Cultural Competency and Risk Management in Rural Healthcare

The assignment delves into the complexities of nursing malpractice by analyzing its legal ramifications and the responsibilities it places on nursing professionals. The discussion centers around ensuring accurate diagnoses and fostering a culture that prioritizes patient safety to mitigate legal...Read More

Legal and Professional Issues In Nursing1
Legal and Professional Issues In Nursing
Name
Name of Class
Instructor
Institution
City and State
Date

Legal and Professional Issues In Nursing2
Introduction
In nursing, just like in any other profession, nurses are expected to adhere to certain
professional standards, which include but are not limited to competency, professional code
conduct, and ethics. Additionally, states have laws that professional ought to abide by, as far as
conducting their duties is concerned (Buka, 2014, p.14). Thus, failure for nurses to adhere to
those rules, standards, and regulations may and often attracts charges to maintain a certain degree
of competency and professionalism expected of nurses. Thus, this paper focuses on a case study
of two nurses on an infant. In so doing, the paper will look at the specific standard of practice;
ethical, competence and professional applicable to the case study that the two nurses appear to
have broken (Douglas et al., 2014, p. 118). In addition to that, the paper will weigh in on the
legal provision relevant to the conduct of the two nurses.
On the other hand, there have been cases of nurses engaging in malpractices. One of the
most common forms of malpractices is a misdiagnosis, where a patient is diagnosed with a
different disease but the one suffering from. Lastly, communicating, documenting and reporting
patient’s conditions are essential for all nurses if at all the patient has to receive proper care
(Yoder-Wise, 2014, p. 23). The paper will give a comprehensive analysis on all of these about
the case study.
Analysis of the Case Study
The case study is a six-month-old infant who is suffering from bowel obstruction and
taken to the emergency department, but the nurses that assess the child fails to recognize the
condition but instead mistakenly confuse it with gastroenteritis. It is the medical staff that
realizes the condition but their attempt to save the child fails as he passes on before the next

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treatment. Thus, due to the conduct of the two nurses, complain is launched against the two
nurses and are found guilty of behaving in an unprofessional way.
Law and malpractices about the case study
In legal practice and health care, there are certain aspects that one considers before a
person is convicted or pronounced to be liable to the charges brought against him or her. For
nurses, for instance, a person must establish that there was a patient-nurse relationship. It is
important to ascribe a duty of care for the nurse or nurses involved (Carroll, Parikh, &
Buddenbaum, 2012, p.140). This can be done by looking at the medical records that stipulates
that such a relationship existed. Secondly, there must be an elaborate way of determining the
scope of duty that the nurse was supposed to offer. In addition to that, it is important that a
complaint establish that there was an omission or absence of good and acceptable care that any
competent and experienced nurse would have offered (Fairman et al., 2011, p. 194). Lastly, there
must be an establishment of a causal of the relationship between what the nurse and nurses did
that resulted in injury or what they omitted to do that could not have led to an injury.
In the case study, there are various aspects that one can draw that are not professional in
any sense that can be used as evidence to establish the malpractices that the two nurses engage
in. Firstly, the two nurses do not document their assessment. In nursing, documentation of patient
assessment is important and mandatory (Westrick, 2013, p.62). The act of not documenting their
assessment is unprofessional and not acceptable (Potts, & Mandleco, 2012, p.12). Secondly, the
two nurses fail to communicate or report earlier enough to the medical staff even though it is an
emergency case. This is another issue that the nurse violates in regards to professionalism
(Mason, Laurie, & Smith, 2013, p. 102). It is not recommended for nurses to report late for cases

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they are unable to handle, or that calls for an emergency intervention. Lastly, the two nurses
make a misdiagnosis for the infant patient. Specifically, instead of diagnosing the patient for
bowel obstruction, they make a wrong diagnosis of gastroenteritis, which encourages delay of
recovery and perhaps more harm to the patient body than good. In effect, the patient is not well
taken care of by the two nurses.
On the other hand, the manner in which the nurses conduct themselves can well be
demonstrated by looking at the specific ethical and code of competency or conduct that they
break as this is what makes them liable for punishment.
Code of ethics
In Australia, the Board of Nurses has laid out specific ethical codes that nurses ought to
follow in his or her provision of services. However, the two nurses in their assessment to the
patient fail to honor one of ethical code. In particular, statement 6 of the code of ethics for nurses
states that nurses value a culture of safety in nursing and healthcare (Ferrara et al., 2013, p. 4).
This suggests that nurses must engage in an undertaking that encourages sharing of knowledge
and understanding as a crucial pertinent aspect of safety in contemporary health care. Thus, the
nurse ought to value safe working environment by working within the limits of his or her
knowledge or skills.
However, from the case study, the two nurses do not honor this but instead practice and
offer services that are not safe to the patient. Precisely, it appears that the two nurses are not
aware of what is ailing the patient. However, they go ahead to diagnose the patient who turns out
to be a misdiagnosis. This keeps the patient health at risk and may have been one of the reasons
why it becomes difficult to save the patient.

