University Nursing Care Analysis Report: Case Study

This report provides a critical analysis of nursing care within a specific case study, focusing on the application of nursing principles and professional standards as defined by the NMBA. The report examines a scenario involving an 81-year-old female patient admitted to the hospital with respiratory distress and other complications. The analysis delves into the nurse's actions and omissions, particularly concerning the patient's deteriorating condition and the adherence to ethical guidelines. The report highlights violations of NMBA standards, including codes of ethics, professional boundaries, and legal regulations, emphasizing the importance of timely interventions, accurate documentation, and patient-centered care. By analyzing the nurse's conduct, the report aims to illustrate the impact of professional behavior on patient outcomes and reinforce the significance of ethical practice in nursing. The case study underscores the need for nurses to prioritize patient well-being, maintain professional boundaries, and adhere to legal and ethical standards to ensure safe and effective care. The report also provides valuable insights into the implications of inadequate care and the importance of continuous professional development and adherence to NMBA guidelines.

Running head: CRITICAL ANALYSIS OF NURSING CARE IN CASE STUDY
CRITICAL ANALYSIS OF NURSING CARE IN CASE STUDY
Name of the student;
Name of the University:
Author Note:

1CRITICAL ANALYSIS OF NURSING CARE IN CASE STUDY
Nursing can be defined as a noble profession within the Health Care Sector that
comprises of caring for different patients, families or communities regardless of contributing
factors like race, gender, religion and socioeconomic status, in order to ensure providing
optimal health care to each and every sector of the society. Nurses can be differentially
recognized from the rest of the allied health care staffs in regard of their specialized training,
codes of conduct and practice, and the scope of the service. Along with that, the registered
nurses are also entrusted with the task of administering medication to the patient during
urgencies given the fact that they are trained and hold certified registration for medication
administration (Blegen et al., 2013). Along with that another very important fact is that
nursing profession and the job roles come with it are very multifaceted, there are various
dimensions to the responsibilities that a nursing professional has to fulfill. For instance, along
with patient assessment, care planning and implementation, a very important aspect of
nursing profession is establishing a mutually respectful therapeutic relationship with the
patient. It has to be understood that the patients and their family members spend most of the
time in the health care facility with the nurses; hence nurses are the most approachable
personnel for the patient and their family members to share their preferences or grievances.
Hence, with the importance of the nursing professional so grave, unsatisfactory professional
conduct can be extremely detrimental to the health and safety of the patient under
consideration. It has to be understood that nurses play the role of a moderator, bridging the
gap between the treatment decisions from physician, therapists or dietician and the perception
and needs of the patient and his or her family. It has to be understood that in certain cases, the
nurses might need to take full responsibility of taking critical clinical decision in emergencies
on their own and save the life of their patient, and the nurses are trained and skilled to take up
this responsibility (Butts & Rich, 2012). Hence, professional ethics mandate the nurses to
take adequate clinical edcisions and implement emergency care protocols in case of any

2CRITICAL ANALYSIS OF NURSING CARE IN CASE STUDY
emergency deteriorating in the condition of the patient, and any nursing professional not
abiding to this protocol violates a number of key codes of conduct of nursing ethics. This
assignment will attempt to incorporate nursing roles and practice guidelines from NMBA in
hopes of exploring the impact of unsatisfactory professional conduct from nurses in case4 of
emergencies taking the help of a case study.
Nurse-client interaction is the main region in cooperative nursing hypotheses. These
speculations are focused on enhancing medical attendant customer relationship, considering
the qualities in nursing like respectability of human and the need of sensitivity and human
associations. From their perspective, nursing care is a human procedure instead of a
mechanical practice and it will build the wellbeing and feeling of prosperity in customers
(Chiarella & White, 2013). An appropriate and viable human collaboration has been one of
the basic necessities for nurture graduates up until this point, yet overlooking the customer as
a care design member and showing standard and programmed nursing care rather than an
expert minding have been left as one of the primary difficulties in nursing training. In an
immediate situation, a succession of exchanges including understanding conduct and medical
caretaker response happens until the point when the patient's requirement for help, as he sees
it, is illuminated. The medical attendant at that point settles on a proper activity to determine
the need in collaboration with the patient. This activity is assessed after it is completed. In the
event that the patient conduct enhances, the activity was fruitful and the procedure is finished.
In the event that there is no change or the conduct deteriorates, the procedure reuses with new
endeavors to illuminate the patient's conduct or the suitable nursing activity. In the
emergency of nursing situation, every patient's conduct must be surveyed to decide if it
communicates as requirement for offer assistance (Colvin et al., 2013). Moreover,
indistinguishable practices by a similar patient may demonstrate distinctive requirements at

