NUR1202: Analyzing Nursing Code of Conduct and Professional Standards
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This essay analyzes a case study involving a nurse, Mary, and her non-compliance with the Nursing and Midwifery Board of Australia (NMBA) standards. The essay examines Mary's failures in providing person-centered and evidence-based care, including neglecting patient hygiene and communication. It discusses the appropriateness of peer reporting and suggests actions Mary could take to improve her practice, emphasizing the importance of adhering to the NMBA Code of Conduct and Registered Nurse Standards for Practice. The essay highlights the significance of therapeutic relationships, professional integrity, and the need for supervision and social support to ensure nurses provide safe and responsive care. The conclusion stresses the importance of guiding and supervising new nurses to adhere to NMBA guidelines for effective patient-centered care.
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1NURSING
The nursing and midwifery board of Australia encompasses the code of conducts for
the nurses and the midwives so that they practice adhering to the guidelines while caring for
the patients. The code of conducts put forward by the nursing and midwifery board of
Australia consolidates legal compliance, cultural practice, building respectable relationships
with the patients while incorporating of proper behavioural professionalism while caring for
the patients. The policies use supervising and teaching tool to empower the midwifery and
nursing workforce within the organizations (Scanlon et al., 2016). The patient centred care is
emphasized in the code of conducts. Culturally safe practice and purposeful practice is
stressed throughout the policies put forward by the nursing and midwifery board of Australia
(Fisher, 2017). It is very important that the midwives and nurses adhere to the guidelines put
forward by the Australian board of nursing and midwifery in order to contribute to proper
patient centred care and patient’s service satisfaction (Lowe & Plummer, 2019). Effective
communication is very vital to the nursing and midwifery practice (Lyons & Bliss, 2018).
Section A:
In this case study, Mary was found not meeting the NMBA standards while applying
the person-centred and evidence-based care during delivery of a safe quality service. As a
nurse, she should have been more careful while caring for the residents placed under her
supervision. Keeping the patient’s environment sustainable and hygienic is a very critical
aspect of patient care and being by the patient’s side is very important, given the emergencies
that can arise at any point of time. Mary, in the case study, has been mentioned to be not
cleaning the blankets of the residents and leaving the urine bottles as it is, which denotes
clear breach of professional behaviour. The NMBA standards focus on patient centred care,
culturally competent practice and fostering of respectful relationships (Endacott et al., 2018).
The standards determine acting with professionalism while with the patients. The principles
of totality, integrity, honesty, compassion and respect (Richardson & Whatmore, 2015)
The nursing and midwifery board of Australia encompasses the code of conducts for
the nurses and the midwives so that they practice adhering to the guidelines while caring for
the patients. The code of conducts put forward by the nursing and midwifery board of
Australia consolidates legal compliance, cultural practice, building respectable relationships
with the patients while incorporating of proper behavioural professionalism while caring for
the patients. The policies use supervising and teaching tool to empower the midwifery and
nursing workforce within the organizations (Scanlon et al., 2016). The patient centred care is
emphasized in the code of conducts. Culturally safe practice and purposeful practice is
stressed throughout the policies put forward by the nursing and midwifery board of Australia
(Fisher, 2017). It is very important that the midwives and nurses adhere to the guidelines put
forward by the Australian board of nursing and midwifery in order to contribute to proper
patient centred care and patient’s service satisfaction (Lowe & Plummer, 2019). Effective
communication is very vital to the nursing and midwifery practice (Lyons & Bliss, 2018).
Section A:
In this case study, Mary was found not meeting the NMBA standards while applying
the person-centred and evidence-based care during delivery of a safe quality service. As a
nurse, she should have been more careful while caring for the residents placed under her
supervision. Keeping the patient’s environment sustainable and hygienic is a very critical
aspect of patient care and being by the patient’s side is very important, given the emergencies
that can arise at any point of time. Mary, in the case study, has been mentioned to be not
cleaning the blankets of the residents and leaving the urine bottles as it is, which denotes
clear breach of professional behaviour. The NMBA standards focus on patient centred care,
culturally competent practice and fostering of respectful relationships (Endacott et al., 2018).
