THE LEADERSHIP IN NURSING

Running Head: LEADERSHIP IN NURSING
LEADERSHIP IN NURSING
Name of the Student
Name of the University

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Introduction
The practice of registered nurse can be illustrated as a person-centered and evidence-
based approach with curative, preventive, formative, restorative, supportive and palliative
elements. According to the principles of the Nursing and Midwifery Board of Australia
(NMBA), every midwife and nurses need to be registered under the board and meet the
professional standards for practicing in Australia (Nursing and Midwifery Board of Australia
2014). The professional standards defining the behaviors and practice of the midwives and
registered nurses must include the code of ethics, standards of practice and the codes of conduct.
The role of registered nurses includes working in a professional and therapeutic relationship with
individuals as well as families and communities in a collaborative nursing team. Being a
regulated health care professionals, the registered nurses are responsible as well as accountable
to the Nursing and Midwifery Board of Australia (NMBA). Together with the NMBA
guidelines, codes and standards, the practice of nursing standards for registered nurses needs to
be evident in the current practice and the aspirations of a registered nurse (Purpora and Blegen
2015). The practice of registered nurses enhances their role in collaborative work. Referring to
the case of Mrs. Galanos who has a history of insulin-dependent diabetes mellitus and currently
suffering from hypertension and renal failure. This essay will critically analyze the role of a
registered nurse and how their role can influence the outcomes of patients as part of the
collaborative team.
Discussion
As per the NMBA, there are seven standards for practice designed specifically for registered
nurses. These include the following.
 Critical thinking and analysis of the practice of nursing

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 Engagement in professional and therapeutic relations
 Maintenance of the capability of practices
 Conducting the assessment at a comprehensive rate
 Development of effective planning for the practice of nursing
 Provision of appropriate, safe as well as responsive nursing quality
 Evaluation of the outcomes for informing the practice of nursing.
Analysis of the case study
This assignment essay is a critical analysis of the case study of Konstantina (“Connie”)
Galanos, with her history of insulin-dependent diabetes mellitus. According to the case study,
Mrs. Galanos underwent hemicolectomy for her bowel cancer which then required a permanent
colostomy. However, she has been managing her health challenge for the past few years by
maintaining a frequent visitor in the outpatient department for her renal, diabetes and colorectal
care (Johansson, Sandahl and Hasson 2013). However, the current situation of Mrs. Galanos has
worsened since she is now living with chronic renal failure as well as hypertension. Her current
health challenge is furthermore restricting her to attend the Greek Orthodox Church, on which
she was a regular visitor. According to the case study, Mrs. Galanos was admitted to the general
orthopedic ward due to the worsening of her health issue. The diabetes mellitus in her body has
resulted in damaging her left lower leg, followed by a persistent, large and infected ulcer on her
heel (Ebert, Tierney and Jones 2016). Diabetes has also caused three gangrenous toes. As per the
advice of the doctor in the hospital, there will a planned left lower leg amputation of Mrs.
Galanos to stop the infection to spread throughout her body. Though the operation has been a

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planned one, Mrs. Galanos is feeling mentally weak and very much distressed regarding the
amputation.
Role of a registered nurse before the operation
Lower extremity ulcers, especially in persons with diabetes mellitus, are of significant
clinical concern for the morbidity and mortality associated with them (Hains, Turner and Strand
2017). In Mrs. Galanos's case, peripheral artery disease (PAD) resulted from diabetes. PAD
decreased the blood flow to her legs and feet and caused her blood vessels to narrow. This also
induced peripheral neuropathy, believed to cause her nerve damage (Pennbrant et al., 2013).
Senior health care practitioners or registered nurses integrate science and technology to deliver
clinical services and to meet the needs of physical, physiological, mental, social and cultural
patients. Because patient care is the first responsibility of the registered nurses to perform a
significant role in diabetes treatment, nursing is categorized into many groups, including clinical
nursing specialists, diabetes nurses and nursing practitioners.
In the early stages of care and treatment, registered nurses specialized in foot care need to
be involved. The role of registered nurses in the treatment of diabetic foot must include foot
inspection, wound dressing as well as daily care and follow-up visits for patients and families.
The main aim is to diagnose diabetic foot problems at an early stage, recognize those at risk and
prepare to reduce the risk of ulcers (Gordon et al., 2013). In the scenario of the above case study,
the registered nurse needs to respect the experiences faced by Mrs. Galanos, as per standard 1.
Furthermore, Mrs. Galanos should be treated through reflection over knowledge, experiences,
feelings, and beliefs towards her current stage of ulcer in her left leg. Before the operation of her
left leg amputation, it is also important for the registered nurses to maintain accurate, timely and

