Nursing Assignment: Registered Nurse Standards of Practice Analysis

This nursing assignment delves into the application of Registered Nurse Standards of Practice in various clinical scenarios, focusing on a student nurse's experiences. Part A analyzes three distinct situations: the documentation of vital signs, a case of a buddy nurse disregarding abnormal blood pressure readings, and a situation involving a patient's unreported headache and slurred speech. The analysis identifies the relevant nursing standards (including documentation, effective communication, collaboration, and advocacy) and their implications. Part B presents an essay discussing the student's role and responsibilities in a case where a buddy nurse's drug use led to patient negligence and a stroke. The essay highlights the importance of mandatory notifications to the Australian Health Practitioner Regulation Agency (AHPRA) and hospital management, emphasizing the threshold for notification, the process, and the potential consequences of not reporting. The essay also differentiates between mandatory notifications and mandatory reporting, explaining the legal obligations of registered health practitioners in ensuring patient safety and well-being. The assignment underscores the importance of ethical conduct, patient advocacy, and adherence to professional standards in nursing practice.

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

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Part A
Answer 1
The student on placement was asked to quantify the set of vital signs. After
completion, documentation of the findings need to be done accurately; thus, none of the
Nursing Standard of practice is applicable as they are developed for registered nurses.
However, if it requires to take that the scenario was predicated on registered nurses, the
standards that fall under the scenario includes Standard 1 states that the nursing professionals
need to maintain precise, timely and comprehensive documentation of the assessment and
thus, quantification of the vital signs is a component of it. Standard 4 involves
comprehensively conducting the assessment in a systematic manner that is verbally expressed
to be holistic and culturally felicitous manner. Verbalize the standards 4.1 can of the nursing
practice to be congruously applied in the given context of the scenario as it involves
conducting of the essential vitals designation of the patients that ascertain that the
environment utilized for quantification is opportune (Nursingmidwiferyboard.gov.au 2020).
With deference to precise documentation, Standards 5.3 withal fall under the provision of
nursing practice. As per the Nursing Standard 5.3, the registered nurse needs to document,
assess and modify the orchestration as per the scenario in order to achieve the concurred
outcomes for the patient. Even though in this scenario, the placement nurse was asked to
document the vital signs; thus, a component of this particular standard can be verbally
expressed to be applicable. From the review, it can be verbalized that the most felicitous
Nursing Standard of Practice for quantifying and documentation of vital signs is Standard 4.
Answer 2
The blood pressure of the patient was outside the normal range and thus, the students
informed it to the buddy nurse, where he says there is nothing to be worried as it was normal

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for the patient. On review, it was noticed that previously the blood pressure was in the normal
range. Thus, the student informs it to buddy where it was strictly stated that he know what he
was doing and thus, this need not be reported to anyone. The standards that fall under this
case was Standard 2.2, 2.8 and 2.9. In Standard 2.2, communication in an effective manner
need to be done to the concerned individual, in this case, the buddy nurses about the
condition of the patient so that he can take appropriate steps in order to mitigate the
concerning situation (Ossenberg, Mitchell and Henderson 2019). Standard 2.8 states that it is
important to participate in or lead in a collaborative practice that indicates that the students on
placement need to collaborate with the buddy nurse in all possible manner that will ultimately
lead to an improvement in health outcome of the patient. However, it was found that despite
the effort of the student, no appropriate actions were taken; as a result, it may lead to
deteriorating health condition. Even though it was stated that reporting upon this situation
should not be made but according to standard 2.9, it is important to report and notify conduct
of any healthcare professionals, staffs or others in case of any breach in taking actions that
would promote of health and wellbeing (Cashin et al. 2017).
Answer 3
The students go to the patient and sit with her where it was informed that she had a
headache and even after informing to the buddy hours ago, no pain relief was given. The
patient stated that she trusts the student because he spends time to know her and thus, she
feels that they can talk openly. However, she begins to have difficulty in talking as she was
having slurred speech. The standards that will fall under this provision were 2.1 and 2.2. As
per the standard 2.1, it is vital to establish, endure and conclude relationship in such a manner
that it differentiated the boundaries between personal and professional relations which were
effectively maintained in this case (Andersen et al. 2018). It was found that the student was
able to establish a therapeutic relationship with the patient; as a result, she was able to share

