Nursing Guidelines, Standards, Reflection, and Patient Care Analysis

This essay analyzes a nursing-related incident reported in the media, specifically the case of Sydney's grandmother who died due to a medication error. The essay delves into the role and responsibilities of nurses, emphasizing adherence to professional standards and ethical guidelines. It highlights the importance of critical thinking, clinical governance, and the application of evidence-based practices, referencing the Nursing and Midwifery Board of Australia (NMBA) and the National Safety and Quality Health Service (NSQHS) standards. The essay reflects on the incident using Rolfe's reflection model and suggests improvements in nursing practice to reduce the risk of similar errors, including enhanced medication safety protocols, comprehensive patient assessments, and the integration of critical reflection to bridge the gap between theory and practice. The author emphasizes the nurse's duty to provide precise, adequate, and appropriate information to patients and the need to establish professional standards such as honor, awareness, sympathy, honesty and honesty. The essay concludes with a call for improved clinical governance and the application of critical thinking to prevent future incidents and promote quality patient care.

Running Head: NURSING GUIDELINES
NURSING GUIDELINES
Name of the Student
Name of the University
Authors Note

Running Head: NURSING GUIDELINES
Nursing is an occupation of the health care segment that focuses on individual care,
families, and societies so that they may achieve, sustain, or recover optimal health and quality
of life. The essay focuses on the incident of Sydney’s grandmother who died because of lack
of nursing care in hospitals. Sydney’s grandmother was admitted in the hospital due to
vomiting, nausea, desiccation, angina and urinary tract infection (UTI). It was found that she
had a therapeutic history of high blood pressure and heart disease. The nurse who in charge
of her was 44 years old, named Mrs Lopez. She found out that the patient was unable to
swallow medicines so she thought to use intravenous mode to implement drug. Mrs Lopez
added three crushed oral tablets into IV-drip. This mistake made the patient experience a
major heart attack and she died. Many nurses deliver care by abiding the rules of physicians.
Nurses needs to implement care according to the patient’s diagnostics. The essay will also
highlight the role and responsibilities of a nurse and its effects on the patients. Reflection is
also carried out using Rolfe’s reflection model.
The consequences showed that there was a lack of clinical governance and there is no
integration of nursing standard such as critical thinking and analysis about the practice
(Bibby, 2015). A registered nurse makes use of various types of thinking strategies and
procedures and best evidences that are available for constructing decisions and ensuring and
providing quality nursing practice by using palliative care and evidence based frameworks.
There are various duties that a registered nurse performs (Daly, Speedy & Jackson, 2017).
Nurses responsibilities includes attending to the role of family, uses moral frameworks while
making decisions, maintaining accuracy, documentation, preparation that contributes to
improvement and relevant research (Kangasniemi, Pakkanen & Korhonen, 2015).
Nurses and midwives must be enrolled in the Nursing and Midwifery Board of
Australia (NMBA), and satisfy the NMBA's professional standards for practicing in
Australia. The code of ethics is mandatory for a nurse to be followed. The chief professional