The standards determine acting with professionalism while with the patients. The principles
of totality, integrity, honesty, compassion and respect (Richardson & Whatmore, 2015)
2NURSING
should be followed. But in the case study, Mary has been unprofessional with her patients as
she has been spending more time away from them, while talking to her nursing colleagues at
the work station.
The evidence in the case study has not led us to believe that Mary has formed any
therapeutic, person-centred relationships with her clients. A person centred care (Reynolds,
2017), as supported by the standards of NMBA (Kreitzer, 2015) has to be provided in an
evidence based practice environment by developing an effective and respectful partnership
with the person and the nursing practice, according to the NMBA code of conduct must
promote shared decision making with the patients for which communication and rapport
building with the patients (Ossenberg, Dalton & Henderson, 2016) is important. In the case
study there is no evidence for any such following of patient care policies as put forward by
the NMBA policies. There is clear lack of care and communication with the patient. Spending
time away from the patients, and conversing most of the times at the nurse stations would not
foster effective communication with any patients who are put into her care. Lack of
communication can become a huge barrier in fostering of therapeutic relationships with the
patients and keeping the patient out of sight, which has been reported in this case study, can
lead to various unfortunate, emergency situations in which the patient can be left
unsupervised. As a nurse, she has not embodied integrity, neither that she has been around
her patients to listen to their problems and concerns. This is another breach of the NMBA
standard. Under-supervision of the patients poses a great threat to their health conditions and
provides more opportunity to the presentation of adverse events in the health care scenario.
Listening to the person and listening to the distress of the patient has not been done which is a
clear concern. Mary should be more aware as a registered nurse and take control of the
situation.
should be followed. But in the case study, Mary has been unprofessional with her patients as
she has been spending more time away from them, while talking to her nursing colleagues at
the work station.
The evidence in the case study has not led us to believe that Mary has formed any
therapeutic, person-centred relationships with her clients. A person centred care (Reynolds,
2017), as supported by the standards of NMBA (Kreitzer, 2015) has to be provided in an
evidence based practice environment by developing an effective and respectful partnership
with the person and the nursing practice, according to the NMBA code of conduct must
promote shared decision making with the patients for which communication and rapport
building with the patients (Ossenberg, Dalton & Henderson, 2016) is important. In the case
study there is no evidence for any such following of patient care policies as put forward by
the NMBA policies. There is clear lack of care and communication with the patient. Spending
time away from the patients, and conversing most of the times at the nurse stations would not
foster effective communication with any patients who are put into her care. Lack of
communication can become a huge barrier in fostering of therapeutic relationships with the
patients and keeping the patient out of sight, which has been reported in this case study, can
lead to various unfortunate, emergency situations in which the patient can be left
unsupervised. As a nurse, she has not embodied integrity, neither that she has been around
her patients to listen to their problems and concerns. This is another breach of the NMBA
standard. Under-supervision of the patients poses a great threat to their health conditions and
provides more opportunity to the presentation of adverse events in the health care scenario.
Listening to the person and listening to the distress of the patient has not been done which is a
clear concern. Mary should be more aware as a registered nurse and take control of the
situation.
3NURSING
There are various actions that can be taken by Mary in order to address the situation.
At first she has to understand her duties and be more responsive as nurse. She should change
the blankets of the patients on a regular basis and the urinal bottled should be emptied, in
order to make sure that the patient environment is sanitary and hygiene is maintained and this
reduces the chance of acquiring hospital acquired infections. Secondly and most importantly,
she should be more around the patient rather than chatting with her peers at the nursing
station. As a nurse, she should develop an awareness of the principles put forward by the
NMBA and their individual importance. She should communicate more often to the patients
put under her care, in order to foster better and stronger therapeutic relationships with the
patients.
