University Nursing Case Study: Professionalism in Action, NURS2002

This case study analyzes an incident involving a nursing student, Caitlyn, and her interactions with patients, specifically Mrs. Giannopoulos. The analysis focuses on breaches of nursing professionalism, including violations of patient autonomy, informed consent, and cultural safety. The student's actions, such as administering medication without consent and failing to consider the patient's cultural and linguistic needs, are examined against the standards of the Nursing and Midwifery Board of Australia (NMBA). The paper highlights the importance of adhering to ethical and legal principles, obtaining consent, and providing culturally competent care. Recommendations for improvement include obtaining consent, following the ABCD framework for cultural assessment, and adhering to NMBA standards to ensure patient safety and ethical practice. The student emphasizes the need for respectful communication, therapeutic relationships, and comprehensive assessments based on patients' cultural identities, and the implications of these actions are discussed to provide valuable insights into professional nursing practice.

Running head: NURSING PROFESSIONALISM IN ACTION
NURSING PROFESSIONALISM IN ACTION
Name of the Student:
Name of the University:
Author note:

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Introduction
In addition to the maintenance of patient care, safety and hygiene protocols, nurses are
obliged to deliver clinical interventions which are compliant to the ethical, legal and moral needs
of the patient and the organization (Suhonen et al., 2018, p. 35). With respect to the above, the
aim of this paper is to expound upon the key aspects of the given incident which are specifically
associated with nursing professionalism, that is, law and ethics as well as cultural safety.
Incident 1
One of the first areas of nursing professionalism which were found to be breached with
regards to given case study, is an absence of nursing adherence to the principles of laws and
ethics relevant to clinical practice. As postulated by Atkins et al., (2020, p. 156), nurses are
required to comply with the ethical needs of patient autonomy. Patient autonomy is the ethical
practice which is characterized by respecting the rights of patients to engage in self-governance
and have the liberty to refuse or communicate a disinterest towards treatment compliance based
on his or her healthcare needs and personal preferences (Jacobs, 2019, p. 1645). In case of the
incident, it can be observed that nurse Caitlyn paid no heed to the fact that Mrs Giannopoulos did
not wish to consume the Paracetamol medication and was rather forced to engage in the same by
her daughter. Additionally, Atkins et al., (2020, p. 165), postulates the need to obtain consent
from the patient as a key prerequisite of ensuring nursing adherence to patient autonomy.
Informed consent implies the need to procure permission from the patient before administering
any form of medications or clinical intervention (Finch, 2020, p. 50). Further according to Atkins
et al., (2020, p. 164) a patient’s ability and sense of capacity to either give or withdraw consent is
legally assumed by common law in Australia. In case of the incident, it can be observed that
nurse Caitlyin met no attempts to obtain any form of consent from Mrs. Giannopoulos, thus

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demonstrating a breach of common law as well as a violation of nursing ethical standards of
patient autonomy and consent. Caitlyn can also be found to violate Standard 1 of the NMBA
(2016), which directs nurses to engage in critical thinking and practice which is evidence based.
Administration of medication by a non-health professional, in this case Mrs Giannopoulos’s
daughter, is a violation of such professional standards of nursing laws and ethics by Catlyin
(Roughead, Semple & Rosenfeld, 2016, p. 115, NMBA, 2016, p. 3).
Thus, for the purpose of counteracting the identified breach, the key action which nurse
Caitlyn is recommended to undertake is to obtain consent from Mrs Giannopoulos based on
Atkins et al., (2020, p. 165), recommendations on ‘Consent Recommendations’. Thus with
respect to the same, considering that a minor nursing action of medication administration has to
be implemented, nurse Caitlyn must obtain from permission Mrs Giannopoulos regarding the
intake of Paracetamol medication. Additionally, nurse Caitlyn can also obtain consent from the
patient’s legal guardian or any substitute family member engaging in decision making, in this
case, Mrs Giannopoulos’s daughter. Lastly, as an additional action it is advisable that nurse
Caitlyn adheres to professional standard 1.4 of the NMBA (2016, p. 3) for her future nursing
practice. This is because this standard directs nurses to respect patient’s rights and demonstrate
compliance to policies, standards and laws relevant to clinical nursing practice. Referring to the
same, nurse Caitlyn should thus follow nursing professional laws and ethics and administer the
medication by herself.
Incidence 2
In addition to the above, the next area of nursing which can be observed to have been
breached with regards to the given case study is a violation of the nursing need to deliver
culturally safe as well as culturally competent nursing practice. According to Stein-Parbury

