Breach in Clinical Governance and Cultural Safety in Nursing

This essay focuses on the breaches of cultural safety and clinical governance in nursing. It discusses the impact of these breaches on patient care and provides strategies to overcome them.

Running head: PROFESSIONALISM IN ACTION
PROFESSIONALISM IN ACTION
Name of the student:
Name of the university:
Author note:

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Introduction:
Cultural safety is referred to as the policy that focusses on providing safety to the individuals
based on their culture and background (Richardson, Yarwood & Richardson, 2017). This essay aims to
focus on the case study which involve the breaches of cultural safety. Apart from cultural safety the
essay also focuses on the clinical governance areas in the nursing profession and also the principle that
has been a breech on the principles. Clinical governances is defined as the nursing framework initiated
by NHS which focusses on improving the patient care and their way of living (Chambers, Rogers &
Boath, 2016). In this essay the, the strategies that can help in determining the breach based on the case
scenario is mentioned. In the essay the activity of the 2nd year nursing student was discussed who was
assigned to take care of the patient and to monitor the treatment of the patient.
Incident 1: Breach caused in clinical governance:
Clinical governance as the name suggests is related to increasing the clinical facilities of the
healthcare organization (Van Zwanenberg & Edwards, 2018). It is a system that is present within every
health organization where the health care facilities provided by the health care organization is constantly
monitored. It constantly works to improve the health care facilities of the organization in order to get the
effective result and quality care of the patient. It also helps in improving the specialty of the doctors to
get quality patient care. To ensure the clinical governance in the health care organization, the health care
staff are constantly motivated to deliver best to the organization for the quality patient care (Sadeghi-
Bazargani et al., 2015). The first incident was chosen as the clinical governance as in the case study it is
observed as a breach. Poor clinical governance is observed between the nurse and the higher authorities
of the health care organization. Accruing to the case study, the nurse is new to the organization and was
assigned to work under a nurse supervisor named as Kylie. The nurse is second year student and has not

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finished his/her studies and hence has less knowledge regarding the rules and regulation of the
healthcare organization. Hence in such case it is the duty of the supervisor nurse to educate the new
students in order to get the quality care of the patient (Beltran-Aroca et al., 2016). However, according
to the case study at her first day she was assigned to take care of the four patient and instead of assisting
the nurse, the supervisor said that she will get late and the nurse has to manage the four patient alone till
the supervisor arrived. As the nurse is new and has not competed the studies yet and hence it is difficult
for the nurse to handle everything alone. This is considered as the clinical governance breach which can
lead to poor health outcomes of the patient, as the nurse is unaware of the medication and treatment of
the patient. The effect of this clinical breach has clearly been observed. The nurse is unable to identify
the appropriate medication which is required for the treatment of the patient. The nurse seems to be
confused while assessing the patient as there was no medication noted by the team leader. To give
appropriate medication to the patient she had to visit the team leader. The team leader without checking
the background of the patient prescribed two Panadol for the patient. Nurse is still confused with the
medication and she went to team leader again. This time the team leader got rude and ask her not to
bring each and every concern to her. She also said that the nurse can proceed with the medication
prescribed by her and she will check the patient again. This is considered as another clinical breach (Bai,
Jiang & Flasher, 2017). This is also against the safety and Quality health service Standard, which
ensures quality patient care (Safetyandquality.gov.au, 2019).
Incident 2: Breach in cultural safety
Cultural safety is one of the chosen factors as the chief occurrence. As it was observed in the
provided case study that there was a major cultural variation was witnessed among the nurse and their
patient. In the case study, Mrs Maria, who is a woman of 87 years old belonging to Greek and has no
knowledge of the English language in a proper manner. She has been suffering from a major

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exacerbation of Chronic Obstructive Airway Disease (COAD). It was also observed that Mrs Maria’s
daughter in law was present at the location. As the nurse visits the Mrs Maria, she was complained by
Mrs Maria’s daughter-in-law that the she has been suffering due to pain for long duration and that she
requires immediate treatment and medication. The nurse examined Mrs Maria’s medication instruction
and she finds out that there was nothing provided to relief Mrs Maria from her suffering due to pain.
Thus she had to visit to her senior clinician where she was administered with 2 Panadol.
Mrs Maria was not taking her medications provided by the nurse. Her daughter-in-law was called
and she then provides the medicine to Mrs Maria by speaking to her in her native Greek language (Usher
et al., 2017). The nurse was not competent enough to communicate with Mrs Maria related to her health
condition or other health related concern which was found to be a major break in the cultural safety
(Pauly et al., 2015). It was observed after going through the case study, that there was a huge cultural
and social gap among the nurse and Mrs Maria which was serving as a blockhead for the nurse and was
not permitting a better therapeutic relationship formation and communicate, which would help the nurse
to explain Mrs Maria the factors regarding her present health complications and the importance of the
medicines and the treatment which would efficiently be an effective measure in overcoming from her
present health suffering.
As a nurse, it is my responsibility to help my patient in her treatment process. In order to do so, I
will need to suggest for arranging nursing staffs with the knowledge of Greek language which would
help her to communicate with Mrs Maria so that she could communicate and explain the discussion to
her in a respecting way which will also be maintaining the cultural safety and ethical values of the
patient. As per the Nursing and Midwifery Board of Australia (NMBA), the cultural safety and a better
communication is found to be an important part of developing a better therapeutic relationship among
the nurse and the patient (Nursingmidwiferyboard.gov.au, 2019). The healthcare nurse having a similar

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cultural background of the patient is found to be helpful for the registered nurse in order to retain better
understanding about the patient and also effectively communicate so that they can treat their patient in a
much effective manner and by reducing the cultural gap (Richardson, Yarwood & Richardson, 2017).
Conclusion:
From the above essay it can be concluded that, breach in the nursing profession can affect the
treatment of the patient. It can have negative impact on the health of the patient. In order to reduce such
negative adverse effect the, certain strategies can be used by the nurses to overcome those breaches. It is
important for the nurse to overcome those breaches in order to get the effective treatment of the patient.
In the above essay, the strategies that can be used to overcome the breaches is discussed in detail. To
ensure cultural safety among the patient, the nurse should work among the patient with different cultural
background. So that formation of any cultural breach in future can be avoided and it also ensures that the
patient is treated with respect. Reducing the cultural breach helps in enhancing the patient’s health
condition and ensures quick recovery of the patient. It is important for the nurse to be aware of such
breaches and the strategies to deal with those breaches. It can only be done with the help of proper
education. Along with education they should be guided properly in the assessment of the patient and the
treatment of the patient. The strategies that are mentioned above helps the nurse to overcome such
breaches in order to get effective treatment.

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Reference:
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Chambers, R., Rogers, D., & Boath, E. (2016). Clinical effectiveness and clinical governance made
easy. CRC Press.
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