Nursing Professionals Standards Report

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

1
NURSING
This essay is based on the theory that following nursing professionals standards and
code of practice helps in improving the overall quality of care. While elaborating the
importance of the theories of nursing and the health related quality standards, the essay will
aim on the case study of a 40 years old aboriginal women named Raelene Ward. Raelene is
mother of has three children and is an active working professional. The entire narration of the
case study is done through excerpts of interview that is being conducted by Natasha Reedy.
The paper will highlight theories of the person-centred care, family centred care, code of
nursing ethics, National Safety and Quality Standards and Erikson psychosocial theory. The
assignment will start with identification of proper nursing theories along with examples of
effective and ineffective care as evidenced in the interview analysis. At the end, the essay
will highlight the importance of “partnering with the consumers” from the theme of the case
study.
The relevant standard of care that can be highlighted in this case study is informed
decision-making. According to the Nursing and Midwifery Board of Australia (2013), it is
the responsibility of the nurse to conduct informed decision making. Although, the case study
revealed that when Raelene was diagnosed with gestational diabetes, she was administered
insulin without taking any prior consent or discussion. According to Faden Beauchamp and
Kass (2014), a nursing professional must respect the autonomy of the patient in order to
practice informed decision making. Informed decision making, deals with discussing the
intended outcomes of the therapy with the service users while highlighting the potential side-
effects. This helps to increase the patients’ engagement in the care plan. The process of
initiation of informed decision making helps to increase the intimacy of a nursing
professional with the patients. This is because nursing professional makes use of the effective
communication skills in order to conduct informed decision making (Crawford, Candlin&
Roger, 2017). Intimacy and Isolation is the prime psychosocial need during 18 to 40 years as

2
NURSING
per the Erikson model. Promotion of intimacy helps in upholding mental health and well-
being and helping to accomplish psycho-social aspects of life (Kerpelman& Pittman,
2018).Raelene reports during the session of interview that after the death of her sister,
Raelene was suffering from extremely depression but no counselling was offered to her. Lack
of proper counselling and mental health support might make her feel isolated during her crisis
situation and thus endangering in basic psychosocial needs. It might be due to isolation that
she was unable to manage her own medication and was feeling further mentally depressed.
However, Raelene herself reported that Aboriginals family members tend look after
themselves. This aspect of Raelene helped in the identification of the level of her self-coping
skills or the coping skills of the indigenous population in the absence of any
support(Kerpelman& Pittman, 2018).
The patient care plan highlighted in the interview is in-effective. The reason behind
this is, it failed to follow the person-centred care plan. As per the case study when Raelene
was detected with gestational diabetes, the physicians prescribed for insulin treatment for
controlling her blood glucose level (BGL). While administrations of insulincan be considered
as an important aspect of diabetes management through lowering of the BGL, but use of
proper diet along with exercise can also be useful for the effective treatment of the gestational
diabetes. This is because during gestation the body is immune-compromised and weak and
diet along with exercise in BGL management has no significant negative effects (Viana,
Gorss and Azevedo 2014).
Another ineffective care is lack of constant presence of the culturally competent
indigenous healthcare workers in designing the care plan for Raelene. Panaretto, Wenitong,
Button and Ring (2014), argued that presence of aboriginal professionals can be regarded as a
crucial aspect of framing culturally competent care plan for the Aboriginals and Torres Strait
Islanders population. McCalmanet al. (2017) presence of family members in designing of the

3
NURSING
care plan for gestational diabetes increases the provision for person-centred care plan.
Moreover, the presence of primary care givers family member in the care plan helps to
increase the partnership in the care process that is important for the patient suffering from
gestational diabetes. The family centred approach for designing of the case plan is again
supported by National Safety and Quality Health Service Standards (NSHSS) (2012) of
Australia. In case of Raelene, it would be her sister. Under the context of family centred care,
McCalman et al. (2017) argued that family-centred care during early stages of disease
development is effective in improving the process of recovery. It also holds promise in
increasing the healthcare utilization for indigenous population.
One indication, towards effective care planning in relation to this case study is
appointment of dietician. The dietician here acted as diabetes educator who promotes to
conduct health literacy in Raelene. Promoting health literacy helps in promoting patients’
empowerment and thereby helping to improve effective disease management (Harris et al.,
2017). However, the study of the case scenario showed that diabetes educator was initially
appointed however, the diabetes educator was not present throughput the process of the care
plan. The lack of presence of the care giver during the entire session of the care plan might
create a gap of knowledge in diabetes management and thus might increase the severity of
gestational diabetes.
According NSHSS of Australia (2012), it is the duty of the leaders of the healthcare
organizations to use proper system for supporting the concept of partnering with the
consumers of health care and their primary care givers. This assists in increasing the quality
and efficacy of care. It also helps in improving the level of patients’ by helping to design
person-centred care plan. According to the Australian Commission on Safety and Quality in
Healthcare (2012), effective partnering with payments and their family members helps in
proper identification of the clinical priority. It also helps in reducing the rate of mortality and

