NURS2002 Case Study: Analyzing Nursing Ethics and Clinical Governance

This case study, submitted by a nursing student, analyzes a scenario involving ethical and legal breaches in a hospital setting. The assignment focuses on a second-year nursing student's experience on a medical ward, detailing instances where patient care protocols, medication administration, and clinical governance were compromised. The student nurse faced challenges due to the absence of a supervisor and the uncooperative behavior of the team leader, leading to breaches of the Health Care Act 2008 and the NMBA code of conduct. The analysis covers the improper administration of medication without a doctor's order, failure to consider patient preferences, and lapses in clinical governance. The student reflects on these experiences, highlighting the importance of patient-centered care, adherence to nursing ethics, and the need for effective communication within the healthcare team. The case study concludes with recommendations for improved practice, emphasizing the significance of evidence-based practice, consulting with doctors, and prioritizing patient safety to maintain clinical governance.

ASSIGNMENT 4: Case-study Analysis
ASSIGNMENT 4: Case-study Analysis
TOPIC: NURS2002
SUBMITTED BY:
Sabina Tamang
Id: 2215264

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ASSIGNMENT 4: Case-study Analysis
Introduction
Nursing professionalism is a factor in which a nurse should consider all the ethical and
the professional factors of the clinical processes. In terms of a nursing student here the nurse is
responsible for 4 patients with different problems and the nurse needs to govern them without the
help of the supervising nurse for some hours. Here the team leader helped the nurse in these
cases however, there are some problems the nurse faced and needs to critically analyse those
problems. The following sector would describe the breaches of care policies in the case scenario
and which are basically the law and ethics of nursing and clinical governance. As the student
nurse did not ask any question regarding the medication and did not thought about the patient’s
or doctor’s point of view the clinical governance and nursing law and ethics are breached.
Scenario 1
In the case of care of the Greek patient Mrs. Maria Gianopolis an 87-year-old lady with
exacerbation of COAD and there was no medication management was found by the nurse. The
nurse administered 2 Panadol as the team leader directed. He also told her that he will talk to the
doctor about it. Here the nursing law and ethics are breached because without the doctor’s order
a nurse cannot administer any medication to the patient. If the consent of doctor is not taken in
account there can be possibilities of deterioration of patient’s health and the condition would lead
the factor of breaching the Health Care Act 2008 (Legislation.sa.gov.au, 2019).. The breach of
the nursing ethics and standards also occur in this factor of medication without any consent of
doctor. The nurse also never considered the opinion of the patient who did not want the
medicine. These factors highlight the breach in the NMBA code of nursing as well which states
the factor of the patient-centered care and prioritizing the needs of the patient and also

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ASSIGNMENT 4: Case-study Analysis
prioritizing the opinion of the patient (Nursingmidwiferyboard.gov.au, 2019). Here, the legal
practice competencies and the patient centered care of nursing priority are breached. Hence, the
occurrence is a failure from the nurse’s end for not delivering proper care to the patient.
However, the team leader Adam Vronsky also did not prioritize the factor of the patient’s care
and let the trainee nurse to handle the situation. When the nurse asked him about the medication,
he was ignorant to the case and not helpful to the nurse. This scenario highlights what has been
done without considering the doctor’s consent and also breaching the laws of health care
however, the situation helped the nursing student in the knowledge development of this kind of
situation handling. The nurse experienced the uncooperative supervisor and this experience
would help the nurse in properly handling this kind of situations on his or her own. On the
contrary it can be stated that the nursing student was careless about the ethics and law of nursing
maintenance. Thus, it can be said that this situation needed to be handled more carefully and the
doctor should be informed before the medication administration to the patient and on the basis of
the doctor’s consent the medication should be administered along with the analysis of her current
and past medical condition (Grace, 2017, p.254). Nurses are responsible for every action
performed so, liability, the standard of care and contractual obligations as a whole play a vital
role in providing safe and competent care (Berman et al., 2017, p. 69). This condition should be
analysed by the nurse and on the basis of the analysis the nurse should be able to research on the
medication of Panadol and also ask the doctor for the proper medication process.
Scenario 2
In case of the clinical governance there are several breaches occurred in this case study.
As there is no presence of the supervisor and the nursing student alone advocating four patients
and the team leader was uncooperative (Iravani et al., 2016). On the other hand there was no