PART B
It is partially appropriate and reasonable for her peers to report the Mary’s non-
compliance with the NBA standards. It appears partially appropriate as because they should
have at least talked to Mary, regarding the breach of the NMBA policies caused by Mary’s
behaviour. It is quite clear that the behaviour expressed by Mary is not intentional and it is
just that she, as a nurse, lacks the realization about the adverse event that might arise due to
the lack of care and hygiene in the patient’s environment. Peer reviews and feedbacks are
important in the nursing profession and research that helps to induce good compliance
behaviours among the nursing professionals. At the same time, it is critical that the peers are
right in understanding the exact problem and nature of the problem (clinical, social or both)
before taking any kind of actions all by themselves. Actions could have included talking
about the exact problems to Mary, the nature and the consequences of the problems and how
important it is to follow the NMBA standards as because otherwise, it can risk the life of the
patients (Ingham-Broomfield, 2017). The colleagues are a part of the immediate social
environment of the Mary and it is their first and foremost duty to identify the problem with
There are various actions that can be taken by Mary in order to address the situation.
At first she has to understand her duties and be more responsive as nurse. She should change
the blankets of the patients on a regular basis and the urinal bottled should be emptied, in
order to make sure that the patient environment is sanitary and hygiene is maintained and this
reduces the chance of acquiring hospital acquired infections. Secondly and most importantly,
she should be more around the patient rather than chatting with her peers at the nursing
station. As a nurse, she should develop an awareness of the principles put forward by the
NMBA and their individual importance. She should communicate more often to the patients
put under her care, in order to foster better and stronger therapeutic relationships with the
patients.
PART B
It is partially appropriate and reasonable for her peers to report the Mary’s non-
compliance with the NBA standards. It appears partially appropriate as because they should
have at least talked to Mary, regarding the breach of the NMBA policies caused by Mary’s
behaviour. It is quite clear that the behaviour expressed by Mary is not intentional and it is
just that she, as a nurse, lacks the realization about the adverse event that might arise due to
the lack of care and hygiene in the patient’s environment. Peer reviews and feedbacks are
important in the nursing profession and research that helps to induce good compliance
behaviours among the nursing professionals. At the same time, it is critical that the peers are
right in understanding the exact problem and nature of the problem (clinical, social or both)
before taking any kind of actions all by themselves. Actions could have included talking
about the exact problems to Mary, the nature and the consequences of the problems and how
important it is to follow the NMBA standards as because otherwise, it can risk the life of the
patients (Ingham-Broomfield, 2017). The colleagues are a part of the immediate social
environment of the Mary and it is their first and foremost duty to identify the problem with
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4NURSING
Mary which is inattention, unresponsiveness as a nurse and how these are big barriers or
rather great challenges to her practice of a person-cantered care. Complaining to the upper
management might disturb her esteem and Mary, if she comes to know about the fact that the
persons she spends so much time with at the nursing stations, that is ’her colleagues’ has
reported about her to the manager - might dishearten her and lead to more disruption at the
work place. Once and if her esteem is hurt, Mary might not return to positivity again and
continue doing the mistakes even more. Hence, care should have been taken by the nurses
themselves to help her comply with the guidelines for the errors she has been committing and
the matter could be solved there and then. Of course if she still continue to do the same out of
a lack of self-realization – then reporting to the manager could be fully appropriate, under the
circumstances.
