Nursing Assignment: Case Study Analysis of Professional Conduct Issues

This nursing assignment presents a detailed case study analysis of a registered nurse, Mr. Abdul Wahid, who faced complaints regarding his conduct towards an elderly patient. The report meticulously examines the breaches of professional conduct, specifically violations of the codes of conduct for nurses in Australia, focusing on principles related to person-centered care and patient dignity. The analysis delves into the specific actions of the nurse, such as rough handling of the patient and failure to maintain privacy, highlighting the impact on the patient's well-being. The assignment further explores the tribunal's decisions, the imposed conditions, and the justification behind the outcomes, including the nurse's required education on patient-centered care and nursing ethics. The report also provides reflections on the implications of the case, emphasizing the importance of adherence to ethical standards, legal obligations, and the promotion of patient dignity in nursing practice. The student reflects on the need for continuous learning, evidence-based research, and the importance of maintaining a professional and compassionate approach to patient care to prevent future misconduct and ensure patient safety and well-being.

Running head: NURSING ASSIGNMENT
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Name of the Student
Name of the university
Author’s note

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Case summary
The case summary is about Mr. Abdul Wahid, who had been alleged with two complaints
to NMBA regarding his ill conduct towards an elderly patient at the hospital, where he had been
working. Mr. Wahid was alleged to have repeatedly shouted at the elderly patient, had handled
the patient roughly and did not draw a curtain while the patient was using she was using a
bedpan. The patient had suffered from a stroke after which he has been transferred to this setting
and he also had a reduced communication skills. As mentioned by the evidences, while
transferring the patients from the wheelchair to the bed, the RN had held her by her armpits, due
to which, the patient cried out in pain. It was known from the beginning that it was already clear
from the medical records that the patient already had some chronic condition in her shoulder that
triggered the pain.
NMBA had the imposed conditions on the registration of the registered nurse. The
tribunal that has been held has agreed with the decision taken by NMBA, that Mr. Abdul Wahid
did not meet up to the professional standards of nursing as set out in the professional conducts
for nurses in Australia and the Code of ethics for nurses in Australia.
As per the tribunal held, Mr. Wahid was asked to complete eight hours of further education
within a 12 months period of time that should include education regarding patient centered care and
nursing ethics.
Professional conduct issues
One of the two professional conducts that has been breached in this case is the principle
2, of the codes of conduct for the nurses, that states that nurses are liable to apply a person
centered care and evidences decision making (Nursing and midwifery board of Australia, 2013).

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They have the legal obligations to ensure a safe and quality care. It is the duty of the nurses to
document and report concerns , if they believe that the practice environment is compromising the
health and safety of the patient (Sharkey, 2014). It is evident from the case study that concerned
nurse had lifted the patient by her armpits, whereas it was already known from the beginning that
she already had a chronic condition on her left shoulder. Hence, the RN could have lifted the
patient in some other ways. Nowadays robotic devices are available in the market that can lift
patients safely and saves the health care workers from physical burden (Matsumoto et al., 2016).
This also decreases the chance of injury to the patients (Burnfield et al., 2016).
Another principle that has been found to be breached in this case is the principle 7 of the
NMBA nursing standards. As per the standard, it is the duty of the nurses to promote health and
wellbeing for the patient and the families (Nursing and midwifery board of Australia, 2013). It is
the evident from the case study that the RN had shouted continuously on the patient for taking
out his hearing aids and had continued shouting after the patient had not been responsive. As per
the professional standards of nursing, it is the duty of the nurses communicate effectively ad is
respectful to the dignity of a person (Nursing and midwifery board of Australia, 2013).
Witnesses have alleged that the RN failed to pull the curtains while the elderly patient was using
the bed pan. All the nurses are entitled with the professional duty to promote dignity of those in
the care. Most of the literary sources states that older people’s dignity had always been
undermined by the health care professionals. The health care professionals should aim to
preserve the autonomy and the dignity of the patient and minimize the distress among the
patients (Gastmans, 2013). Essential steps for maintaining the dignity of the patient involves
allowing the patient to choose their clothing, providing them private space while doing the
toileting activities, which has been clearly found to have been avoided by Mr. Wahid (Raee,

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Abedi & Shahriari, 2017). It is the nurses to understand the power relativities and thus respect
the vulnerable and powerless population through practiced kindness. Additionally, compassion
and ethics are the main features of nursing and should be maintained while communicating with
elderly patients (Kadivar et al., 2016). It can be seen from the case study that the RN had shouted
on the patients, which is definitely not in accordance with the nursing standards. Nurses are
responsible to develop a sense of trust in the patient receiving care. Shouting or showing
aggressive behavior to patients creates a hostile environment.
Analysis of the case outcomes
According to the decisions made by the court, Mr. Wahid should make a nomination for
undertaking one on one education or a formal educational course to understand about the current
nursing ethics and professional standards. This education has to be completed before 22
December. Monash health has determined to dismiss the RN, if the professional course was not
taken by him. The following decisions were being taken with the justification, that although Mr.
Wahid had failed to meet the professional standards, but the court has accepted the explanation
that his failure to meet the conduct has not been intentional and he did whatever, he felt justified.
Hence, the court has accepted it as a lower level of professional misconduct.
The decision made by the court can be considered to be justifiable due to the fact that,
nurses have the legal obligation to maintain the professional standards. The veto lies in the hands
of the patient to take legal actions, if the conducts are breached or any malpractices are detected
(Haber & Singh, 2014). The way, the elderly patient was being lifted from the wheelchair could
have caused serious injury to the patient. Actions like manhandling patients and using other
forms of abuse like neglect, bullying, putting restraints, verbal abusing can affect the wellbeing

