1PROFESSIONAL CARE BY NURSES Professional practice issues in this case study In this case study, we see that a patientdied due to medical negligence of the health workers. A patient had complained of feeling dizzy with very low heart rate, respiratory rate and blood pressure. The enrolled nurse had informed the respondent to review her condition but it kept on getting delayed because of the absence of the locum. When the respondent was informed about the patient suffering from continual diarrhoea, she went to review her condition but failed to document it.The respondent had understood that the patients' condition was getting critical but still waited for the locum doctor.When there was a committee meeting, she acknowledged the deteriorating condition in the vital parameters of the patient. After this, the respondent arranged for an ECG to be undertaken for the patient. After about 2 hours the respondent informed the clinical nurse manager about medications for another patient which she signed. However, the clinical nurse manager Mrs. Jones was not informed about the patient’s condition and her need for immediate treatment. After about 4 hours of the patient’s admitting to the hospital the registered nurse and the respondent completed the procedure of ISBAR form after assurance from the family. The ISBAR form is used for prompt communication and is an important document for health care settings. The respondentintheformindicatedthatthepatient’sconditionwasseriousandwas deteriorating with no sign of recovery. Based on the remarks made on the form, the emergency on-call doctor was called to inspect her health. After some time the doctor arrived and inserted a large-bore IV cannula to treat her dehydration but there was still no sight of recovery. On seeing the condition it was attempted to shift her to better health care settings but shifting her could have made the situation worse. Ultimately she died when air evacuation team arrived to assess her the next morning.
2PROFESSIONAL CARE BY NURSES Relevant professional errors that contributed to the situation The primary rationale for collaboration and professionalism in health care is to ensure safety to the patient as perthe principle 2 in the Nursing and Midwifery Board of Australia ("Professional standards", 2019). In this situation, collaboration was missing between health professionals. It can be said that in this particular situation there was a serious issue of professional practice and lack of seriousness given to the patient's situation. The situation of the patient couldhave been recovered if immediate health care service was provided with doctors and senior nurses informed without delay.In this situation,it would have been ideal if the respondent could manage time and understand the gravity of the condition of the patient. Taking decisions in an emergency situation is what nurses are supposed to do. The emergency on-call doctor should have been approaches instead of waiting for the locum. The four hours turned to be critical for the patient as her situation worsened. The lapse on the respondent’s part worsened the situation of the patient. Instead of starting her treatment on a priority basis, the enrolled nurse and the respondent failed to treat the patient efficiently. There are important domains of professional care for nurses where communication and interpersonal skills were missing between the health professionals("Professional standards", 2019). The reason for her death was given septicaemia. Septicaemia is a life-threatening disease where the bacteria spreads into the blood and is treated in the hospital. Due to lack of clinical expertise, the patient did not receive the correct diagnosis and eventually led to her death.Nurses and doctors need to put more emphasis on the service that is being provided to the patient. When a critical patient arrives at the hospital, careful and immediate assessment of their vital signs needs to be carried out to chalk out a treatment plan for the patient. This will ensure proper treatment of the patient with increased satisfaction. The maintenance of clinical standards and professional competencies is a mandatory requirement in the clinical domain. Time management is a crucial issuewhich is mandatory
3PROFESSIONAL CARE BY NURSES in a hospital setting("Professional standards", 2019). In the case study, there was lack of compliance among the respondent and the enrolled nurse.The health organization must take adequate measure to cope up with such an emergency condition. The respondent must have let known the clinical nurse manager about the patients' situation and informed about the need for immediate treatment. There must be a professional practice followed to ensure quality in care delivery in an adverse situation like this. Qualities like decision-making and implementation were missing in the health scenario. This eventually led to the delay and worsening condition of the patient. The patient could have been shifted to the rural referral hospital if the doctor arrived earlier and made the decision where the patient could get advanced treatment. Implications for future practice This situation has an importantimplication in future practice in the health sector. In the given case study we saw how lack of communication and time management led to an adverse situation in clinical practice("Communicating for Safety Standard", 2019). The patient A was brought to the hospital where she wascomplaining of nausea and abdominal pain. The doctor was not present while the nurse and respondent were not sure of the seriousness of the patient. Therefore in future clinical practice, it must be ensured that the nurses or the respondents inform the concerned health staff like the doctor on an emergency basis. The respondents must be responsible to note down the diagnostic results when examining a patient. Diagnostic results are important for the clinical point of view and for treatment. Patient safety and quality of health care is a mandatory requirement in health care and health professionals must be accountable to the organization and ensure patient care (Grace, 2017). In such extreme situations, the doctors and the registered nurses must be informed and examine the patient without any delay. The functioning of small units must be
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4PROFESSIONAL CARE BY NURSES there without any fail. The role-played by governing body, management personnel and executive leaders play an important role. In an extreme situation when there is a lack of proper care or personnel due to any reason, the governing body must make an immediate decision to shift the patient without any delay. In this case study, the patient was suffering from a severe infection that was spreading in her body. However, it could be curable with adequate clinical expertise and time management (Regan, Laschinger & Wong, 2016). This kind of actions can threaten the actions of all health care professionals. As a result of this learning, I would like to be provided with organizational resources that would support management and dissemination to other health workers as well. There must be more encouragement in supporting clinical decision making and management. I would like to educate health professionals about the connection between management and safety practices. To avoid the health care gap there must be adequate staff members in the workforce to tackle the adverse situations with clinical knowledge and skills. There must be a strict program followed in health care settings where the nurses or the respondents have adequate training and communication skills to address the issue (Stevens, & Raferty, 2018). There is a strong need to implement such processes to ensure that medical errors are minimized. The health professionals must be aware of the consequences, with proper implementation mitigate, and prevent errors. A strict professional practice is needed in health care settings and could effectively manage the patients' condition in the given case study. This professional behavior would change the situation of health care and help in getting desired results in quality care to the patients. The nurses or the trainers who first admit the patients must be aware of the threat to patient safety caused by abdominal pain or fatigue. There must be a collaboration between the health professionals and identify high risks for a
5PROFESSIONAL CARE BY NURSES better outcome in health care and safety to the patients. Complex patient care must be given more importance to combat such adverse situations.
6PROFESSIONAL CARE BY NURSES References CommunicatingforSafetyStandard.(2019).Retrieved20August2019,from https://www.safetyandquality.gov.au/standards/nsqhs-standards/communicating- safety-standard Grace, P. J. (Ed.). (2017).Nursing ethics and professional responsibility in advanced practice. Jones & Bartlett Learning. Nursing and Midwifery Board of Australia - Professional standards. (2019). Retrieved 18 August2019,fromhttps://www.nursingmidwiferyboard.gov.au/Codes-Guidelines- Statements/Professional-standards.aspx Regan, S., Laschinger, H. K., & Wong, C. A. (2016). The influence of empowerment, authentic leadership, and professional practice environments on nurses’ perceived interprofessional collaboration.Journal of nursing management,24(1), E54-E61. Stevens, A., & Raferty, J. (2018).Health Care Needs Assessment: The Epidemiologically Based Needs Assessment Review. CRC Press.