Professional Nursing Case Study Analysis: Implications for Practice

This case study analyzes a nursing incident involving an 81-year-old patient who experienced deteriorating health leading to death. The assignment identifies professional practice issues, including lack of duty of care, poor communication, and inadequate documentation. The analysis highlights violations of the non-maleficence ethical principle, failure to provide timely interventions, and ineffective communication among healthcare professionals. The student reflects on these errors, emphasizing the importance of patient-centered care, timely assessments, effective communication, and comprehensive documentation. The assignment outlines implications for future practice, including improved patient assessment, adherence to nursing principles, and proactive communication with clinical managers. The student aims to develop assertive communication skills and engage in continuous learning to enhance nursing skills and provide quality patient care. The case underscores the significance of professional behavior, emphasizing that proactive communication and a sense of urgency could have potentially improved the patient's outcome.

Running head: NURSING PROFESSIONAL
NURSING PROFESSIONAL
Name of Student:
Name of University:
Author’s Note:

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Answer 1. Case Summary: Summarizes the case and presenting professional practice
issues’
The case study reflects to show the deteriorating health condition of the patient who was
of 81 years initially suffering from shortness of breath, leads to death of the patient. The patient
was administered oral Lasix drugs which did not prove to be effective in her health. The chest X-
ray and blood test, revealed diarrhea and tenderness in the right abdomen. Ventilation lung scan
result was not clear. The patient was observed with sign of dizziness, depression and anxiety.
She was continuously refusing food and liquid, as a result, she became physically weak. No
nursing intervention was given to patient regarding it. The health care professionals were not
performing the duty of care and they were not accountable for their work. His blood sugar level
and heart rate increased for which he was administered valium and digoxin. He showed many
significant symptoms like cold, grey and pale body, which was ignored by the health care
professional. His health was continuously being deteriorated with severe back pain, UTI,
leukocytosis and immobilization. Then doctor did not arrive on time, and respondent waited for
his arrival, even after observing increase in respiratory rate and low heart rate and blood
pressure, which was not, paid any attention. In the case study despite describing patient as
“deteriorating” during clinical handover, emergency doctor arrived one hour late, and patient was
referred to another rural hospital, which should not be entertained because of her critical health
and they are not accountable for their action. While being assessed by air evacuation team,
patient died because of septicaemia. Due to two major professional issues noticed in the case
scenario, which is lack of duty of care and responsibility has deteriorated her condition in faster
rate.

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Answer no 2. Contributory factors: relevant professional errors that potentially
contributed to the incident happening.
From the review of the case study, there are many shortcomings in practice by health care
professional which is describe as follow:
The first professional error noticed in the case study is relate to violation of non-
maleficence ethical principle. The principle is focused to not adopt any action that can cause
harm to the patient (Wong et al., 2017). In the case history, the diagnosis of disease was also
executed late, which is supposed to be performed at the time of admission or notice of
interpretive sign in patient for better recovery (Hutchinson et al., 2016). Health care
professionals should not ignore her diet plan, and should have paid attention in necessary
interventions and took steps on her continuous refusal of food. Additionally, the health care
professional should have provided important medication to improve the health of the patient
instead of waiting for assigned doctors. According to Shlisky et al. (2017), it can be said that it is
essential to consider diet of the patient as balanced diet with medication improve the health of
person and result in faster recovery. It is also evident that it is the duty of the nurse and health
professional to ensure quality care plan to avoid harm to the patient (Mira et al., 2015).
The second professional issue noticed is poor communication. It is evident from the case
study that when the health of the patient was deteriorating and she needed immediate medication.
The patient has showed symptoms of high respiratory rate, low blood pressure, and high
abdominal pain. Such sign and symptoms were important to be taken care as ignorance can lead
to poor health of the patient. Respondent communicated to Clinical nurse manager, but seek for
medication for another patient. They did not raise any issue or query regarding the patient A with

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Ms Johns. Lack of effective communication by the clinical nurse manager has worsen the health
of the patient. They should have timely communicated to the nurse manager as this could help in
controlling the deteriorating signs. It is evident that effective and timely communication of the
health of patient with senior health professional helps in improving the conditions (Griffiths et
al., 2017).
The third professional issue noticed in the case scenario is lack of timely documentation
after the every patient interaction. It is seen from the case study that patient was having continual
diarrhea, the respondent did observe the vital sign of the patient, but fails to document it. They
should have actively documented all the changes of the patient and made a clear report. It is
reviewed from the study of Cleary (2016) as the mean of healthy practice, the health care
professional need to document significant observation in the patient for better health outcome of
the patient. It is seen from his study that such practice helps to makes the other health care
professional aware about the changes in the vital sign so that important and relevant intervention
could be applied to improve the health of the patient. Failure in doing such activity can cause
emergence of situation where caregiver can administer wrong medicines and interventions.
Answer 3. Implications for future practice
From the review of the case study, many professional errors have been noticed in the case
scenario, which has given me insight to improve my action. In my future practice, I will be
conscious enough toward my responsibility of providing effective care to the patient. I have
learned that due to ignorance by the health care professional, patient health can get worse, and
even death can I occur. I will implement the principle of nursing in my practice, which focuses
on therapeutics relationship and patient-centred care as evident from the study of Richardson,
Percy and Hughes (2015). In my practice, I will bring changes in assessment of the patient.

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When I observe any vital sign indication critical illness, quick laboratory test and diagnosis will
be performed.
Additionally, I will take into account the decision of patient and its effect on their health.
If the decision leads to harm the patient, I will make them understand the need for interventions
for better health outcome. I will develop healthy practice and make a habit of documenting every
sign and symptom of patient both related to physical and mental health. It is reviewed that due to
lack of reporting of vital signs, health professional was not able to recognize the urgency of the
situation, which ultimately causes the death of the patient. When I come in an emergency
situation, where doctors are not available, I will develop a practice of telecommunications with
clinical nurse manager to arrange medication to improve the deteriorating health of the patient.
As equipped hospital can provide more intensive care to the patient in any health condition
(Marshall et al., 2017). Further, in my practice, I will implement a habit of communicating the
clinical issue arising due to non-availability of resource in hospital to the administration of health
organization. I will try to be assertive in my nursing practice. It will help me to build confidence
and able to express and communicate my feeling to other health care professional (Castro et al.,
2016). It will assist me to become a successful nurse in future.
I will be engaged in training program where I will learn essential nursing skills required
in handling patient. I will also involve in online course where I will get enough knowledge about
the healthy practice in nursing which is relevant to duty of care and accountability.
For my future practice, after getting handful of training and learning, I will get involve in
care of the patient and try to gain practical experience of those learning. The major reason is to
evaluate my training and education, whether I have sufficiently developed nursing skill to
provide quality care to the patient.

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Thus, lastly, it can be said that the professional behaviour of being actively conscious,
responsible, and committed towards ones work, would have made a difference in the situation. If
the nurse has communicated the issue to senior professional instead of waiting for the doctor or
have shown urgency of the situation, patient deteriorating health might have been better.

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