient and myself. I will learn from each patient
through their clinical manifestation, planned and implemented nursing care and the
evaluation of the care (NMBA, 2016). This will improve my skill and clinical knowledge
and help me to provide quality nursing care to the patients I will care in the future.
Identify the clinical deterioration and act promptly
Identification of clinical deterioration is the essential aspect of nursing care. Prompt and
instant actions of the nurse will save the patient’s life. In the case scenario, the patient was
clinically deteriorating and the signs and symptoms were noticeable, but the nurse did not
notice the warning signals of the clinical deterioration (NSQHSS, 2012). This case scenario
reveals the importance of identifying and acting on clinical deterioration. I will periodically
revise my theoretical knowledge and practical knowledge. I will continually monitor the
patient’s based on my clinical knowledge (Massey, 2017). I will periodically, report the
medical condition of the patient to the senior staff and to the doctors. In this case scenario,
the nurse did not act promptly according to the need of the patient. The patient was refusing
oral intake, and she was undergoing dehydration. The nurse did not identify the signs and
symptoms of the dehydration. She did not administer IV fluids to prevent the patient from

dehydration. I will assess the patient and do immediate decision to improve the patient from
clinical deterioration (NMBA, 2016). I will improve my decision making ability with the help
of my senior staffs and doctors. I will enthusiastically involve myself in group effort and
share my clinical knowledge and I will show interest in learning new nursing techniques. I
will identify the patient need and act promptly with other health care professionals (Johansen,
2016).
Reference List
Australian commission on safety and quality in health care. (2012). National safety and
quality service standards
https://www.safetyandquality.gov.au/sites/default/files/migrated/NSQHS-Standards-Sept-
2012.pdf
NSW government. (2018). Health
https://www.health.nsw.gov.au/policies/manuals/Pages/default.aspx
Professional codes and guidelines. (2019). Nursing and Midwifery board of Australia.
https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Codes-
Guidelines.aspx
Johansen, M. L., & O'Brien, J. L. (2016, January). Decision making in nursing practice: a
concept analysis. In Nursing forum (Vol. 51, No. 1, pp. 40-48)
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Gausvik, C., Lautar, A., Miller, L., Pallerla, H., & Schlaudecker, J. (2015). Structured nursing
communication on interdisciplinary acute care teams improves perceptions of safety,
efficiency, understanding of care plan and teamwork as well as job satisfaction. Journal of
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Decker, S. I., Anderson, M., Boese, T., Epps, C., McCarthy, J., Motola, I., ... & Scolaro, K.
(2015). Standards of best practice: Simulation standard VIII: Simulation-enhanced
interprofessional education (sim-IPE). Clinical Simulation in Nursing, 11(6), 293-297
https://www.sciencedirect.com/science/article/abs/pii/S1876139915000304
Boamah, S. A., Read, E. A., & Spence Laschinger, H. K. (2017). Factors influencing new
graduate nurse burnout development, job satisfaction, and patient care quality: a time‐lagged
study. Journal of advanced nursing, 73(5), 1182-1195.
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Nursing and Midwifery Board of Australia. (2016). Registered nurses Standards for
practice. file:///C:/Users/admin/Desktop/Nursing-and-Midwifery-Board---Standard---
Registered-nurse-standards-for-practice---1-June-2016.PDF
Massey, D., Chaboyer, W., & Anderson, V. (2017). What factors influence ward nurses’
recognition of and response to patient deterioration? An integrative review of the
literature. Nursing open, 4(1), 6-23 https://onlinelibrary.wiley.com/doi/full/10.1002/nop2.53
Ryan, E. J. (2016). Undergraduate nursing students’ attitudes and use of research and
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