NMBA Code of Conduct for Nurses (2018) and the Registered Nurse Standards for
Practice (2016) can surely guide Mary’s nursing peers and supervisor in managing this
situation. As per the latter, making Mary understand the importance of providing a safer,
appropriate and responsive nursing practice is the first critical step to help with appropriate
compliance. Timely action and supervision is an important practice principle and
nevertheless, the same can be ensured. She can be politely re-educated about the policies,
guidelines, standards, legislation and regulations of Registered Nurse Standards for Practice,
not as reminders but as to stimulate a realization in Mary so that she adheres back with
clinical guidelines. NMBA Code of Conduct for Nurses (2018) can help the manager and the
peers of Mary to help comply with the ‘lawful behaviour’ as put forward by the legislative
sections of the NMBA. Acting with professional integrity is important and it is critical to
understand or rather make Mary understand, the importance and the vitality of practicing with
integrity, honestly, respect and compassion for the patients and hence, the nursing principles
compliance is required (Ralph, Birks & Chapman, 2015). An important intervention can be a
Mary which is inattention, unresponsiveness as a nurse and how these are big barriers or
rather great challenges to her practice of a person-cantered care. Complaining to the upper
management might disturb her esteem and Mary, if she comes to know about the fact that the
persons she spends so much time with at the nursing stations, that is ’her colleagues’ has
reported about her to the manager - might dishearten her and lead to more disruption at the
work place. Once and if her esteem is hurt, Mary might not return to positivity again and
continue doing the mistakes even more. Hence, care should have been taken by the nurses
themselves to help her comply with the guidelines for the errors she has been committing and
the matter could be solved there and then. Of course if she still continue to do the same out of
a lack of self-realization – then reporting to the manager could be fully appropriate, under the
circumstances.
NMBA Code of Conduct for Nurses (2018) and the Registered Nurse Standards for
Practice (2016) can surely guide Mary’s nursing peers and supervisor in managing this
situation. As per the latter, making Mary understand the importance of providing a safer,
appropriate and responsive nursing practice is the first critical step to help with appropriate
compliance. Timely action and supervision is an important practice principle and
nevertheless, the same can be ensured. She can be politely re-educated about the policies,
guidelines, standards, legislation and regulations of Registered Nurse Standards for Practice,
not as reminders but as to stimulate a realization in Mary so that she adheres back with
clinical guidelines. NMBA Code of Conduct for Nurses (2018) can help the manager and the
peers of Mary to help comply with the ‘lawful behaviour’ as put forward by the legislative
sections of the NMBA. Acting with professional integrity is important and it is critical to
understand or rather make Mary understand, the importance and the vitality of practicing with
integrity, honestly, respect and compassion for the patients and hence, the nursing principles
compliance is required (Ralph, Birks & Chapman, 2015). An important intervention can be a
5NURSING
social support that must be provided to Mary to help her develop social and clinical
awareness about adherence to clinical guidelines at a higher rate. She might be supervised
and mentored by a senior nurse in order to help her comply with the rules.
Conclusion
The non-adherence of the clinical guidelines by the registered nurses is a common
issue in the nurses working in a clinical environment. The reports has been very clear about
the role of new nurses being not fulfilled on the required basis and the evidence based
practice procedure not being followed on a daily basis. Being unaware of the clinical risks
posed in a clinical environment are multi-faceted and it is very common that the new
graduate nurses are unaware of the situation and hence nurses like Mary needs to be guided
and supervised properly so that they adhere with the NMBA guidelines and contribute to
patient centred care in a more effective way. Mary, in the case study, should have been more
aware of her functioning as a nurse and it is critical that her peer should have supported her
before escalating the matter to the senior manager. As for addressing the problem, the
manager needs to assign a supervisor to Mary in order to better her practice and principles of
care (Thomas, Wakerman & Humphreys, 2015).
social support that must be provided to Mary to help her develop social and clinical
awareness about adherence to clinical guidelines at a higher rate. She might be supervised
and mentored by a senior nurse in order to help her comply with the rules.
Conclusion
The non-adherence of the clinical guidelines by the registered nurses is a common
issue in the nurses working in a clinical environment. The reports has been very clear about
the role of new nurses being not fulfilled on the required basis and the evidence based
practice procedure not being followed on a daily basis. Being unaware of the clinical risks
posed in a clinical environment are multi-faceted and it is very common that the new
graduate nurses are unaware of the situation and hence nurses like Mary needs to be guided
and supervised properly so that they adhere with the NMBA guidelines and contribute to
patient centred care in a more effective way. Mary, in the case study, should have been more
aware of her functioning as a nurse and it is critical that her peer should have supported her
before escalating the matter to the senior manager. As for addressing the problem, the
manager needs to assign a supervisor to Mary in order to better her practice and principles of
care (Thomas, Wakerman & Humphreys, 2015).