Running Head: NURSING GUIDELINES
duty of a nurse is for patients demanding nursing care. During care, the nurse encourages a
situation where the rights, standards and spiritual principles of the patient, family and
community are valued (Nursing and Midwifery Board of Australia [NMBA- Standard 1],
2016). The nurse confirms that the patient obtains precise, adequate and appropriate
information for giving consent for treatment. The patient can share personal information with
the nurse that the nurse needs to keep it confidential. The nurse takes the charge for
implementing interventions to fulfil the well-being and social requirements of the patient
(Dang & Dearholt, 2017). The nurse should establish professional standards such as honour,
awareness, sympathy, honesty and honesty (Nursing and Midwifery Board of Australia
[NMBA], 2018). The code of conduct focuses to educate the nurses and midwives in the
supply of nursing care and maintain their professional conduct (Savage, 2015). Nurses help
the NMBA to safeguard the public, in acquiring and preserving the standards maintained in
the code and ensures non-violent and operative nursing approach. The nurse should evaluate
the patient’s condition and implement measures accordingly (ICN, 2012). If expert behaviour
varies enormously from the standards within the code, the nurses must be ready to elucidate
and defend their decisions in a correct way (Australian Commission on Safety and Quality in
Health Care [ACSQHC, standard 4], 2017). Serious detention to abide by this code may have
adverse penalties for the registration of the nurses in the Nursing Board of Australia and may
be considered as unacceptable professional presentation, professional misconduct in the
Australian health system (Nursing and Midwifery Board of Australia, 2016). These includes
the administration, rules, and regulation development by health services in nursing education,
that is required in management and for the supervision of midwives, nurses and students
(Cloete, 2015). The Registered nurse values for exercise consists of seven different standards
that includes critical thinking and analysis of nursing exercise, appealing in beneficial and
professional situations, continuing the ability for practicing nursing, systematically conducts

Running Head: NURSING GUIDELINES
assessments and plans, develops schedule and programs for nursing exercise, ensures non-
violent, suitable and reactive superiority in nursing exercise, assesses outcome for the nursing
practice. The nurse should consult with the practitioners before administering any medicine
(Patton & Lewallen, 2015).
The aim of the Medication Safety Standard is to safeguard that the clinicians
recommend, distribute and manage suitable medications, and evaluate its use. It also purposes
to safeguard that customers are well educated about medications and recognize their own
medicine requirements and needs and the risks of their consent (White, Dudley-Brown &
Terhaar, 2016). The criteria for nursing standards are medical governance and quality
improvement and its establishment to enhance medication management, collecting patient
information, continuousness of medication management and its processing (Karttunen,
Sneck, Jokelainen & Elo, 2019).
Nursing is a profession that has many responsibilities towards the society and the
population comprises of patients, health care workers and the community people. I was
feeling dissatisfied because of the decision of the nurse toward the care of the elderly
grandmother. The nurse administered the oral medications tablets into a syringe, and it causes
the death of an elderly grandmother. The action was inappropriate, and in my opinion the
nurse required to consult with others and had not followed the standards (Rolfe, Freshwater
& Jasper, 2001). It was also not the best practice as she did not consider the consequences of
the medication. The nurse may have been thinking that the intravenous medication might
work while it was difficult for the patient to swallow the tablets, however, the process failed.
My opinion is that medication practices should be under the governance of the clinical
system, and there should be critical philosophy and investigation of the influence and
consequences of the actions.

Running Head: NURSING GUIDELINES
Nurses improve the care plan, work in partnership with GPs, counsellors, the patient,
and the family of the patient that focuses on treatment of illness to improve quality of life.
Nurses provide care with GPs and as nurture professionals. Critical reflection can help to
uncover the issues and learning, whereas the further occurrence of incidents can be
prevented. Therefore, critical reflections can help the nurses to bridge the gap of theory and
practice, whereas more aligned care can be fostered.

Running Head: NURSING GUIDELINES
References
Australian Commission on Safety and Quality in Health Care (2017). National Safety and
Quality Health Service Standards (Medication Safety standard No. 4, p.29-31, 2nd
Ed.). Retrieved From:
https://www.safetyandquality.gov.au/sites/default/files/migrated/National-Safety-and-
Quality-Health-Service-Standards-second-edition.pdf.
Australian Commission on Safety and Quality in Health Care (2019). National Safety and
Quality Health Service Standards (Comprehensive Care Standard No. 5). Retrieved
From:
https://www.safetyandquality.gov.au/standards/nsqhs-standards/comprehensive-care-
standard.
Bibby, P. (2015, February 22). Sydney grandmother who died after nurse's error was already
'at death's door', court hears. The Sydney Morning Herald. Retrieved From:
https://www.smh.com.au/national/sydney-grandmother-who-died-after-nurses-error-
was-already-at-deaths-door-court-hears-20150222-13lim1.html.
Cashin, A., Heartfield, M., Bryce, J., Devey, L., Buckley, T., Cox, D., ... & Fisher, M. (2017).
Standards for practice for registered nurses in Australia. Collegian, 24(3), 255-266.
Retrieved from: https://doi.org/10.1016/j.colegn.2016.03.002
Cloete, L. (2015). Reducing medication errors in nursing practice. Cancer Nursing
Practice, 14(1).
Daly, J., Speedy, S., & Jackson, D. (2017). Contexts of nursing: An introduction. Elsevier
Health Sciences. Retrieved From: https://books.google.co.in/books?