4
NURSING
morbidity along with decreasing the chances of hospital readmission. Partnering with the
consumers especially for the older adults, pregnant women and children helps to increase
therapy adherence. The excerpts of the interview revealed that Raelene used to inject insulin
on her own after getting diagnosed with gestational diabetes. Even if she is taking insulin
injection, she lacks proper information regarding why she is administering that particular
subcutaneous injection. Administration of insulin helped Raelene to recover from gestational
diabetes but sudden demise of her younger sister created extreme emotional turmoil in her
life. She was failing to manage her own medication and diet chart. She is an active working
professional and supports her family, but her sister’s death not just devastated her
emotionally but also she physical health condition became poor. Involvement of an adult
family member if any (husband, mother or father) in designing care plan for Raelene) might
assist Raelene to follow proper medication management (Gaugler, Potter & Pruinelli, 2014).
It is the responsibility of the healthcare profession for establishing a strong sense of
governance for facilitation the development of therapeutic relationship between the client and
the healthcare professionals. Evidence also argue that proper training of the healthcare
consumers under community health settings by community health nurse is important to
improve the safety level of care (Gaugler, Potter & Pruinelli, 2014).
Thus from the above analysis of the case study, it can be stated that proper
management of gestational diabetes for Raelene must be done taking help and consulting
with her family member. Use of effective communication skills and establishment of
therapeutic communication helps to pave partnering with the consumers. Partnering with
consumers helps to increase the therapy adherence and also helps in conducting proper
medication management. The interview based on case study also highlighted the importance
of Aboriginal and Torre Strait Islander based healthcare professionals or culturally competent
nurses for improving the provision for generating patient-centred care plan.

5
NURSING
References
Alfano, M. (2015). Placebo effects and informed consent. The American Journal of
Bioethics, 15(10), 3-12. https://doi.org/10.1080/15265161.2015.1074302
Australian Commission on Safety and Quality in Healthcare. (2012). National Safety and
Quality Health Service Standards (NSHSS) of Australia. Access date: 20th August
2019. Retrieved from:
https://www.safetyandquality.gov.au/wp-content/uploads/2011/09/NSQHS-
Standards-Sept-2012.pdf
Crawford, T., Candlin, S., & Roger, P. (2017). New perspectives on understanding cultural
diversity in nurse–patient communication. Collegian, 24(1), 63-69.
https://doi.org/10.1016/j.colegn.2015.09.001
Faden, R. R., Beauchamp, T. L., &Kass, N. E. (2014). Informed consent, comparative
effectiveness, and learning health care. N Engl J Med, 370(8), 766-768. Retrieved
from:
http://www.cmtpnet.org/docs/resources/20140220_nejm_CER_Consent_Kass.pdf
Gaugler, J. E., Potter, T., &Pruinelli, L. (2014). Partnering with caregivers. Clinics in
geriatric medicine, 30(3), 493-515. DOI: https://doi.org/10.1016/j.cger.2014.04.003
Harris, M., Taggart, J., Williams, A., Dennis, S., Newall, A., Shortus, T., ... &Zwar, N.
(2017). Effective determinants for supporting lifestyle health literacy and self
management skills in primary care.
https://openresearch-repository.anu.edu.au/bitstream/1885/119204/3/
appendices_17386.pdf

6
NURSING
Kerpelman, J. L., & Pittman, J. F. (2018). Erikson and the relational context of identity:
Strengthening connections with attachment theory. Identity, 18(4), 306-314.
https://doi.org/10.1080/15283488.2018.1523726
McCalman, J., Heyeres, M., Campbell, S., Bainbridge, R., Chamberlain, C., Strobel, N., &
Ruben, A. (2017). Family-centred interventions by primary healthcare services for
Indigenous early childhood wellbeing in Australia, Canada, New Zealand and the
United States: a systematic scoping review. BMC pregnancy and childbirth, 17(1), 71.
doi: 10.1186/s12884-017-1247-2
Nursing and Midwifery Board of Australia. (2013). Code of Ethics. Access date: 20th August
2019. Retrieved from: https://www.nursingmidwiferyboard.gov.au/search.aspx?
q=code+of+ethics
Panaretto, K. S., Wenitong, M., Button, S., & Ring, I. T. (2014). Aboriginal community
controlled health services: leading the way in primary care. The Medical Journal of
Australia, 200(11), 649-652. doi: 10.5694/mja13.00005
Viana, L. V., Gross, J. L., &Azevedo, M. J. (2014). Dietary intervention in patients with
gestational diabetes mellitus: a systematic review and meta-analysis of randomized
clinical trials on maternal and newborn outcomes. Diabetes Care, 37(12), 3345-3355.
https://doi.org/10.2337/dc14-1530