Professional Accountability and Patient Safety

PROFESSIONAL ACCOUNTABILITY AND PATIENT SAFETY
Professional Accountability and Patient Safety
Name of Author
Institution
Date of Submission
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PROFESSIONAL ACCOUNTABILITY AND PATIENT SAFETY
Professional Accountability and Patient Safety
Introduction
Nursing practice presents diverse and unique challenges to the nurses that can be difficult
to handle at times. However, the conduct of nurses in every presenting situation is governed by
the existing Australian nurses and midwifery professional codes of conduct as well as the
national competency standards of registered nurses (Birks et al. 2016). This case paper relates to
the case of Mr. Smith, a registered nurse who got himself into a situation while working at the
mental health unit. His conduct raised a lot of questions regarding his professionalism and
competency as a registered nurse after he causes injury and pain to a patient under his care.
Question One: Synopsis of the Case
Link:
http://decisions.justice.wa.gov.au/SAT/SATdcsn.nsf/%24%24OpenDominoDocument.xsp?
documentId=59FFDF9C16C2A1EF48257FED0018CB44&action=openDocument
The case involves a patient whose name has been withheld from the website. The patient
had been admitted at the Mental Health Unit which is a campus of Joondalup Health Campus and
located in Western Australia. The patient suffered injuries and pain, especially in their left eye
and throat. The registered nurse involved was Mr. Smith Roha. Subsequently, the State
Administrative Tribunal of Western Australia found Mr. Smith in breach of the professional code
of conduct. As such, he was reprimanded and disqualified from applying for any kind of
registration as a nurse for a period spanning one year as well payment of $1700 to the Nursing
and Midwifery Board of Australia (Nursingmidwiferyboard.gov.au 2017).
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PROFESSIONAL ACCOUNTABILITY AND PATIENT SAFETY
Question Two: Actions of Mr. Smith
Firstly, Mr. Smith got himself involved in a physical altercation with a mentally ill
patient. Notably, Mr. Smith failed to exercise emotional control and professional decorum. This
is because; he clearly understood the reason why the patient had to be restrained by more than
one nursing staff. Being aware of such a mental incapacity, he was to exercise professionalism
and ethical practice principles while dealing with the patient to avoid getting into an altercation
with them. During the process, he got his arms around the neck of the patient in a way that
possibly restricted the airway of the patient. Moreover, he utilized unnecessary force by putting
his fingers into the eyes of the patient.
Secondly, Mr. Smith utilized a very inappropriate physical restraint on the patient during
the physical contact. His emotional imbalance clouded his ability to make the right decisions in a
professional manner. He sought to survival rather than respecting the health condition of the
client and taking necessary realistic actions. This was done by holding the airways of the patient.
Further, he held onto the client for too long on the ground. This was a deliberate act to punish the
patient for not behaving according to his expectations and putting up a fight with him. Mr. Smith
failed to act in a professional manner.
Moreover, by inappropriately restraining the patient and engaging in a physical
altercation, he breached the Australian professional code of conduct. According to the Australian
professional code of conduct, he deliberately failed to respect the dignity of the patient who was
receiving care. Similarly, Mr. Smith failed in his responsibility of providing safe and highly
competent care to the patient. Based on the same professional code of conduct he violated the
provision that expects him to promote the preservation of trust and privilege associated with
patient-nurse relationships. Further, he has acted unethically by not upholding the ethical
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PROFESSIONAL ACCOUNTABILITY AND PATIENT SAFETY
principle of beneficence. He did not have passion to the client who was under his care, and failed
to take positive actions towards the patient. His actions were largely tainted with malice.
Further, Mr. Smith failed to act in an appropriate manner to protect the dignity and
integrity of the patient by losing control and engaging in an altercation. He violated the National
Competency Standards for registered practicing nurses. This is because he failed to fulfill his
duty and responsibility of care as expected of a registered nurse. Mr. Smith lost emotional
control quickly without thinking about alternative causes of action. He would have requested for
help from the fellow nurses who were still in the vicinity. He could have avoided the fight if only
he disengaged himself early enough from the patient upon falling on the floor. Further, Mr.
Smith failed to let the patient go upon falling on the floor. He persistently held the patient in an
uncomfortable manner for a considerable duration of time. It indicates that he was out of control.
He manifests his anger by supporting himself on a patient’s throat while getting up. Further, Mr.
Smith violated the ethical principle of autonomy by not respecting the wishes of the patient.
Hence, there was a lack of competency on his part as a trained registered nurse and non-
maleficence where a nurse is not expected to behave in a manner that can be interpreted to be
malicious and likely to cause harm to the client.
Question Three: System-Based Factors that contributed to the Action and Adverse
Reaction
The case of a physical altercation and forceful restraint surrounding Mr .Smith reveals
some systemic inconsistencies that should be addressed. First, one can note that the hospital
lacks a well laid out standard procedure for straining patients. The incidence follows a meeting
on the specified intramuscular injection to be administered as well as the required availability of
other nurses to help with the restraining. However, it seems the nurses are not prepared with
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