Nursing Accountability and Critical Thinking

The assignment delves into the crucial role of critical thinking and professional accountability in nursing practice. It emphasizes the need for nurses to analyze patient situations, make informed decisions, and act responsibly to ensure safe and effective healthcare delivery. The text highlights the significance of reflective practice, ethical considerations, and adherence to professional standards.

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

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Assessment 3: Critical Analysis Essay of a Case Study
Nursing is considered as a noble profession in which apart from professional competence
and essential skills, the nursing practitioners are to work in compliance with the professional
standards and principles as laid down by the concerned authorities. It is imperative for the nurses
to abide by these guidelines for ensuring appropriate professional conduct, accountability and
ensuring so that there is no violation of the accepted norms and regulations (Masters, 2015). In
the following essay, critical analysis will be performed with respect to a chosen case study
whereby evaluation of the unsatisfactory professional conduct as performed by nurse will be
conducted. The relevant professional standards as applicable to the case scenario will be
identified. Discussions will be made in terms of professional behaviors that could have made a
difference to the case. Further, evaluation of self-preparedness for professional practice will also
be carried out to offer deeper probe into the matter.
As per the given scenario, the nurse was found guilty of unsatisfactory conduct with
respect to her failure in acknowledging and responding to the deteriorating health status of the
patient. Moreover, she was also declared guilty of not documenting her assessments and
subsequent plan of action for the patient. Thus, in conformance with the give situation it is
evident that the nurse did not act up to the mark in performing her duties. It has been stated that
the nurse after being informed about the observations with respect to the vital signs, did not take
appropriate actions in managing the ensuing situation. Patient was left without any proper
medical review or intervention until a long period of time even though her vital parameters were
found to be within the ‘red zone’ as depicted in the Hunter New England NSW Health Policies.
As per the governing policy, a patient exhibiting such symptoms call for ‘rapid response’ in
which the patient is to be attended by either a medical officer or a rapid response team within 10

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minutes. Further, it is expected that in absence of all these facilities, the patient’s general
practitioner or the on-call visiting medical officer be immediately notified to undertake prompt
therapeutic actions. In this respect, lack of critical reflection on the part of the nurse may be
indicated as she failed to recognize the deteriorating health status of the patient. Empirical
evidences have cited that critical thinking skills and its integration into nursing practice is vital in
facilitating proper planning and implementation of strategies for ensuring speedy patient
recovery (Burrell, 2014). Moreover, the nurse did not document the patient’s medical record that
is crucial to her assessment, plan of action and rationale behind selection of undertaking a
particular course of treatment. Neither did the nurse escalate the situation to the concerned
authority of the clinical nursing manger for proper intervention. Documentation in the pursuit of
nursing is vital for smooth operation of the nursing practice as it is indicative of the prospective
course of treatment to ensure positive health outcomes for the patient. Staff competency and
education are two prerequisites that account for improved documentation in nursing practice
(Okaisu et al., 2014). Hence, correct following of appropriate actions in immediate situation
would have averted the negative repercussions.
It is imperative in nursing practice to abide by the professional standards for ensuring the
safety and provision for optimal healthcare service for the patient, the end user of the healthcare
service facility. These standards are responsible for governing the professional nursing practice
and dictate the professional accountability in the vocation. A foundational framework is rendered
by compliance to these standards and ensures so that optimal outcomes may be achieved for the
patient population (Krautscheid, 2014). In the given scenario, it has been reported that the nurse
was guilty due to unsatisfactory professional conduct. A strict violation of the professional
standards as lay down by the concerned authority consisting of the Nursing and Midwifery Board

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of Australia was evident in the given scenario. Breach of standards has occurred pertaining to the
given condition whereby the nurse has failed to accurately recognize the deteriorating health
condition of the patient and did not even document the medical record of the patient. Standard 1
was breached because as per the statement, a nurse must think critically and analyze the situation
in course of nursing practice. Further, standard 5 was breached, as the nurse did not develop a
plan for nursing practice. Lack of documentation has been observed, as the nurse did not take
appropriate actions in terms of harboring positive outcomes for patient. Moreover, breach of
Standard 6 is also noted as the nurse failed to provide safe, appropriate and responsive quality
nursing practice (Nursingmidwiferyboard.gov.au, 2017). According to the Code of Professional
Conduct for Nurses, the nurses must practice in a safe and competent manner, in conformance
with the standards pertinent to the profession and broader health system. Reflective and ethical
consideration in nursing is also an important virtue as stated in code of professional conduct for
nurses. However, all these codes were violated in given context thereby culminating in
unprofessional conduct as it opposed the agreed and accepted practice standards
(Nursingmidwiferyboard.gov.au, 2017).
Nursing practice demands for prudent ad pragmatic approaches in terms of conducting
professional behaviors that are essential to ensure safe and quality healthcare services to the
patient. As per the given scenario, the nurse exhibited lack of professional approach that
ultimately resulted in death of the patient following progressive deterioration of her health status.
It has been clearly stated in the case study that the nurse was informed about the declining health
status of the patient evident through clinical manifestations of hypotension, tachypnoea in
addition to abdominal pain and diarrhea upon her arrival to the ward. However, the nurse failed
to acknowledge the criticality of the situation and did not resort to undertake prompt actions that