6NURSING
References
Endacott, R., O'Connor, M., Williams, A., Wood, P., McKenna, L., Griffiths, D., ... & Cross,
W. (2018). Roles and functions of enrolled nurses in Australia: Perspectives of
enrolled nurses and registered nurses. Journal of clinical nursing, 27(5-6), e913-e920.
Retrieved from: https://doi.org/10.1111/jocn.13987 [Retrieved on: 5 Sep, 2019]
Fisher, M. (2017). Professional standards for nursing practice: How do they shape
contemporary rehabilitation nursing practice?. Journal of the Australasian
Rehabilitation Nurses Association, 20(1), 4. Retrieved from:
https://search.informit.com.au/documentSummary;dn=084306952978817;res=IELHE
A;type=pdf [Retrieved on: 5 Sep, 2019]
Gardiner, F. W., Gale, L., Bishop, L., & Laverty, M. (2018). HEALTHY AGEING IN
RURAL AND REMOTE AUSTRALIA: CHALLENGES TO OVERCOME.
Ingham-Broomfield, R. (2017). A nurses' guide to ethical considerations and the process for
ethical approval of nursing research. Australian Journal of Advanced Nursing,
The, 35(1), 40. Retrieved from:
https://search.informit.com.au/documentSummary;dn=509772218688556;res=IELAP
A [Retrieved on: 5 Sep, 2019]
Kreitzer, M. J. (2015). Integrative nursing: Application of principles across clinical
settings. Rambam Maimonides medical journal, 6(2). Retrieved from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4422455/ [Retrieved on: 5 Sep,
2019]
Lowe, G., & Plummer, V. (2019). Advanced Practice in Nursing and Midwifery: The
Contribution to Healthcare in Australia. Advanced Practice in Healthcare: Dynamic
Developments in Nursing and Allied Health Professions, 51-63. Retrieved from:
References
Endacott, R., O'Connor, M., Williams, A., Wood, P., McKenna, L., Griffiths, D., ... & Cross,
W. (2018). Roles and functions of enrolled nurses in Australia: Perspectives of
enrolled nurses and registered nurses. Journal of clinical nursing, 27(5-6), e913-e920.
Retrieved from: https://doi.org/10.1111/jocn.13987 [Retrieved on: 5 Sep, 2019]
Fisher, M. (2017). Professional standards for nursing practice: How do they shape
contemporary rehabilitation nursing practice?. Journal of the Australasian
Rehabilitation Nurses Association, 20(1), 4. Retrieved from:
https://search.informit.com.au/documentSummary;dn=084306952978817;res=IELHE
A;type=pdf [Retrieved on: 5 Sep, 2019]
Gardiner, F. W., Gale, L., Bishop, L., & Laverty, M. (2018). HEALTHY AGEING IN
RURAL AND REMOTE AUSTRALIA: CHALLENGES TO OVERCOME.
Ingham-Broomfield, R. (2017). A nurses' guide to ethical considerations and the process for
ethical approval of nursing research. Australian Journal of Advanced Nursing,
The, 35(1), 40. Retrieved from:
https://search.informit.com.au/documentSummary;dn=509772218688556;res=IELAP
A [Retrieved on: 5 Sep, 2019]
Kreitzer, M. J. (2015). Integrative nursing: Application of principles across clinical
settings. Rambam Maimonides medical journal, 6(2). Retrieved from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4422455/ [Retrieved on: 5 Sep,
2019]
Lowe, G., & Plummer, V. (2019). Advanced Practice in Nursing and Midwifery: The
Contribution to Healthcare in Australia. Advanced Practice in Healthcare: Dynamic
Developments in Nursing and Allied Health Professions, 51-63. Retrieved from:
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7NURSING
https://onlinelibrary.wiley.com/doi/abs/10.1002/9781119439165.ch4 [Retrieved on: 5
Sep, 2019]
Lyons, J., & Bliss, S. (2018). Nursing as a profession. The Road to Nursing, 183.
