Importance of Nursing Professional Standards in Nursing Practice

This essay highlights the importance of following nursing professional standards in nursing practice and discusses the interview with Raelene Ward, a 40-year old aboriginal woman. It focuses on person-centred care, family-centred care, nursing code of ethics, National Safety and Quality Standards, and Erikson psychosocial theory. It also discusses examples of effective and ineffective care and the importance of partnering with consumers.

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

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Nursing code of practice and nursing professional standards are an important aspect of
nursing profession as it helps in improving overall aspect of care (Nursing and Midwifery
Board of Australia [NMBA] (2013). The essay will aim to highlight the importance of
following nursing professional standards while procuring care to the patient. In discussing the
importance of the nursing professional code of conduct in nursing practice, the essay will
focus on the interview conducted by Natasha Reedy with Raelene Ward, 1 40-year old
aboriginal woman who has three children and as active working professionals. The paper will
elaborate the theories associated with person-centred care, family-centred care and nursing
code of ethics along with the National Safety and Quality Standards and Erikson
psychosocial theory. At the end, the essay will highlight few examples of effective and in-
effective care and importance of the “partnering with the consumers”.
The standard of care that can be stated in the case study is the approach of informed
decision-making. According to the NMBA (2013), a nursing professional must practice
informed decision making in order to respect the autonomy of the patient. However, during
the interview session, Raelene stated that when she was diagnosed with gestational diabetes,
she was prescribed with insulin injection by the endocrinologist in the antenatal care. At that
time she had no knowledge about insulin and its role with diabetes management, thus it
complained that she received no support for informed decision-making. Powers et al. (2017)
are of the opinion that informed decision-making helps to respect the ethics of autonomy and
at the same time helps to increase patients’ participation in the care plan. Under the psycho-
social model of Erickson, intimacy and isolation is considered as the prime psychological
need of the individuals between the age group of 18 to 40 years (Syed & McLean, 2017).
Increase in intimacy through social and community level participation and spending time
with the family members helps to improve the mental and physical well-being of the
individuals (Syed & McLean, 2017). The excerpts from the Raelene interview stated that she

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was a single working mother and thus she used to get no mental and financial support from
her husband. The death of her younger sister made her mentally alone. This might be the
reason why Raelene reported that after the death of her sister she developed depression
however, she received no mental support like mental counselling. Lack of proper mental
health counselling among the older adults with depression increases the mental health
complication (Mills, 2019). It was due to this lack of mental support and depression. Raelene
was unable to manager her own medication and at the same time was feeling mentally
depressed. Raelene however, stated that people who are from aboriginal origin are well-
equipped to look after themselves and thus helping to understand the degree of self-coping
skills or resilience among the indigenous population of Australia.
The care plan followed for Raelene as illustrated through her own words was in-
effective. The care plan designed for Raelene did not follow the approach of the person-
centred care plan. When she was diagnosed with gestational diabetes mellitus (GDM), she
was immediately prescribed and injected with insulin for managing her elevated blood
glucose level (BGL) with no prior consent taken from her. Alfadhli (2015) is of the opinion
that initial treatment of GDM includes diet and exercise. If these measures failed to achieve
proper control of the BGL then insulin must be initiated. Insulin like lispro, aspart and
detemir are permissible for GDM unlike glargine. Oral hypoglyemic agents like glyburide
and metformin are also safe for treating GDM. Magon and Seshiah (2014) stated that clear
understanding of the insulinic management for GDM is important for endocrinologist in order
to deliver a comprehensive care to women during and after pregnancy. The use of the person-
centred care approach helps in the selection of ideal BGL control plan for managing GDM.
Another example of ineffective care is lack of presence of culturally competent
indigenous healthcare workers while designing the care plan for Raelene and she also
complained about the same in her interview. The study conducted by Campbell et al. (2018)

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over aboriginal women stated that highest priority of care during GDM management is
holistic social sport and presence of culturally appropriate resources. The presence of
aboriginal or culturally competent nurse helps in understanding the aboriginal women’s
perspective and thus helping to develop person-centred care strategies for improving the
postpartum care after GDM. Entering into partnership with the GDM consumers under the
presence of the aboriginal healthcare worker promotes client health literacy and integration of
quality improvement strategies. The presence of family member for designing the care plan
for GDM helps in therapy adherence and patients’ efficacy in the disease management (Baig,
Benitez, Quinn & Burnet, 2015). National Safety and Quality Health Service Standards
(NSHSS) (2012) also promotes the application of family centred care plan. For Raelene, the
main participants for the family centred care plan might have been her younger sister. The
support coming from family might not create a scenario of Raelene self-injecting insulin on
her own or doing blood sugar test alone.
Effective care planning that can be ascertained from the case study is presence of the
dietician. Here the dietician acted as a diabetes educator and thus helping to increase health
awareness. Guo, Chen, Whittemore and Whitaker (2016) stated that promotion of health
literacy helps in improving patient’s empowerment and thereby helping to increase therapy
adherence. Guo, Chen, Whittemore and Whitaker (2016) also stated that effective
management of diet is an important non-pharmacological intervention for GDM
management. According to Australian Commission on Safety and Quality in Healthcare
(2012), clinical governance helps to increase patient’s health literacy and is an important
aspect of the nursing profession. However, lack of presence of the dietician throughout the
care procedure might further be highlighted as one of the drawback of the study.
According to NSHSS Australia (2012) a nurse must indulge in partnering with the
consumers in order to improve the efficacy and quality of care. Partnering with the

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consumers also helps in increase the level of patient’s participation in the care plan and thus
increasing the provision for person-centred care plan. Australian Commission on Safety and
Quality in Healthcare (2012) stated that effective partnering with patents and their family
members helps in highlighting the clinical priority and thus further increasing the provision
for generation of person-centred care plan. From the interview, it can be understood that
Raelene used to inject insulin on her own after getting diagnosed with GMD while she was
pregnant with her third child. However, though she was self-administering she was not aware
of the exact mechanism of insulin over the BGL or why she was using this medication.
Nevertheless, use of insulin helped her to reduce escalating BGL. However, demise of her
younger sister made her feel devastated and this reduced her medication adherence. Ng, Lai,
Lee, Azmi and Teo (2015) stated that targeted insulin interventions for the diabetes
management could help to increase the level of therapy adherence. For safer and regular
insulin administration and maintenance of healthy lifestyle in diabetes management, client
education and support coming from family members is primitive. However, it can be sated
that for Raelene after the death of her sister there were no adult members in family to support
her. But proper health literacy might have helped her in effective disease management.
The critical analysis of the above interview with Raelene an aboriginal women
highlight several gaps in care plan planning. The primacy gaps in the care planning include
lack of person-centred care plan, lack of informed consent and lack of family-based
interventions. The lack of support coming from the family members or healthcare
professionals also endangered her psychosocial needs of isolation and intimacy. Raelene was
suffering from depression and she was alone or isolated after sudden death of her sister.
Support coming from aboriginal nurse and counselling coming from mental health
professionals might have been helpful in this case. However, the presence of trained dietician
helped her understand the importance of diet in GDM management.

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