Professional Conduct in Healthcare: A Tracheostomy Patient Case Study

This report presents a case study centered on a tracheostomy patient, Catherine, and the application of professional conduct by a Tracheostomy Nurse Practitioner (TNP). The report details the nurse's adherence to the Nursing and Midwifery Council (NMC) standards, emphasizing professional values, communication, nursing practice, and leadership. It highlights the importance of patient-centered care, including managing the patient's schedule, providing education on tube maintenance, and addressing complications. The case illustrates the significance of open communication, ethical considerations, and the nurse's role in safeguarding the patient's dignity and rights. The report further discusses the nurse's actions during a post-discharge complication, emphasizing the importance of immediate assessment and intervention. The nurse's actions showcase the commitment to maintaining professional standards and providing quality patient care within the healthcare setting.

EXAMINE AN INTERACTION OR EVENT FROM A CLINICAL
AREA TO DEMONSTRATE PROFESSIONAL CONDUCT

TABLE OF CONTENTS
Topic: Examine an interaction or event from a clinical area to demonstrate professional conduct 3
REFERENCES................................................................................................................................6

Topic: Examine an interaction or event from a clinical area to demonstrate professional
conduct
This essay is based on the reflective in gaining an understanding the concepts related to
the interaction with the tracheostomy patient. A professional must conduct the duties' and
responsibilities in accordance with the ethical standards and code of conduct mentioned by the
Nursing and Midwifery Council (NMC) (Duffy and Gillies, 2018). There are several events that
occur during the patient's recovery plan at the premises of the hospital. It is also important to
know that nurses work at both inside and outside the critical care units. Moreover, there is need
to demonstrate an event for better understanding of application of NMC domains and the impact
on the patient centred care.
I have been practising as a Tracheostomy nurse practitioner (TNP) at Ambivalent
Hospital for five years now. It was my dream to help others and in my growing years, I started
taking interest in the medical procedures and thus, I decided to become a nurse. The following
case study is about an elderly woman named Catherine who was 60 years old and underwent a
tracheostomy operation five months ago. She was under the monitoring for 4 weeks and later got
discharged. However, during her stay, I realised the importance of following the domains
mentioned in the revised policies of NMC. I followed the professional values and gave her my
complete attention and made her feel comfortable during her entire stay. It is indeed important to
follow all the steps of the procedure under an organised system (Kangasniemi, Pakkanen and
Korhonen, 2015). This tracheotomy procedure is complex in nature and the usage of tube
depends on the nature of condition, shape and size of neck with purpose of conducting
tracheostomy.
Additionally, the focus areas included complete recovery plan to maintain the well being
of this patient during the initial care involving the seven days plan (Papadopoulos, 2018). I took
care of Catherine in managing her schedule and assist her in maintaining the correct positioning
of the tube. Nevertheless, I gave her teaching sessions on how to align the patency of the new
tube to avoid any challenging situation when she would get discharged. I also taught her to use
the kit associated with this procedure and ensured that the equipments were available. This kit is
important and must be carried with the patients all the times to use it when required on the
immediate basis (Amin and et.al., 2017). It came handy when Catherine complained about
difficulty in breathing and had to used this kit efficiently and avoided a severe medical

emergency. Consequently, there were few signs which took my attention towards Catherine's
recovery.
Moreover, I had learnt about NMC and always tried to follow them through proper
implementation. The four domains mentioned in the revised NMC plan of 2015 consists of
professional values, communication and interpersonal skills, nursing practice with the decision
making and lastly leadership, management and team working (Standards for competence for
registered nurses, 2019). I helped Catherine by having an open end interactive session on each
day which gave me insights about her conditions. Along with this, I also improved my nursing
practices by being vocal and staying curious in addressing the queries of the patients and their
families. I learnt about the advanced programs and latest updates in the tracheostomy to remove
the challenges and bring improvisations for the entire taskforce. It has been also shown that a
nurse is accountable in safeguarding the dignity, respect and avoid any violation of rights of the
patients (BEGLEY and SENGSTACK, 2018). When I saw Catherine struggling in understanding
part, I was patient and took slow steps in giving instructions to give clarity and build mutual trust
between us.
It was also helpful when she learnt that there are chances of building an infection or
might have small complications. Thus, she also coordinated with me well and communicated me
each and every detail about her signs and symptoms properly and elaborately. I also supported
her by informing her about the tapes to keep the tracheostomy tube intact and provided her with
the airway safety. However, soon after she got discharged, there were few complications that
arose due to mishandling and ignorance shown by her family. The major obstacle was air leakage
around the neck area and affected her surrounding tissue. In addition to these, there was swelling
that was shown nearby the affected area of the patient and needed to contact the ENT medical
team (Whitcroft, Moss and McRae, 2016). The swelling took place due to tightness that might
have appeared due to the building up of tension around the taping zone.
She was not in a serious concern but needed immediate change of taping to safeguard the
complete affected area from further infection. Initially it seemed that she might have to be taken
to an operation theatre but soon it came out that there was a minute gap which was affecting its
breathing and led to formation of tightness as well around the neck area. I also took another test
after her taping got done and shifted to normal ward for supervision. The three steps for testing
the aftermath influence comprises looking, listening and feeling (Anderson and Leahy, 2017). I

examined her entire neck area and observed the movements for her breathing in and out of her
chest. Next I checked her breathing sounds from the tracheostomy tube and lastly I felt her nose
or mouth. This helped me to practice my training for the betterment of my patient.
I was relieved when I saw Catherine coming to us immediately she felt uneasiness and
informed our emergency medical team about her conditions. I understood the significance of my
role as a nurse in my patient's life. I will always try to be professional and will follow the ethical
standards to maintain the ethical standards as the nurse practician at the hospital. This case
highlighted the regions for the betterment of the services mentioned and fulfilment of the
patients' expectations and needs to give a platform of transparency and reliability.

REFERENCES
Books and Journals
Amin, R. and et.al., 2017. What families have in the emergency tracheostomy kits: Identifying
gaps to improve patient safety. Pediatric pulmonology. 52(12). pp.1605-1609.
Anderson, J.R. and Leahy, T.W., 2017. Tracheostomy crisis management. Australasian
Anaesthesia. (2017). p.21.
BEGLEY, E. and SENGSTACK, P.P., 2018. Tracheostomy Patient Care. Heart. 1.
Duffy, K. and Gillies, A., 2018. Supervision and assessment: the new Nursing and Midwifery
Council standards. Nursing Management. 25(3).
Kangasniemi, M., Pakkanen, P. and Korhonen, A., 2015. Professional ethics in nursing: an
integrative review. Journal of advanced nursing. 71(8). pp.1744-1757.
Papadopoulos, M., 2018. Patient operated for an intraparenchymal brain tumor with serious
lower limb weakness. The role of in-hospital physiotherapy. Hospital Chronicles. 13(1-4). pp.32-
35.
Whitcroft, K.L., Moss, B. and McRae, A., 2016. ENT and airways in the emergency department:
national survey of junior doctors' knowledge and skills. The Journal of Laryngology &
Otology. 130(2). pp.183-189.
Online
Standards for competence for registered nurses. 2019. [Pdf]. Available
through:<https://www.nmc.org.uk/globalassets/sitedocuments/standards/nmc-standards-
for-competence-for-registered-nurses.pdf>