Analyzing Professional Identity and Conduct in Nursing: A Case Study

This case study examines the professional conduct of a registered nurse, Mary, working in aged care, whose behavior raises concerns regarding adherence to the Nursing and Midwifery Board of Australia (NMBA) standards. The analysis focuses on Mary's failure to meet NMBA standards in applying a person-centered approach, evident in her inattentive behavior and lack of care for residents. The study explores the importance of therapeutic relationships, highlighting the negative impact of Mary's actions on patient care and the working environment. It evaluates the benefits of developing person-centered relationships and provides guidance on how Mary's peers can use NMBA codes of conduct and professional standards to address her conduct. The conclusion reinforces the significance of NMBA guidelines in regulating nurses' behavior and ensuring quality nursing services.

Running Head: NURSING 0
Professional identity: nursing

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Introduction
Mary is a registered nurse, working in a residential aged care. Several of her colleagues
have noticed Mary’s careless behavior as a nurse. They found the aged residents have not been
rightly attended, their wet bedsheets were not changed and she was seen spending a lot of time at
her nursing station. Such kind of behavior is not acceptable as a nurse and puts Mary under the
suspicious light. Her careless behavior caused them to report to the manager. The main aim of
the case study is to judge the Mary’s conduct as a nurse according to the standards and the code
of conduct for nurses in Nursing and Midwifery Board of Australia.
Section A
Application of NMBA standards to achieve Person-centered approach
Nursing and Midwifery board of Australia (NMBA) standards lays down ethical and
professional code of conduct that are to be followed by the Registered nurses to be termed as a
professional nurse (Wilson & Jaques, 2018). These professional standards regulate the practices
of registered nurses and help them in easy application of person-centered approach to patients
(Nunnery, 2015). In the case study, Mary is not meeting the NMBA standards in applying
person-centered and evidence-based care for the delivery of safe and quality care. Her careless
behavior towards her residential aged patients is evident of it. Person centered approach is about
caring for patients by making the patient’s personal needs, desires and goals the top-most priority
and curing them with the professional healthcare knowledge (Ross & Clarke, 2015). Therapeutic
relationship is an empathetic relation between the client and nurse. The components that make up
a good therapeutic relationship are trust, professional intimacy, respect, empathy, and power.
There was an absence of professional intimacy in the Mary’s professional conduct due to her
indifferent behavior towards her patient and the non-adherence to the NMBA professional

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standards for nurses. Her relationship with patients also lacked empathy, trust and respect that
could be seen from her behavior. For several shifts, the wet bed sheets remained unchanged, the
urine bottles were not emptied and she was found spending the large portion of her time at
nursing station. The patients under her nursing care were left unattended. The careless behavior
of Mary is also the reflection of the non-applicability of person –centered and evidence-based
approach for the delivery of safe and quality care to patients (Harper & Shinners, 2017). From a
person-centered perspective, Mary was not careful about the patient’s hygiene as she did not
change the wet bedsheets and did not provide quality care by timely emptying the filled urine
bottles. Thus, Mary did not meet the NMBA standards in applying person-centered and
evidence-based care for safe and quality care.
Person-centered and therapeutic relationships with patients
The evidence in the case study did not form the belief that she shares a person-centered
relationship with clients. Person- centered relationships is all about providing quality care to the
patients by meeting their personal needs, desires, and goals. It is concerned with providing
quality holistic treatment to patients where the nurses meet patients unclaimed needs effectively
(Harper & Maloney, 2017). Mary did not share therapeutic relations with the patients. There are
many advantages of therapeutic care that include better relations with clients, peaceful working
environment, increased productivity, and improved goodwill of healthcare department. The non-
applicability of therapeutic relations with the clients by Mary affected the working environment
in her healthcare ward. It made her co-workers to report to the managers thus creating tensions.
The good relations were not forged between the nurse and the clients as She even did not
consider herself responsible for changing wet bedsheets and emptying the filled urine bottles. If,
the patients in the Mary’s ward were provided with the quality care where there was a good