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of a patient and might bring about lawsuits against a clinician (Griffith & Tengnah, 2017). It has
been found that the attitude of the staffs affect both the quality of treatment of the older people.
The nurses often possess pessimistic viewpoint, that can translate in to a loss of dignity, identity
and the decision making power for the seniors (Huston, 2013). As per the studies that involved
surveys from the older people, it has been found that in most of the cases the older people are
treated disrespectfully and insensitively. It should be remembered that confidentiality, privacy is
among the basic rights that should be the same for all age groups (Haber & Singh, 2014).
According to Heidari, Ahmadpour and GharehBoughlou, (2013), a nurse should be able to create
a positive professional relationship with elderly client that is kind, respectful, compassionate and
honest. It should be remembered that during old age, people suffer from several physical burden
as well as emotional burden and hence certain gestures like kind gestures, using soft words and
providing spiritual care might speed up the process of healing (Gastmans, 2013) .Hence, rules
should be stringent, under which any reluctant professional would be compelled to follow the
rules. Hence if a tribunal finding any health care professionals guilty of the codes of ethics, then
the registration might get cancelled depending upon the degree of the professional breach.
Reflection and prevention
The implication of breaking the law is directly related to the content in which the law has
been broken, the conscience and knowledge of the nurse about the breaking of the law, the
degree of harm, whether other health care professionals knew about the incident and whether the
incident has been reported to the higher authorities (Sharkey, 2014). Such cases might set example
as of how and why professional ethics can be breached and what are the consequences that might
occur with respect to the licensure and the job (Haber & Singh, 2014). The case had provided a

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vivid description of the litigation processes that was held, which could alert the graduate nurses
as what should be avoided to maintain a professional conduct (Huston, 2013).
In my future practice, I ensure that I will abide by all the nursing codes of conduct listed
in the NMBA codes of conduct fact sheet. I intend to do evidence based research on more of
these case studies so that, I am well aware of the practical applications of the codes of conduct. I
should be updated with the new sets of rules and regulations, if published. I would ensure a
mandatory reporting, if any such incident occurs in front of me and should always keep the
interest of the patients in the forefront. Furthermore, I believe that ethics are guided by personal
values and ethics and hence, it my embedded values that would help me to give a person
centered care. I believe that I would never lose my mind or overburden self with excessive
workload, so that I engage in any kind of misconduct out of mistakes.

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References
Burnfield, J. M., McCrory, B., Shu, Y., Buster, T. W., Taylor, A. P., & Goldman, A. J. (2013).
Comparative kinematic and electromyographic assessment of clinician-and device-
assisted sit-to-stand transfers in patients with stroke. Physical Therapy, 93(10), 1331-
1341.
Gastmans, C. (2013). Dignity-enhancing nursing care: a foundational ethical
framework. Nursing Ethics, 20(2), 142-149.
Griffith, R., & Tengnah, C. (2017). Law and professional issues in nursing. Learning Matters.
Haber, J., & Singh, M. D. (2014). Legal and ethical issues. Nursing Research in Canada-E-
Book: Methods, Critical Appraisal, and Utilization, 112.
Heidari, A., Ahmadpour, Z., & GharehBoughlou, Z. (2013). Patients and nurses awareness of
patient’s rights: A comparative study. Health, Spirituality and Medical Ethics, 1(1).
Huston, C. J. (2013). Professional issues in nursing: Challenges and opportunities. Lippincott
Williams & Wilkins.
Kadivar, M., Manookian, A., Asghari, F., Niknafs, N., Okazi, A., & Zarvani, A. (2017). Ethical
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history of medicine, 10, 15.
Matsumoto, H., Ueki, M., Uehara, K., Noma, H., Nozawa, N., Osaki, M., & Hagino, H. (2016).
Comparison of Healthcare Workers Transferring Patients Using Either Conventional Or

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Robotic Wheelchairs: Kinematic, Electromyographic, and Electrocardiographic
Analyses. Journal of healthcare engineering, 2016, 5963432. doi:10.1155/2016/5963432
Nursing and midwifery board of Australia, (2013).Code of conduct for nurses. Access date:
15.4.19. Retrieved from: https://www.nursingmidwiferyboard.gov.au/codes-guidelines-
statements/professional-standards.aspx
Raee, Z., Abedi, H., & Shahriari, M. (2017). Nurses' commitment to respecting patient dignity.
Journal of education and health promotion, 6, 16. doi:10.4103/2277-9531.204743
Sharkey, A. (2014). Robots and human dignity: a consideration of the effects of robot care on the
dignity of older people. Ethics and Information Technology, 16(1), 63-75.