3CRITICAL ANALYSIS OF NURSING CARE IN CASE STUDY
various circumstances. The nursing activity should likewise be particularly intended for the
prompt experience.
Nursing and Nursing Board of Australia or NMBA have several statements or
guidelines in order to ascertain the ambit and responsibilities of the registered nurses in
Australia. Registered nurse (RN) practice is person centered and proof dependent with
deterrent, remedial, developmental, steady, remedial and end of life components. The RNs
perform in remedial and proficient relations with different people, be it patients or their
families, gatherings and groups. These individuals might have medical complications
manifested as physical or psychological instability along with wellbeing challenges. These
challenges can be represented by physical, mental, formative and additionally intelligent
handicaps. As controlled wellbeing experts, RNs are capable and responsible to the Nursing
and Midwifery Board of Australia (NMBA). The above mentioned are considered the
National Registered medical attendant norms for training for each and every RN (Dinç &
Gastmans, 2013). Simultaneously with NMBA benchmarks, codes and rules, these Registered
medical caretaker gauges for training ought to be clear in present practice, and advise the
improvement of the extents of training and goals of RNs. The Registered medical attendant
norms for training comprise of the accompanying seven measures:
 Critical and analytical thinking for nursing practice
 Building mutually respectful and therapeutic relationship
 Maintaining and broadening the practice scope and competence
 Comprehensive and realistic patient assessment
 Devising scientifically reasonable nursing care plans.
 Providing safe, suitable and receptive quality nursing care.
 Evaluating patient outcome to improve quality of care (Johnstone, 2015).

4CRITICAL ANALYSIS OF NURSING CARE IN CASE STUDY
There are in total ten codes of professional standards for registered nurses. According
to these codes, there are some guidelines nurses are required to follow when working which
include nurses must practice in safe and competent manner; the professional approach should
always be given the highest importance; the laws relevant to nursing practice should be kept
in mind while practicing; nurses should maintain the confidentiality factor in regard of the
identity and disease condition of the patient. Now it has to be understood that the illustration
of any standards is governed by the criteria mentioned in the standard itself. These criteria
require being deciphered in accordance to the training received by the RNs. It can be further
explained by the fact that all the registered nurses have to work in collaborative manner and
delegate obligations, however only one out of each odd RN will employ any medical
caretaker for the practice if need be. In case the criteria lack comprehension and empower
and facilitate for the RNs to achieve absolute advancement in their professional expertise
(Levett-Jones & Bourgeois, 2015).
The Registered medical attendant guidelines for training involve all training ranges
for all RNs. However the standards mandates these principles to be followed in coordination
with applicable NMDA buddy archives, for instance, the gauges, codes and regulations, such
as the Code of expert refers to medical attendants, Code of morals involves the medical
caretakers, most basic nursing care leadership devices are addressed and improved by
National system, Supervision rules assist in maternal nursing care, and Guidelines for
compulsory notices.
The professional boundaries of nurses are mentioned in different set of guidelines. A
nurse enters into a therapeutic relationship with the patient and they do get access to
voluminous amount of personal information with respect to the patient and the concerned
family. The imbalance in command will result in poor quality of service putting the lives of
the vulnerable patients at risk. The professional standard requires the best outcome to be met

5CRITICAL ANALYSIS OF NURSING CARE IN CASE STUDY
by the nurses in regard of the therapeutic fate of the patients. There is another accountability
of helping other colleagues in the same profession and all of these actions are to be executed
within the set limit. Professional boundary in nursing is defined as limits that protect the
freedom between occupational power and the naiveté of patient (McGowan, 2012). This
means there is a margin that marks brinks between an occupational, therapeutic relationship
along with an attachment involving nurse and a diseased person. When a nurse transcends a
guideline, usually behaving in a manner that is not coherent to the norms the misuse of power
is to be perceived as a breach of NMBA statement.
Figure 1: Professional Boundaries of nurses
Source: (Nursingnursingboard.gov.au 2017)
There are guidelines for registered nurses providing suitable framework and scaffolding for
the actions to be taken up by them. They work in a more person-centered atmosphere and
now a days the evidence based practice has turned the contribution by registered nurses more
effective and fruitful (McGowan, 2012).
The concerned patient in the case study is an old patient who is 81 years old and was
admitted in the hospital on 6th January, 2013 with gasping for breath symptom along with
other complications. These complications include diabetes, leg edema, tachycardia and
hypotension. The patient was a female patient and her condition did not improve over a
period of time after the admission. Her condition was aggravated in the afternoon on 11th