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her feeling in an open manner. Another standard that was found to be applicable in this case
was 2.2 that states communication with patient needs to be effective, respectful with respect
to dignity, culture, value, rights and belief of the patient. The student was able to respect the
dignity, communicated and cared for the patient in such a manner that helped in building a
trust factor between them, which can be useful in offering the nursing intervention to the
patient. Therefore, the importance of communication and interpersonal skills in order nursing
care to the patient is important and crucial for obtaining positive health outcomes (Barbosa
and Silva 2017).
Answer 4
The buddy nurse was approached for reporting about the headache, slurred words and
blood pressure. He says that to measure again. On measuring, it was found the blood pressure
was higher and pulse was dropping. A medical emergency was called and the patient was
treated for a stroke. Her plan was changed from being discharged to home to moving her to
ICU. The foremost standard that can be applied in this scenario was standard 2.9 that involve
reporting against the buddy nurse. A specific process is used for reporting or notifying the
authority of the hospital about any negligence that needs to be followed by the student
(Wholihan and Tilley 2016). Another Standard that was being taken into account, in this case,
was 2.5 where the student had advocated on behalf of the patient by respecting the autonomy
and legal capacity by reporting all the factors that were found to be deteriorating with time.
After the medical emergency and shifting of the patient to ICU, there is a change in nursing
plan; thus, standard 7.2 need to be applied that involves revision of the plan based on the
evaluation and 7.3 that involve determination, documentation and communication of change
in priorities, goals and outcome with the physician. This will help in better recovery and
adoption of the approach that involves safety and high quality of care.

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Part B: Essay
Mandatory notification falls under section 130 of the National law registered health
practitioners, as well as students, need to notify Ahpra of any events with seven days of
occurrence that involve issue related to the negative impact of patient safety and exposure to
harm (Nursingmidwiferyboard.gov.au 2020). With regard to the case of negligence of a
buddy nurse, it was found that he was using drugs and had used it during work hours that led
to serious complication upon the patient who had a stroke. The aim of the essay was to
discuss the role of the student on placement in this particular case and the responsibility that
need to be taken.
As a registered nurse, it was the responsibility to offer quality care to the patient,
monitor the vital signs in order to soothsay any negative or harm from time-to-time and
offering nursing intervention. It was evident from the case that the patient’s condition was
gradually deteriorating and despite apprising it, the registered nurse was reluctant in nature
and did not act upon it. This lead to a medical emergency where it was found that the patient
suffered from a stroke and the orchestration of discharge was transmuted to moving her to the
ICU. After the incident, it was notified by the buddy nurse to the student that he used drugs at
an extreme level that made him dismissive that leading to neglecting his obligations. Clancy,
Kelly and Loth (2019) opined that nurses with substance abuse have impaired judgment and
slow reaction time and thus, there is a compromise in the performance. It was found that
many healthcare professional are into substance abuse to a number of factors. Albeit the
nurse asked the student not to report, however, it was thought to solemn concern and if
unreported may be reiterated. Thus, it is important to mandatory notify the authorities of the
Australian Health Practitioner Regulatory Agency (AHPRA) and the hospital management in
a formal manner that is written document. Even though the mandatory notification has a