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Code of professional conduct
In addition to the ethical code, the Australian Board for nurses has a professional code of
conduct as other requirements for practicing nurses. In this category, the two nurses violate
statement 11 which states that it is the responsibility of all the nurses to maintain the required
competency by participating in professional development education programs (Furrow et al.,
2014, p.15). In the case study, it appears that the nurses have not been participating in this
program to boost their competency. Such mistake like not documenting or reporting an
emergency case is not something that is expected of not only one, but two nurses. Thus, the
nurses do not conform to this code of conduct which attracts disciplinary actions for it puts the
patient at risk.
National Competency standards for registered nurses
Lastly, as far as professional standards for nurses are concerned, there are competency
standards for all nurses. In the case study, the two nurses also violate some of them in their
professional handling of the patient. Firstly, competency standard 1.3 embraces the notion that
nurses ought to recognize and respond appropriately to unsafe or unprofessional practice
(Iglehart, 2013, p. 12). In their ruling, the committee in charge of investigating the conduct of the
two nurses concludes that the two failed to manage or communicate with the pediatrician for any
changes and responses to the patient condition or even maintain clinical records of the patient’s
observation. It is not in line with this standard, and thus, the two are liable to punishment.
Secondly, another competency standards that the two nurses fail to honor is 2.2 which
stipulates that nurses are obliged to integrate organizational policies and guidelines with
professional standards (Jalian, Jalian, & Avram, 2013, p.12). Although the two nurses are in the

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department of emergency, they are unable to differentiate and properly diagnosis bowel blockage
but instead confuses it with gastroenteritis. This is not what the hospital expects of the two
nurses as per their guidelines. The hospital tasks them with the responsibility they believe are
capable of handling.
Additionally, they ought to integrate nursing health care knowledge, attitude, and skills to
provide safe and effective nursing care. It is clear that the two did not seek intervention at the
right time and if only they had done so, the medical staff was in a better position to help the
patient. Lastly, competency standard 5.3 states that a nurse must analyze, interpret assessment
and data accurately (Kukreja, Dodwad, & Kukreja, 2013, p.19). It is evident that the two nurses
responded to the emergency case and the changes in the patient in contrast to what a competent
nurse would, in analyzing and assessing the conditions of the patient, leading to wrong judgment.
Legal Provision that the two nurses Bleaches
In Australia, the National law provides for disciplinary actions for nurses who violate
section 139B. In its readings, it stipulates that nurses ought to be punished for portraying
“unsatisfactory professional conduct” (Kapp, 2012, p.17). According to the section, the conduct
is unsatisfactory if it is below the reasonable standard. This is one that demonstrates that the
knowledge, care exercised, or skill is below the bar that the professional body expects of a
healthcare practitioner of an equivalent level of training. In the case study, the two nurses do
some things that are indeed below the standard of practice. Firstly, they fail to make the patient’s
clinical records of the observations (Wachter, 2012, p.78). Secondly, they do not communicate in
time to medical staff although it is an emergency case. Lastly, they misdiagnose the patient. This
is below the standards expected of the two nurses.

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Communication, response, and call for help
Research indicates that there is a lot of concern about ineffective communication between
nurses and doctors. Some reasons have been attributed to this poor communication. To start with
the first one, junior nurses and those with minimal experience may feel uncomfortable to call for
assistance because of fear of doing the wrong thing or be seen as incompetent (Raingruber, 2016,
p. 71). Additionally, another study reveals that nurses may not be in the best position to articulate
the concerns as well as it should be or as urgent as it should (Dearmon, and NEA, 2013, p. 14).
Lastly, they may not be confident enough to cross hierarchical or occupational boundaries, and
this affects the patient from receiving the best medical care. The case study is in a rural area, and
similar cases have been reported where nurses who are not competent enough work in the
various important department. This happens due to the shortage of medics, and it is a problem
affecting many parts of rural areas in Australia. However, the nurses have violated various legal
provisions and professional code of conducts or standards of practice, and they must account for
as per the rules and judgment of the body in charge (Schwartz, 2013, p.17). Additionally, there is
a separate case that the nurse is charged with that also demonstrates incompetency and
unwelcoming behavior which further demonstrate that the incident is not an accident but a
repetitive behavior that is likely to persist if something is done.
Conclusion
Thus, the case study provides various ways in which legal and professional conduct of
nurses in taking care of a patient can be bleached. Specifically, the two nurses conduct
themselves in a manner that is in violation of the national laws and of what is expected by their
professional standards. In addition to that, there are various ways to establish the charges of

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whoever appears to have engaged in malpractice. In the case study, four of the most basics
elements that one has to consider have been highlighted, which include establishing whether the
nurse has a duty, omission of behavior that made an impact or injury to the patient and scope of
duty among others. It is worth noting that one can learn from the case study that failing to make
clinical records of patient’s observation is in violation of professional standards and this makes
the charges against nurses valid. In addition to that, cases of misdiagnosis can come from nurses
not reporting to medical staff as soon as possible who are in a better position in terms of skills,
knowledge, and experience to handle patients. Although rural hospital faces challenges in
treating patients, the misconduct of the nurses needs to be taken care of to avoid recurrence.

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