Ossenberg, C., Dalton, M., & Henderson, A. (2016). Validation of the Australian nursing
standards assessment tool (ANSAT): a pilot study. Nurse education today, 36, 23-30.
Retrieved from:
https://www.sciencedirect.com/science/article/pii/S0260691715002828 [Retrieved on:
5 Sep, 2019]
Ralph, N., Birks, M., & Chapman, Y. (2015). The accreditation of nursing education in
Australia. Collegian, 22(1), 3-7. Retrieved from:
https://www.collegianjournal.com/article/S1322-7696(13)00103-0/fulltext [Retrieved
on: 5 Sep, 2019]
Reynolds, W. J. (2017). The measurement and development of empathy in nursing.
Routledge.
Richardson, A., & Whatmore, J. (2015). Nursing essential principles: continuous renal
replacement therapy. Nursing in critical care, 20(1), 8-15. Retrieved from:
https://onlinelibrary.wiley.com/doi/abs/10.1111/nicc.12120 [Retrieved on: 5 Sep,
2019]
Scanlon, A., Cashin, A., Bryce, J., Kelly, J. G., & Buckely, T. (2016). The complexities of
defining nurse practitioner scope of practice in the Australian context. Collegian,
23(1), 129-142. Retrieved from:
https://linkinghub.elsevier.com/retrieve/pii/S1322769614000912 [Retrieved on: 5
Sep, 2019]
https://onlinelibrary.wiley.com/doi/abs/10.1002/9781119439165.ch4 [Retrieved on: 5
Sep, 2019]
Lyons, J., & Bliss, S. (2018). Nursing as a profession. The Road to Nursing, 183.
Ossenberg, C., Dalton, M., & Henderson, A. (2016). Validation of the Australian nursing
standards assessment tool (ANSAT): a pilot study. Nurse education today, 36, 23-30.
Retrieved from:
https://www.sciencedirect.com/science/article/pii/S0260691715002828 [Retrieved on:
5 Sep, 2019]
Ralph, N., Birks, M., & Chapman, Y. (2015). The accreditation of nursing education in
Australia. Collegian, 22(1), 3-7. Retrieved from:
https://www.collegianjournal.com/article/S1322-7696(13)00103-0/fulltext [Retrieved
on: 5 Sep, 2019]
Reynolds, W. J. (2017). The measurement and development of empathy in nursing.
Routledge.
Richardson, A., & Whatmore, J. (2015). Nursing essential principles: continuous renal
replacement therapy. Nursing in critical care, 20(1), 8-15. Retrieved from:
https://onlinelibrary.wiley.com/doi/abs/10.1111/nicc.12120 [Retrieved on: 5 Sep,
2019]
Scanlon, A., Cashin, A., Bryce, J., Kelly, J. G., & Buckely, T. (2016). The complexities of
defining nurse practitioner scope of practice in the Australian context. Collegian,
23(1), 129-142. Retrieved from:
https://linkinghub.elsevier.com/retrieve/pii/S1322769614000912 [Retrieved on: 5
Sep, 2019]
8NURSING
Thomas, S. L., Wakerman, J., & Humphreys, J. S. (2015). Ensuring equity of access to
primary health care in rural and remote Australia-what core services should be locally
available?. International journal for equity in health, 14(1), 111. Retrieved from:
https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-015-0228-1
[Retrieved on: 5 Sep, 2019]
Thomas, S. L., Wakerman, J., & Humphreys, J. S. (2015). Ensuring equity of access to
primary health care in rural and remote Australia-what core services should be locally
available?. International journal for equity in health, 14(1), 111. Retrieved from:
https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-015-0228-1
[Retrieved on: 5 Sep, 2019]
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