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were required of her. She could not fathom the urgency of therapeutic treatment intervention and
hence did not perform the necessary actions that would have altered the situation for good. No
doctor was summoned at that hour although her vital signs observations clearly indicated
debilitating health status of the patient. The locum doctor appeared at the scene approximately
three and half hours later. Moreover, she did not record her personal observations on arriving at
the scene. However, the early presence of the doctor would have been of utility in terms of
gauging the relative urgency of the situation and implementing suitable therapeutic actions.
Further, documentation of valid observations would have aided in framing the nursing care and
plan as suitable for the patient. Possession of the essential nursing skills such as that
encompassing critical reflection and analysis would have generated positive outcomes. These
virtues would have upheld competency and safe practicing norms for the nurses (Missen et al.,
2016). Moreover, apart from these personal attributes, prior clinical experience to similar setting
would have made difference. As far as critical care nursing is concerned, research has revealed
that experience across the nurse practitioners is majorly responsible for inducing positive
outcomes (Morton et al., 2017). Hence, it may be commented that a more professional approach
would have reversed the given context and culminate in generating positive outcomes for the
intended patient.
Reflecting on the case study, I became aware about my own professional preparedness. I
came to acknowledge the usefulness of biding by the professional standards and code of conduct
in professional practice. Further, significance of lawful and ethical compliance to nursing
practice became clearer to me. Codes of ethics as suitable to relevant situation was clearly
elucidated to me as I perceived that keeping aside the safe and quality practice in nursing, the
ethical virtues must also be maintained in due course to account for optimal outcomes for the

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patient (Nursingmidwiferyboard.gov.au, 2017). Reviewing the content of case study, I feel
enlightened in terms of knowing the pivotal role of documentation in nursing practice. I believe,
as an integral part of nursing care, the nurses should strive to document their observations
explicitly even though it might appear trivial a times. Correct documentation would account for
indicating the course of appropriate therapeutic practice thereby aiding in formulation of an
appropriate care plan directed to the patient (Woods et al., 2015). As a new graduate nurse, I
think it is within the scope of practice to undertake the actions that might ultimately result in
rendering safe and competent care services to the patient.
Nurses must be proactive in their efforts and thorough about their knowledge regarding
their professional conduct and work in alliance with the professional standards and code of ethics
as fostered by competent authorities. In case of deviation from these ideal behaviors, they are
liable to be prosecuted under the court of law. Gross violation of accepted protocols and
practices would account for proceeding with necessary actions that might be leading to legal
trials and appropriate actions as applicable in particular case scenario. Moreover, nurses must
take responsibility or be accountable for their behaviors. Critical reflection to a specific situation
is necessary to strategize suitable actions in favor of holistic outcomes for the patient. Prudent
insight into a given scenario is vital to acknowledge the specific condition of patient. Therefore,
nurses must be well versed and aware about their professional accountability to ensure safe and
optimal healthcare service for the patients.

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References
Burrell, L. A. (2014). Integrating critical thinking strategies into nursing curricula. Teaching and
Learning in Nursing, 9(2), 53-58. doi: 10.1016/j.teln.2013.12.005
Krautscheid, L. C. (2014). Defining professional nursing accountability: a literature
review. Journal of Professional Nursing, 30(1), 43-47. doi:
10.1016/j.profnurs.2013.06.008
Masters, K. (2015). Role development in professional nursing practice. Jones & Bartlett
Publishers.
Missen, K., McKenna, L., Beauchamp, A., & Larkins, J. A. (2016). Qualified nurses' rate new
nursing graduates as lacking skills in key clinical areas. Journal of clinical
nursing, 25(15-16), 2134-2143. doi: 10.1111/jocn.13316
Morton, P. G., Fontaine, D., Hudak, C. M., & Gallo, B. M. (2017). Critical care nursing: a
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http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-
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Okaisu, E. M., Kalikwani, F., Wanyana, G., & Coetzee, M. (2014). Improving the quality of
nursing documentation: An action research project. curationis, 37(2), 1-11. doi:
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Woods, C., West, C., Mills, J., Park, T., Southern, J., & Usher, K. (2015). Undergraduate student
nurses’ self-reported preparedness for practice. Collegian, 22(4), 359-368. doi:
10.1016/j.colegn.2014.05.003