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(2012, p. 165), the nursing practice of ‘cultural competence’ is characterized by the ability and
need of healthcare professionals to respect an individual’s diverse personal characteristics with
respect to cultural identity as well as influence of culture on his or her lifestyle. Additionally, the
NMBA (2016, p. 3), professional standards 1 and 2, guides nursing obligation on the need to
communicate, build therapeutic relationships and comprehensive assess the needs of a patient
based on his or her unique cultural identity and preferences. When compared to the case study, it
can be observed that nurse Caitlyn overlooked the need to introduce herself, her interventions as
well as educate Mrs Giannopoulos on the importance of the medication which she is
administering, via consideration of her diverse linguistic needs. Additionally, she also did not
seek to comprehensively conduct an assessment of healthcare needs of Mrs Giannopoulos which
are associated with her unique cultural identity (Repo et al., 2017, p. 100). Such actions thus
demonstrate the violation of the professional nursing standards established by NMBA (2016, p.
3), by nurse Caitlyn. It can further be observed that nurse Caitlyn did not revert to the services of
language interpreter considering that Mrs Giannopoulos knows limited English. It is worthwhile
to note that pain assessments – a condition suffered by Mrs Giannopoulos – include
comprehensive assessments like the PQRST tool. Administration of the same without a language
interpret would yield the likelihood of errors for Mrs Giannopoulos and raises disregard of the
adherence to culturally competent services for linguistically diverse patients (Western Australia
Government, 2017, p. 37).
Thus, for the purpose of rectifying the breach, a key action which can be implemented by
nurse Caitlyn is the adherence to the ABCD framework as a prerequisite for cultural assessment
prior to the determination of key clinical interventions to the implement. The ABCD framework
assists nurses in assessing the influence of culture on the concerned patient’s healthcare needs

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and personal preferences (Greenawalt & Hawkins, 2019, p. 593). As per the ABCD framework,
it is recommended that nurse Caitlyn to first assess influence of culture on attitudes concerning
illness meaning, diagnosis and dying held by Mrs. Giannopoulos and her daughter. This must
then be followed by nurse Caitlyn inquiring about the healthcare beliefs and influence of political
context upon Mrs. Giannopoulos and her daughter as well as implement nursing interventions
based on the culturally diverse decision making style held by them (Gould, Bittoun & Clarke,
2016, p. 104).
An additional key action which nurse Caitlyn must implement to rectify the breach is to
demonstrate adherence to NMBA (2016, p.3) standards of 1 and 2, during her future nursing
practice. There is also a need for the concerned healthcare organization to adhere to standard 1.4
of the National Safety and Quality Health Service Standards (Australian Commission on Safety
and Quality in Health Care, 2017, p. 6), which direct organizations to develop policies and
procedures of cultural competence, by making arrangements and directing nurses like Caitlyn on
the compulsory need for inclusion of language interpreter. This is required since in addition to
nurse Caitlyn, even team leader Adam seemed to pay no heed to the need to consider Mrs
Giannopoulos’s culture when responding to Caitlyn’s queries.
Conclusion
I will firstly adhere to the ‘Consent Requirements’ suggested by Atkins et al., (2020, p.
165). Based on the same, I will ensure to obtain consent prior to administration of any nursing
action, either from the patient, or his or her legal guardian or his or her substitute decision-
maker. This exercise has also provided me key insights concerning the fact that I must remember
to not just respect all patients irrespective of their cultures, but must also ensure to deliver
empathetic and compassionate interpersonal communication and therapeutic relationships based

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on the unique cultural, racial, ethical and spiritual identity of the patient. Integrating nursing
professional standards 1 and 2, by the NMBA (2016, p. 3) within my future nursing practice will
prove to be useful since they direct nurses on the need to therapeutically communicate and
comprehensively assess patient needs based on their cultural identity.

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