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comprehensive documentation of the planning, assessment, actions, decision making as well as
proper evaluation of the reports of Mrs. Galanos and check her current rate of diabetes.
Being a crucial part of the healthcare system, the registered nurses need to practice there
nursing based on purposeful engagement towards effective professional relations and therapeutic
relationship with the patient in the discussion (Bodenheimer and Bauer 2016). According to the
standards by the registered nursing standards and the national framework for the development of
decision-making tools for nursing and midwifery practice, the registered nurses need to sustain,
establish and conclude relationship with Mrs. Galanos in a way which may differentiate the
boundaries among professional and personal relationship, does providing her with enough
comfort to forego her distress before her operation (Foster et al., 2015). Thorough checking of
her current rate of hypertension and insulin dose together with the percentage of diabetes within
her body, are some of the essential roles of the registered nurses about the specific case study.
The role of registered nurses furthermore includes effective communication in a respectful way
towards showcasing personal cultures as well as rights of the patient while discussing her
feelings before her surgery of left leg amputation (Haas and Swan 2014). The midrange
understanding of spoken English by Mrs. Galanos although might be a challenge for the
registered nurses towards effective communication, however according to the standard 5, it is the
role of the registered nurses for communication and planning of effective nursing practices with
relevant information and evidences which has been documented throughout the 20-year history
of insulin-dependent diabetes mellitus of Mrs. Galanos.
According to this case study, a teamwork approach towards the care of Mrs. Galanos
regarding her diabetes mellitus can effectively help her to come up with a vast array of

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complications that might arise from her current health challenge. Mrs. Galanos has been
admitted to the hospital due to her planned left leg ambulation for her high rate of diabetes.
However, a collaborative approach by the register nurses can help Mrs. Galanos to lower the risk
from microvascular complications like kidney disease, eye challenges and macrovascular
complications like heart challenges followed by nerve damages (Raven 2012). This can be done
by a team of registered nurse engaging to control measures nines blood pressure and cholesterol,
making her follow an individualized meal plan, taking care of prescribed medicines and finally
popping effectively towards the demand of this complex chronic disease and its effects
(Dellefield et al., 2015). Collaborative teamwork in registered nursing practice is also beneficial
for the accurate management of blood pressure in Mrs. Galanos. According to the research
studies, the treatment and diabetes care is a multidisciplinary approach that draws upon the
collaboration of several specialists and nurses. Thus the achievement of the acceptable outcome
for the case of Mrs. Galanos depends majorly on the provision of organized knowledge-based
care by effective and skill registered nurses. While treating the foot ulcer which is a complicated
result of diabetes, an elaborative approach by the contribution of several registered nurses is
required for the achievement of a common goal following the clinical guidelines (Wilkinson
2013).
The responsibility of a registered nurse toward the successful recovery and the
readjustment of Mrs. Galanos after ambulation will extend beyond the time when she leaves the
hospital. The registered nurse under the responsibility needs to keep a long-range view within
her plan of daily care. After the ambulation of the lower left leg of Mrs. Galanos, the registered
nurses should immediately seek specific data from healthcare professionals regarding the factors
that might influence the ability of this patient for using artificial limb and adjust satisfactorily

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towards her life situation. According to Cashin et al., (2017), lower extremity ambulation are
some of the most commonly performed operation due to advance chronic diabetes. Towards the
case study of Mrs. Galanos, according to the doctors and her 20-year history of insulin-
dependent diabetes mellitus, her current stage of chronic renal failure and high diabetes has
resulted in persistent and infected ulcers and three gangrenous toes which is a threaten for her
life. After the successful amputation of her left lower leg, some of the most common
postoperative register nursing care includes assessment and maintenance of the patients airway,
circulation and breathing, together with monitoring some of the vital signs and managing heart
pain by taking relevant steps for preventing any respiratory complication or pain in the lower
part of our body (Fedoruk and Hofmeyer 2012).
Towards discussing the influence of the role of a registered nurse towards the patient
outcome in this case study, it is to note that one of the major duty of a registered nurse as per the
standards of nursing is to help Mrs. Galanos to have and improve her movement after her
operation of feet amputation. The registered nurses should encourage as well as teach Mrs.
Galanos to use assistive devices by introducing her to the types of devices based on a condition
and for her mobility. Clinical and psychological counseling followed by therapy sessions are also
essential for Mrs. Galanos during the entire process of the operation before and post-operation to
help her gain confidence towards living a happy life afterward (Scanlon et al., 2016). The co-
operation towards the diabetic foot treatment for Mrs. Galanos by registered nurses as per the
guidelines and the standards of nursing and midwifery board includes post-operative care like
diagnosis, intervention, and evaluation of the outcome. For Mrs. Galanos, it is important for the
registered nurses under post-operative care towards the management of her mind as well as
psychological well being by engaging in effective communication with her to reassure her in

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case of distress with the situation of left leg emulation as well as her safety for the upcoming
years.
Conclusion
Thus it can be concluded from the above that the highest priority in nursing is patient
care. To ensure that patients receive the best possible healthcare treatment, registered nurses
must coordinate their therapy plans with the appropriate professionals and recognize the
responsibilities of each member of the assigned team. The registered nurses are effectively a
bridge between doctors, patients, and the hospital. This position depends on teamwork and
collaboration. Collaborative collaboration between health care providers and nurses is intended
to increase access to medical facilities, improve health quality, provide more' seamless facilities'
and maximize healthcare performance. The above essay thus illustrates the importance of the
role of the registered nurse under the principle and the guideline of nursing and midwifery board
towards the case stud of Mrs. Galanos and her health condition of serious diabetes mellitus and
her mental and psychological condition before and after the surgery of left leg amputation.

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