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ASSIGNMENT 4: Case-study Analysis
medication information of the patient Mrs. Maria Gianopolis and the nurse was told by the team
leader to give the patient 2 Panadols and when the nurse approached him he was not helping the
nurse and was not want to cooperate. Hence, it can easily be stated that there are several breaches
in the clinical governance aspect and the factor of the NMBA nursing code of conduct also
breached. On this aspect the patient’s needs were not assessed properly which is the most needed
factor of a nurse in terms of the NMBA nursing standards (Kluijtmans et al., 2017). Proper
advocating of the patient’s concern and the consent of the patient was not taken when the
medication was administered forcefully. This factors show that the team leader and the
supervisor was not properly governing the factor of the medication management and the patient’s
good and forcing the student nurse to work on an extra pressure (Rechner & Sampson, 2016).
Hence, on the basis of this concern the student nurse would be able to experience the situation of
the clinical governance breach and the uncooperative supervisor aspect as well. On the basis of
this experience the nurse can be able to counteract against this problems. The nurse should be
able to talk with the supervisors and also contact the management of the health care institution.
The student nurse should be able to think about the processes of nursing and also consult with
the doctor for the proper clinical governance and treatment of the patient. All these factors
would help the nurse in the future experiences and the nurse should focus on the patient
prioritization and the patient safety over any other aspect so that the clinical governance is
maintained (Veenstra et al., 2017).
Conclusion
Based on above discussion it can be concluded that the nursing student appointed to the
medical ward for respiratory cases was over committed in the absence of supervisor and the team
leader never taken in account the factor of the doctor’s consent in the medication administration.

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ASSIGNMENT 4: Case-study Analysis
The nurse also did not ask anything about this condition and taken the action instructed by the
team leader. Student Nurse has the right to refuse or say no if he/she knows that the given thing
is wrong. Hence, the clinical governance and the law and ethics of nursing were breached.
However, the nurse had the chance to experience of this situation and gathered knowledge how
to handle these situations without breaching the nursing codes by means of knowing the factors
of the medication management and the supervisor pressures. On the basis of this experience the
student nurse can be able to rethink about the experience and try to consult with the doctor and
also implement evidence based practice that is the factor which helps in the improved care
providence.

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ASSIGNMENT 4: Case-study Analysis
References
Grace, P. J. (Ed.). (2017). Nursing ethics and professional responsibility in advanced practice.
Jones & Bartlett Learning.
Iravani, M., Janghorbani, M., Zarean, E., & Bahrami, M. (2016). Barriers to implementing
evidence-based intrapartum care: a descriptive exploratory qualitative study. Iranian Red
Crescent Medical Journal, 18(2).
Kelly, S. E., Naft, M., Bautista, A., &LoGrippo, M. (2017). The Development of Professional
Self-Concept and Leadership Skills Among New Graduate Nurses.
Kozier, E., Kozier, B., Berman, A., Erb, G. L., Snyder, S., Levett-Jones, T., Dwyer, T., &
Hales, M. (2017). Kozier and Erb's Fundamentals of Nursing Pack Vols 1-3: Australian
Edition.
Kluijtmans, M., Haan, E. D., Akkerman, S., &Tartwijk, J. V. (2017). professional identity
Professional identity in clinician-scientists: brokers between care and science.
Legislation.sa.gov.au. (2019). South Australian Legislation. Retrieved from
https://www.legislation.sa.gov.au/LZ/C/A/Health%20Care%20Act%202008.aspx
Nursingmidwiferyboard.gov.au. (2019). Nursing and Midwifery Board of Australia -
Professional standards. Retrieved from https://www.nursingmidwiferyboard.gov.au/Codes-
Guidelines-Statements/Professional-standards.aspx
Rechner, J., & Sampson, R. (2016). Perioperative management of Anticoagulant and Antiplatelet
medication GL067. Governance.
Veenstra, G. L., Ahaus, K., Welker, G. A., Heineman, E., van der Laan, M. J., & Muntinghe, F.
L. (2017). Rethinking clinical governance: healthcare professionals’ views: a Delphi study.
BMJ open, 7(1), e012591.

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ASSIGNMENT 4: Case-study Analysis