Running Head: NURSING GUIDELINES
id=xmclDwAAQBAJ&printsec=frontcover&source=gbs_ge_summary_r&redir_esc=
y#v=onepage&q&f=false
Dang, D., & Dearholt, S. L. (2017). Johns Hopkins nursing evidence-based practice: Model
and guidelines. Sigma Theta Tau. Retrieved From:
https://journals.lww.com/neponline/Citation/2008/07000/Johns_Hopkins_Nursing_Ev
idence_Based_Practice.20.aspx
Grace, P. J. (Ed.). (2017). Nursing ethics and professional responsibility in advanced
practice. Jones & Bartlett Learning. Retrieved From:
https://doi.org/10.1111/nup.12207
ICN, (2012). ICN Code of ethics. Retrieved From:
https://www.icn.ch/sites/default/files/inline-files/2012_ICN_Codeofethicsfornurses_
%20eng.pdf#targetText=The%20nurse%20takes%20appropriate%20action,workers
%20to%20advance%20ethical%20conduct.&targetText=The%20ICN%20Code
%20of%20Ethics,on%20social%20values%20and%20needs.&targetText=To
%20achieve%20its%20purpose%20the,all%20aspects%20of%20their%20work.
Kangasniemi, M., Pakkanen, P., & Korhonen, A. (2015). Professional ethics in nursing: an
integrative review. Journal of advanced nursing, 71(8), 1744-1757. Retrieved From:
https://doi.org/10.1111/jan.12619
Karttunen, M., Sneck, S., Jokelainen, J., & Elo, S. (2019). Nurses’ self‐assessments of
adherence to guidelines on safe medication preparation and administration in long‐
term elderly care. Scandinavian journal of caring sciences. Retrieved From:
https://doi.org/10.1111/scs.12712

Running Head: NURSING GUIDELINES
Nursing and Midwifery Board of Australia, (2016). Registered nurse standards for practice.
Retrieved From: https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-
Statements/Professional-standards/registered-nurse-standards-for-practice.aspx.
Standard-1
Nursing and Midwifery Board of Australia, (2018). Code of conduct for registered nurse.
Retrieved From: http://www.nursingmidwiferyboard.gov.au/documents/default.aspx?
record=WD17%2F23850&dbid=AP&chksum=L8j874hp3DTlC1Sj4klHag%3D%3D.
Patton, C. W., & Lewallen, L. P. (2015). Legal issues in clinical nursing education. Nurse
educator, 40(3), 124-128. Retrieved From:
https://doi.org/10.1097/NNE.0000000000000122
Rolfe, G., Freshwater, D., & Jasper, M. (2001). Critical reflection in nursing and the helping
professions: A user’s guide. Basingstoke, England: Palgrave Macmillan. Retrieved
From: https://philpapers.org/rec/ROLCRF
Savage, P. (2015). Legal issues for nursing students (3rd Ed). Sydney, Australia: Pearson
White, K. M., Dudley-Brown, S., & Terhaar, M. F. (Eds.). (2016). Translation of evidence
into nursing and health care. Springer Publishing Company. Retrieved from:
http://lghttp.48653.nexcesscdn.net/80223CF/springer-static/media/samplechapters/
9780826106155/9780826106155_chapter.pdf