6CRITICAL ANALYSIS OF NURSING CARE IN CASE STUDY
January, 2013 and her blood pressure and respiratory rate were abnormal and the concerned
respondent nurse was called in to the picture at this instance of time. There are various
aspects associated with this case study has been discussed in the following section (Moxham,
2012).
The accountability of the concerned nurse cannot be overlooked in this particular
case. The nurse herself has also accepted the fact that duty derelictions have happened on her
part. Nurses are usually given appropriate training and clinical internship provision in order
to enable them to handle the work pressure in real life situation. Hence, it is expected that
there should be a clear conscience on the part of the concerned respondent or the nurse
regarding the fact that professional responsibilities have been breached on several occasions
(Moxham, 2012).
The NMBA standards or codes or statements which have been violated in this context
include the codes of ethics. Ethics direct a nurse to always put the well being of patient as the
prime priority. That has not been met here. The statements of professional standards and
boundaries have also been violated when the nurse was indifferent to the first instance of
aggravation of patient’s condition and later reluctant when doctor was expected to be called.
The first guideline in the NMBA standards deals with the laws and regulations which have
been violated in this regard. The laws identify legislation that governs different nursing
practices; explains nursing practice standards in accordance with the common law; explains
medication administration protocols in regards with the legislative requirements; recognizes
the legal implications of providing nursing care; intervention actions express the level of
awareness of the said lawful implications of nursing practice along with explaining effects
imparted by the legislation upon the caring procedure of patients, and lastly it also uncovers
unethical practice which relates to confidentiality and privacy legislation
(Nursingnursingboard.gov.au., 2017).

7CRITICAL ANALYSIS OF NURSING CARE IN CASE STUDY
The policies of registered nurses ensure that the interests of the patient and his or her
families are always addressed properly which has not been followed in this particular case
study pertaining to the flag policy. That means when vital status of the patient was in red
zone after 17:20 hrs, emergency action was not taken up.
Some contributing factors in the professional behavior of the concerned nurse could
have been changed; the outcome of the patient could have been different. These action points
include the first occasion when the respiratory rate and blood pressure level showed the
primary concern; the time when doctor should have been called which was not performed and
a local doctor accidentally came at 2200 hrs. The nurse did not document the aggravation of
symptoms at 1820 hrs. The fatal outcome of the patient could have been avoided in case the
first time reading abnormality could churn the nurse to pay heed and doctor or specialist was
called immediately (Powell & Davies, 2012).
The example care at par the graduate training in the nursing school should include an
immediate care plan right after the admission of the patient and the abnormality in respiratory
rate and blood pressure readings would have been informed to doctor. The onset of
abdominal pain and diarrhea should have been treated with specific medication, rehydration
and care plan. The red zone readings of vital statistics should prompt the nurse to inform the
physician further along with checking the care plan and attached installations again. These
exemplary actions could have been able to avoid the fatal consequence or death of the patient
on the next day (Ross, Barr & Stevens, 2013).
The profession of nurses and midwives consists of tremendous responsibility
regarding the health of the patients and their general well being and hence, a sense of duty
should always prevail among the professionals in this field. The concerned respondent or the
nurse has been proven to be guilty of dereliction of duty as a nursing care specialist on

8CRITICAL ANALYSIS OF NURSING CARE IN CASE STUDY
several occasions and thus the applicable regulations should be implemented in this regard.
The patients are usually vulnerable in most of the cases not being aware of their actual health
condition and nurses are the primary set of people who come in contact with these naïve
sufferers. They need to be adequately aware in order to serve in an infallible and efficient
way (Chiarella & White, 2013).
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education in nursing and patient outcomes. Journal of Nursing Administration, 43(2),
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Butts, J. B., & Rich, K. L. (2012). Nursing ethics. Jones & Bartlett Publishers.
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