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threshold, it can be trigger it which need to be assessed prior to notification (Tricarico et al.
2017). In addition to this, the reporter needs to have a reasonable belief that the incident or
behavior had led to serious implication and caused harm or risk to the public or patient. From
the case, it was evident that the patient had suffered from a stroke because of the delay in
offering care to her by the nurse despite the fact that information related to deterioration was
available.
Mandatory notification and mandatory reporting are two variants of aspects in the
medical term. As verbally expressed by Spittal et al. (2016), a mandatory notification is an
earnest step of notifying the ascendancy to avert any harm to the public and need to be made
on adequate grounds. The guidelines that are covered under the National Law of making a
mandatory notification against registered practitioners and need to be done by a treating
practitioner, a non-treating practitioner or employers of practitioners. Others are not liable for
making a mandatory notification; however, they have the provision of making a voluntary
notification. The substructure predicated on which the notification can be made was
impairment, intoxication, a departure from standards and sexual malfeasance (Ahpra.gov.au
2020). The process of notification needs to be according to Ahpra guidelines and it is
consequential to make it within seven days of the occurrence of the event. On the other hand,
a mandatory reporting is a legislative requisite that is imposed on the culled group for
broadcasting suspected cases cognate to child abuse or neglect, elder abuse or notifiable
conduct by a practitioner to the ascendant entities. The threshold required for a mandatory
reporting is high in nature (Tonmyr et al. 2018). Thus, there are mandatory reporting laws
that have been enacted in parliaments in all the states and territories of Australia. According
to Rishoej et al. (2017), registered health practitioners have licit obligations in offering care
to the patient for promoting the health outcomes and actions that are taken that follows
negative outcome may result in licit implicative insinuations. The mediatory heralds are

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individuals that are responsible for distributing care to patients overall or partial manner and
thus, are obliged to meet the licit requisites. Therefore, the student on placement, healthcare
professionals that are registered under the NMBA can report the incident to the reporting
system.
The use of mandatory notification is used for protecting the public as well as the
health care services from any potential risks or harms. Since it is under the National Law and
has strict guideline associated with it, it is stated to be an important policy initiative that
involves public protection. From the case study, it was clear that the buddy nurse had
conducted notifiable conduct. As per the opinion of Raz (2017), notifiable conduct can be
referred as the situation where the practitioner had practiced the profession in an intoxicated
manner, engaged in sexual abuse or had placed the potential public at risk and may result in
impairment. As found the nurse intoxicated and if notified to the management and the nurse
was assessed, the evidence against him would be gathered and presented as evidence for
mandatory notification. In addition, the patient after her recover can be interrogated for
evidence as she was present at the incident and was conscious. The mandatory notification
will ensure that strict action was taken against the practitioner and in severe cases, may lead
to cancellation of his registration or license of nursing practice. Thus, it can be stated that it is
used for ensuring the public is being protected from harm.
It can be concluded by stating that the intoxication of drugs at working hours by the
buddy nurses lead to negligence and thus, the patient suffered from a stroke. In case, the
nurse had acted, the medical emergency can be avoided. Thus, it is the duty of care, stating
the student to notify using mandatory notification to the authority about the situation in order
to take action and guarantee the protection of the public from any such events. This will help
in student to gain practical experience of such emergency and would help in acting immediate
in case of arousal of a medical emergency.

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References
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mandatory notification. Retrieved 18 April 2020, from
https://www.ahpra.gov.au/Notifications/Raise-a-concern/Mandatory-
notifications.aspx
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Nursingmidwiferyboard.gov.au. 2020. Nursing and Midwifery Board of Australia -
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https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/
professional-standards/registered-nurse-standards-for-practice.aspx

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Nursingmidwiferyboard.gov.au. 2020. Nursing and Midwifery Board of Australia -
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Ossenberg, C., Mitchell, M., & Henderson, A. (2019). Adoption of new practice standards in
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Raz, M. (2017). Unintended consequences of expanded mandatory reporting
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Rishoej, R. M., Almarsdóttir, A. B., Christesen, H. T., Hallas, J., & Kjeldsen, L. J. (2017).
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Tonmyr, L., Mathews, B., Shields, M. E., Hovdestad, W. E., & Afifi, T. O. (2018). Does
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