Being a Professional Nurse or Midwife - Assessment 2 Case Study Report

This report presents an analysis of a nursing case study, focusing on a patient experiencing dizziness and abdominal pain. The case highlights critical professional practice issues, including the respondent's rigidity, delays in diagnosis, and general incompetence, ultimately leading to the patient's death. The report identifies contributory factors such as workplace rigidity, delays, and incompetence. It also discusses implications for future practice, emphasizing the importance of timely diagnosis, equipment preparation, clarification, collaboration, and patient-centered care. The author reflects on the importance of accountability, effective communication, and flexibility in nursing practice. The case underscores the need for professional behaviors like accountability, timely preparation, collaboration, and effective communication to prevent similar incidents in the future.

401021 Being a Professional Nurse or Midwife – Assessment 2
Criteria 1. Case Summary: Summarises the case and presenting professional practice issues.
This paper presents a detailed discussion on case study 2 which revolves around patient A. As
per the case study, patient A notifies a nursing staff about dizziness and abdominal pain feelings. The
nursing staff observes the patient and realizes a respiratory rate between 40 and 44/min, heart rate of 88
accompanied by a lower blood pressure (89/53). After a certain period of time, an enrolled nurse
observes the patient and realizes the patient’s condition is deteriorating. The nurse reports her concerns
to the respondent but the respondent assumes the message claiming that the patient shall be reviewed
after an arrival of the locum. This is one of the fundamental professional nursing practice issues in the
case study. It is irrational as a professional nurse to ignore any message delivered regarding the patient.
Also, the fact that the respondent is receiving this message from an enrolled nurse implies that the
respondent is not periodically checking over the condition of the patient. In this respect, the respondent
lacks accountability in her area of profession. Accountability is a significant aspect in the nursing
practice.
The case proceeds by notification of the respondent about patient A’s constant diarrhea. At this
point, the respondent remains rigid upon her first decision and insists that the patient shall be reviewed
after the arrival of the locum. This brings us to the second professional practice issue in the nursing
practice. It is irrational to ignore the symptoms and changes in the patient’s condition. The professional
nursing practice emphasizes the need to provide patient centered care. This means that all the
complaints and changes that occur in the patient’s condition have to be tackled responsibly. However,
in this case, the respondent ignores the diarrhea of the patient.
The case proceeds by the respondent checking the patient by herself.
Professionally, it is advisable to regular check on the patient and record any changes in her
condition. However, the case here is quite different. The respondent checks on the patient but
fails to record any changes in the patient’s condition. In the case, the respondent argues that no
changes had occurred. This argument is irrational because the respondent had not seen checked
over the patient in the first place.
The case proceeds with the nursing manager who makes a call to the respondent
requesting all medication to be obtained from a drug safe. However, the instructions in this call
were not directed to apply on patient A. A few minutes later, the manager arrives at the
hospital and signs medication. Still at this point, professional nursing issues present
themselves. Firstly, the respondent does not discuss anything with the manager regarding
patient A’s condition. On the other hand, the nursing manner does not check through the
hospital setting to evaluate the condition of the patient as emphasized by Spigelman, &
Rendalls (2015). In professional nursing practice, collaboration is significant. Furthermore, it is
necessary to clarify from colleagues when things are complicated so that patient’s safety is
realized. However, silence and in accountability is the order of the day in the case provided. As
a result, the patient’s condition deteriorates significantly causing her death.
Criteria 2. Contributory factors: Identify relevant professional errors that potentially
contributed to the incident happening?
Diverse professional errors contributed to the occurrence of the incident. Firstly, rigidity in
the workplace is a great contributory factor. As a professional nurse, it is vital to be flexible in order to
tackle any issues presented by the patient. In the case presented, patient A diarrheas but the respondent
insists that the patient shall be reviewed when locum arrives. This caused great dehydration within the
patient thus deteriorating the patient’s condition.
Secondly, delays in the workplace caused the big issue (Harrison, Sargazi, Yin, &
Chandrasekar, 2016). The respondent in this case delayed to diagnose the patient. As a result, the
patient’s condition deteriorated thus leading to her death. On the same note, the arrival of the locum
also delayed. Quick arrival of the locum might have changed the order of the since the patient could
have been diagnosed on time. Thus, delays in the workplace are fundamental contributory factors to the
occurrence of the incident.
Thirdly, general incompetence is a key player in the occurrence of the incidence. As a nursing
manager, it is important to check on patients within the hospital setting and evaluate their progress

