Negligence in Patient Care: A Critical Analysis of a Case Study

Running head: NURSING
Nursing
Name of the Student
Name of the University
Author Note

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NURSING
Introduction
When the new graduate nurses enter into the professional force, they find difficult to
practice as they neither had practice expertise nor they have the required confidence to
navigate in order to become dynamic under intense clinical requirement (Duchscher, 2018).
The following essay is based on the case study showing how negligence due to lack of proper
professional goals and lack of awareness in the professional code of conduct might lead to
fatal outcomes in patient care. The essay will initiate with critical analysis of the case study
followed by discussion and personal reflection of the author.
Critical analysis
The case study is mainly centred on 81 year female patient who was initially
presented to a GP with breathlessness while lying fat. GP observed that she has fine crepes at
the base of both lungs, elevated jugular venous pressure and normal renal function and
prescribed oral Lasix for two days. On next day only patient reported to local (rural) hospital
with shortness of breathe and subsequently she was admitted as oral Lasix failed to improve
her symptoms. According to Pellicori, Kaur and Clark (2015), oral Lasix is not functioning
and the breathless is persisting hospitalization is recommended. However, the case study did
not provided any documentation of the patient’s vital parameters which prompted urgent
hospitalization like heart rate, respiratory rate, blood pressure. Esmailian and Nasr-Esfahani
(2014) is of the opinion that it is the duty the outdoor nursing professional to keep a detailed
tabulation of the patient’s vital parameter while the patient is being hospitalised and report
the same to the medical officer. Three days after patient refused food and water intake and
was complaining for being weak, abdominal pain along with atrial fibrillation (120 beats per
minute). On basis of the reported symptom, VMO was called. This again highlighted that it is
the role of the nursing professional to communicate the patient’s problem to the medical

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NURSING
officer in order to ensure fast recovery of the patients (Arnold and Boggs, 2015). VMO
concluded that patient was depressed and anxious and recommended nursing staff to mobilise
patient and then frame the discharge planning and the same has been documented by the
nursing professional. According to the Nursing Code of Professional Conduct Australia
(2018), it is the duty of the nursing professional to provide a detailed documentation of the
discharge planning in order to assist the care giver at home. Later patient’s respiratory rate
was recorded and was found to be 28 to 30 minutes and other vital signs was found to be
normal. However, the attending nurse did the same to the medical officer. Dwyer, Gabbe,
Stoelwinder and Lowthian (2014) reported that high respiratory rate (normal 12 to 20 beats
per minute) can be fatal and required non-invasive monitoring. During the evening also,
patient’s condition did not improved as she refused to have dinner along with further high
respiratory rate and tachycardic (122/min). However, when the patient stated feeling “woozy”
with skin turning pale and cold, and heart rate of 168/min, VMO was called. This delay in
VMO intervention might have increased the severity of the disease. However, Smith et al.
(2014) are of the opinion when a patient is showing no promising improvement or rather
experiencing further deterioration, it the duty of the attending nursing professional to go for
MET call or Medical Emergency Team call. Smith et al. (2014) are of the opinion that MET
call is a sentinel event that promotes intervention from multidisciplinary team of healthcare
professionals and thereby helping to overcome the critical situation. Boniatti et al. (2014)
stated that Delayed MET call can caused adverse health outcome and this is what the cause
with this 81 year old patient. Intervention of the VMO prompted administration of Digoxin
(medicine for arterial fibrillation) and Valium (medicine for anxiety). Later when Digoxin
failed to produce quality results, blood test and chest X-ray was prescribed which revealed
urinary tract infection and thereby explaining the reason behind abdominal or back pain along
with high white blood cell count in the absence of fever (Foxman, 2013).