401021 - Professional Nursing: A Case Study of Aged Care Ethics

This case study analyzes the clinical course of an 81-year-old patient who presented with breathlessness and was ultimately diagnosed with septicaemia. It identifies several key areas where nursing interventions and professional behaviors could have improved the patient's outcome. These include more thorough initial assessments, better communication between healthcare providers, a more holistic approach to patient care that addresses both physical and emotional needs, and adherence to professional standards and guidelines. The analysis highlights the importance of teamwork, comprehensive documentation, and continuous skill development in delivering quality healthcare. The author reflects on the lessons learned from the case study and outlines their commitment to ethical practice, patient advocacy, and ongoing professional development.

Running head: BEING A PROFESSIONAL NURSE 1
Being a Professional Nurse
Student’s Name
Institution of Affiliation
Date

BEING A PROFESSIONAL NURSE 2
Being a Professional Nurse
The clinical incidence
On day one the 81 years old patient visited GP clinic complaining of breathing challenge.
The diagnosis revealed of fine creps at the base of both lungs with slightly elevated jugular
venous pressure. The patient received oral Lasix and was to report back after two days for
review. The following day the patient visited a local hospital complaining of the similar problem.
On 9th January 2013, the patient became dizzy, had atrial fibrillation, not eating or drinking,
with pain in the abdomen. She became depressed, anxious, required mobilisation, the respiratory
rate doubled, became “woozy”, skin cold and clammy. Blood sugar level was 16.1mmol/L. She
received Digoxin and Valium drugs.
On 11th January 2013, she could not void, was pale and grey with nausea. White cell
count was at 17.5. Urinary tract infection was observed. On 11th January 2013, the blood
pressure and heart rate were below normal. An Introduction Situation Background Assessment
Recommendation (ISBAR) form was completed in the presence of a respondent. The patient’s
family was contacted. The patient was critically unwell. An emergency on-call doctor was called
to treat the patient. The condition was critical that a referral was done. The patient died due to
septicaemia.
Activities to be completed by the nurse in the immediate situation
It was concluded that the patient died of septicaemia. Septicaemia is a risk disease
affecting mainly the aged, individuals who have diabetes and suffering from urinary tract
infections and challenges of breathing (Hsu, Yu and Guo, 2015). Upon arrival in the health
facility, the nurse should have identified from the patient a person who can assist the patient

BEING A PROFESSIONAL NURSE 3
through the treatment process and have the person come to the health facility. Once treatment
was offered, the nurse was to present the clinical report to the patient’s assistance. With the
patient complaining of challenges of breathing, an Electrocardiogram would have been
conducted to establish whether the condition arose from atrial fibrillation or it was another
disorder in the heart rhythm. A chest X-ray would also reveal the conditions of the patient’s
lungs.
Upon diagnosis, the patient was found out to be suffering from atrial fibrillation. The
nurse should have given the patient medications and other interventions that would aid in altering
the electrical system of the heart. When it was noted that the patient could neither eat nor drink,
the nurse should have administered food and liquids intravenously. The patient will also need
assistance in breathing. Vincent (2017) concludes that the supply of oxygen and intravenous
fluids will ensure that the blood pressure of the organs does not fall further. The nurse should
have helped the patient mobilise as well as massaging the patient’s back with warm water to
alleviate the back pain. The nurse will need to give antibiotics and fluids. The antibiotics will
counter the effects of microorganisms (Banks, 2016).
The nurse will need to communicate swiftly to the Clinical Nurse Manager who will, in
turn, call the doctor who will carry out a test to identify the infection affecting the patient before
it escalates further. The doctor should come and find documentation of the patient’s treatment
history which should have been prepared by the Registered Nurse. The RN will make the
documentation following an alarm raised by the Enrolled Nurse. The oral Lasix, Digoxin and
Valium will need to be withdrawn if need be (Marik, 2018). Mclver, Mukerjee, Tokis and Taylor
(2018) observes that if a specific source of the infection has been identified, then it will need to

BEING A PROFESSIONAL NURSE 4
be removed such as the blood vessels, breathing organs as well as removal of observed
microorganisms and foreign materials.
Professional behaviours that may have made a difference in the situation
The General Practice health centre was attending to an old patient who may not be able to
make informed decisions regarding her treatment program. It was important for the health centre
to request her to be accompanied by responsible individuals who can guide her in decision
making (Stein-Parbury, Gallagher, Fry, Chonoweth & Gallagher, 2015). The health centres
serving the patient should have carried out the right diagnosis to ensure that the patient is getting
the right treatment. Sometimes some ailments need urgent attention. According to Quanjer et al.
(2015), proper diagnosis and treatment procedure should have been observed. When the patient
visited the local health centre, she was not asked of her medical condition and treatment history
as documentation was not taken seriously in both health centres.
Treatment should be about alleviating patient’s painful experiences which were not
observed in the GP centre. Clayton, Isaacs and Ellender (2016) note that professional ethics and
personnel interrelationships should be at the core of our work. Registered Nurse John ignored
treating the patient and would not listen to his colleague who was just but an enrolled nurse. This
was compounded by the fact that RN John never informed the Clinical Nurse Manager, Ms
Smith of the patient’s condition (Nursing and Midwifery Board of Australia [NMBA], 2015).
Performance appraisal of personnel is essential to allow matching of skills and competencies to
ensure that the right staff is doing the correct assignment. The building of trust between caregiver
and patient as well as between personnel themselves. The VMO was not able to carry out a
proper diagnosis of the disease and therefore treated the wrong ailment. The discharge plan never
worked as the patient got worse within a short period.

BEING A PROFESSIONAL NURSE 5
Further, the engagement of external personnel who may not be available when urgently
required can only work against the provision of health services (Griffiths et al., 2016). As in the
case of the VMO, external personnel do not have enough time to make careful observations of
how the patient is responding to treatment. Such personnel should be avoided for they may not
deliver the mandate of the health centre. There is also a time lag between the calling of the VMO
and locum, and they're arriving at the health centre to treat the patient who was not mentioned by
the nurses to the management for appropriate action.
Lessons learnt from the case study regarding my preparedness for professional practice
Health care provision cannot be delivered by a single caregiver. It involves different
personnel who have to work together as a team. The team members have different cultural
backgrounds, competencies and individual differences. I will encourage staff to work together as
a group and capitalise on synergy. Health care delivery is a process, and the process needs
comprehensive documentation to improve efficiency. I will there give records of the whole
process of treatment of the patient. This will ensure that in the event of any referrals, the
treatment process will continue seamlessly. I will treat every employee with dignity and take
them advises positively. If there is anything that needs my attention, I will handle it swiftly.
I will endeavour to acquire in-depth nursing skills which will help me accomplish my
assignments. Most of the patients seeking medical care are vulnerable. I will attempt to address
their issues most humanely, their cultural backgrounds notwithstanding. I will work on
sharpening my skills through learning from my supervisors who possess past and vast
experiences as well as my juniors. I will comply with the requirements of the National Safety
and Quality Health Service Standards as well as the Nursing and Midwifery Board of Australia.

BEING A PROFESSIONAL NURSE 6
This will support me in delivering quality health care. If there are any standards issues which
may not be clear to me, I will not shy away from seeking clarification from my seniors.

BEING A PROFESSIONAL NURSE 7
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