(Phillips et al., 2017). In so doing, it will be easy to identify patients whose conditions are
deteriorating and incorporate corrective measures to save their situation. However, in this case, the
nursing manager fails to check on the patients which in turn leaves patient A at the mercy of the arrival
of the locum. On a similar note, the respondent exercises a higher degree of incompetence. The
respondent does not make regular visits to the patient. Thus, the respondent cannot tell the progress of
the patient. Furthermore, the respondent does not record the progression in the patient’s condition.
Thus, the respondent cannot realize any changes in the patient. Also, the respondent ignores all the
information delivered to her regarding the state of the patient. She is not willing to discuss with anyone
regarding the condition of the patient. As a result, the patient’s condition deteriorates and she finally
dies.
Criteria 3. Implications for future practice: Discussion that includes how your practice might
change and develop as a result of this learning. What professional behaviours may have made a
difference in this situation?
This case is of great importance to my professional nursing practice. Currently, I have
learnt plenty of things. Firstly, ignorance is disastrous in the nursing practice. It is not worth to
ignore any kind of information however insignificant it may seem. Also, I have realized the
importance of timely diagnosis. In this case, failure to make timely diagnosis led to the
deterioration of the patient’s condition. Thus, timely diagnosis shall guide my operations in the
hospital setting.
Also, I have realized the importance of timely preparation of diagnosis and treatment
equipment. In the case provided, nursing equipment are not placed in order. For instance, a
locum is not in the hospital setting. The patient’s condition deteriorates because of waiting for
a locum. Things could not be the same if the locum had arrived on time. Thus, as a
professional nurse, I shall ensure all the equipment necessary are timely placed in the hospital
setting.
Furthermore, the incidence has taught me the importance of clarification in the
workplace. On the same note, collaboration plays a significant role in the nursing practice. I
have realized the importance of seeking help from other professionals in case a situation is
worsening. This aspect is possible through effective communication (Slade et al., 2015). In the
case provided, the respondent is rigid on her decisions. Effective communications requires an
individual to be flexible and accept other peoples’ ideas where necessary.
Finally, this case has emphasized on the importance of promoting patient centered care.
As a professional nurse, I shall promote patient centered care in all aspects of treatment and
diagnosis (Australian Commission on Safety and Quality in Health Care, 2012). In the case
provided, the patient presented diarrhea. However, the respondent failed to handle the
condition because she did not employ patient centered care. Neither did she no diarrhea shall
lead to great dehydration which will adversely impact the patient’s condition.
Different professional behaviors would have made a difference in this case. For
instance, professional accountability would have made the manager and respondent competent
in their work setting hence saving the patient’s condition. Also, timely preparation would have
made the locum available thus saving the patient from deteriorating. Collaboration between the
respondent and the manager would have promoted creativity to save the patient from death

(Shneiderman, 2019). However, collaboration also calls for effective communication which is a
necessary behavior in the professional nursing practice. Finally, flexibility in the workplace
would have made the respondent to seek other option in the management of the patient’s
condition.

Reference List
Australian Commission on Safety and Quality in Health Care. (2012). National Safety and
quality health service standards. Australian Commission on Safety and Quality in
Health Care.
Harrison, W. D., Sargazi, N., Yin, Q., & Chandrasekar, C. R. (2016). Delayed diagnosis in primary care
—The main cause of sarcoma litigation in the United Kingdom. Journal of surgical
oncology, 113(4), 361-363.
Phillips, C., Hall, S., Pearce, C., Travaglia, J., de Lusignan, S., Love, T., & Kijakovic, M.
(2017). Improving quality through clinical governance in primary health care.
Shneiderman, B. (2019). Creativity and collaboration: Revisiting cybernetic serendipity. Proceedings of
the National Academy of Sciences, 116(6), 1837-1843.
Slade, D., Manidis, M., McGregor, J., Scheeres, H., Chandler, E., Stein-Parbury, J., ... &
Matthiessen, C. M. (2015). The context of communication in emergency departments.
In Communicating in Hospital Emergency Departments (pp. 25-54). Springer, Berlin,
Heidelberg.
Spigelman, A. D., & Rendalls, S. (2015). Clinical governance in Australia. Clinical
Governance: an International Journal, 20(2), 56-73.