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hygiene factor and high satisfaction among the aged patients then it could be concluded that the
Mary formed the person-centered and therapeutic relationships. In this case, her nonchalant
behavior towards the patients was representative of not-so good relationship with patients.
Benefits of Developing person-centered relations with clients
Mary is portraying a nonchalant behavior towards her aged patients in the healthcare
ward. She could achieve a person-centered approach by providing quality care to the patients and
by being responsive to their unspoken needs and desires (Leung & Waters, 2016). A wet
bedsheet is unhygienic and needs to be changed in time. By changing the bedsheets in time and
the urine bottles she would be able to take care of the hygiene aspect properly. The large portion
of time spent by Mary at her nursing station could be utilized in observing any kind of problems
faced by the patients and then finding effective solutions for those problems. Mary can develop
a therapeutic relationship with patients by diligently applying the NMBA code of conduct that
include compliance to professional laws, implementing a professional behavior, person-centered
relationships, and respectful professional relationships. The application of a good professional
behavior and person-centered relationships will bring trust, respect, and empathy in the
relationship of patient and client. For example, A nurse following a person-centered approach
will result in the development of trust and respect in the relationship. The benefits for
establishing person-centered relations with patients are numerous. The person-centered
relationships will improve the recovery rate of patients in the healthcare department as they
would be able to connect themselves with the hospital staff. It would improve the financial
position of the hospital in a long run due to highly satisfactory treatment rendered to its major
stakeholders. It would result in good coordination between the doctors and nurses thus resulting
in quality care to the patients (Pickles & King, 2019).

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Section B
NMBA code of conducts and professional standards to guide Mary’s peers’ decisions
Yes, it is reasonable for Mary’s peers to report conduct to their manager as such kind of
behavior is not acceptable for the patients whose matter of death and life lie in the hands of
nurses. According to the principal five of NMBA code of conduct, the colleagues or peers have
the right to evaluate the performance of their peers. They have the right to report their conduct to
managers with full honesty, fairness, and objectivity. Moreover, they can supervise, teach, and
train their peers and colleagues. In this case, Mary’s peers can report her conduct to the manager.
Mary did not adhere her professional behavior according to the second principal
mentioned in the NMBA code of conduct for nurses 2018. According to its second principal
nurses are expected to behave with the person-centered approach where they are professionally
expected to take care of the needs and desires of the patients. (Nursing and Midfrey Board of
Australia, 2018). In the Mary’s code of conduct, the person-centered approach was missing. She
did not consider the needs of the patients in the health care ward allocated to her. The Mary’s
peers can report her inappropriate conduct as a nurse based on mentioned second principle.
Mary’s behavior did not comply to the Principal of professional behavior as she did not render
her nursing job with highest integrity and honesty. The fourth principle, which is of professional
behavior, states that the nurses should be honest and should have highest integrity in their job
(García-Moyano, 2019). Mary was not honest in rendering her services as nurse as she wasted
the major portion of her duty timings at her nursing station and did not perform duties allocated
to her genuinely. Her colleagues could also report to her inappropriate conduct according to the
fourth mentioned principal of Professional Behavior. The first principal of legal compliance
makes it compulsory for nurses to project lawful behavior and reporting mandatorily to the

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clients. Mary did not display the lawful behavior at her work place as she was most of the time
found at the nursing station. She also did not report to patients in time. The seventh principle is
concerned with promoting health and well-being of patient. The principle further seeks to take
care of the needs and desires of the people around. It is concerned with promoting the public
health awareness. Mary as a nurse did not give attention to promoting health awareness among
the people. Her behavior conveys that she was less concerned about the staff around.
The NMBA professional standards 2016 expects nurses to comply with the standards.
The standard one that states the nurses, to develop professional and therapeutic relations with the
patients where nurses are required to communicate effectively and provide unconditional support
to the patients to help them recover at a fast rate. In the case, Mary as a nurse did not share any
therapeutic and professional relations with the patients. She did not respect the dignity of the
aged patients by not changing their wet bedsheets and the filled urine bottles in time. Her peers
can report behavior in non-compliance of the standard one of NMBA 2016 by Mary. The
standard sixth is based on providing appropriate, safe, and responsive quality of nursing practice
( Nursing Midwifery Board, 2018). Mary did not provide the safe and responsive quality of
practice to the nurses. She was less concerned in providing good quality of services to the
patients rather was more concerned about the satisfaction of her needs. Mary did not comply
with the standard sixth of NMBA and her peers could report the behavior on non-compliance of
standard sixth. The standard third of NMBA 2016 states the capability of practice by nurses. It
mandates the timely response to the well-being of the staff and patients around. Mary was not
responsive to the well-being of the patients around. She was found spending maximum time at
her nursing station. Her conduct did not comply with the established code of conduct.

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Conclusion
The case study deals with the professional code of conducts and behaviors of the nurses.
These are the code of conducts and behaviors that are to be followed by the nurses to deliver the
good quality of nursing services to the patients. The Nursing Midwifery board of Australia
provides the appropriate guidelines for the right conduct of nurses in the hospital. These
guidelines act as a basis for the nurses to act in a certain specified way. The NMBA set of
conducts act as a bible for the hospital management to regulate their behavior in an effective way
and to direct them when anything in their practice goes wrong. The standard helps the nurse to
act in a right manner in different specified situations.

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