Analysis of Nursing Standards and Mandatory Notifications

This assignment delves into the Registered Nurse (RN) standards of practice and mandatory notifications, crucial for ethical and safe healthcare delivery. Part A examines how specific standards apply to scenarios involving patient assessment, documentation, and error reporting, emphasizing the importance of accurate vital sign assessment, timely documentation, and the consequences of failing to report critical information. The analysis references the Nursing and Midwifery Board of Australia (NMBA) standards, the International Council of Nurses (ICN) code of ethics, and the development of therapeutic relationships through effective communication. Part B addresses the student nurse's responsibilities regarding mandatory notifications, particularly in situations involving a colleague's substance abuse and its potential impact on patient care. It outlines the student's duty of care, the role of counseling and education, and the circumstances under which mandatory reporting to the Australian Health Practitioner Regulation Agency (AHPRA) becomes necessary. The assignment underscores the importance of RNs in promoting practice improvement, patient safety, and the overall quality of care within healthcare settings, referencing relevant guidelines and research to support the analysis.

Running head: NURSING
Nursing
Name of the Student
Name of the University
Author Note

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Part A
The standards of practice that falls under this standard 1.6 of registered nurse
standards of practice as proposed by Nursing and Midwifery Board of Australia (NMBA)
(2016). According to this standard, it is the duty of the registered nurse (RN) to maintain
accurate, timely yet comprehensive documentation of the assessments followed by planning,
proper decision-making, followed by actions and evaluation. Akhu‐Zaheya, Al‐Maaitah and
Bany Hani (2018). stated that proper documentation of the patients’ healthcare details help in
avoiding the chances of the practice related errors. The assessment of the vital signs of the
patients falls under the standard 4 of NMBA (2016) RN standards of practice. According to
this standard, it is the duty of the nursing professional to conduct comprehensive yet
systematic assessment of health. This assessment must be done in a holistic yet culturally
competent manner. 4.2 states that it is the duty of RN to make use of arrange of assessment
techniques in order to collect accurate information and at the same time work in partnership
with other nursing professionals and allied healthcare professionals to determine the priorities
of care. Cardona-Morrell et al. (2016) highlighted upon admission of the patient under the
hospital settings or in the out-patient department, it is the duty of the nursing professionals to
conduct a detailed assessment of the vital signs of the patients. Proper assessment of the vital
signs of the patients help in the easy identification of the health priority and thereby helping
to design person-centred care plan and followed by identification of other health assessment.
Reporting error in practice falls under standard 6 of RN professional standards of
practice (NMBA, 2016). According to this standard of practice, it is the duty of the nursing
professional to provide safe, appropriate and responsive care to the patient. According to 6.6,
it is the duty of RN to employ appropriate process for the identification of errors and gaps in
practice while reporting the potential and actual risk related system issues and where the
practice might remain below the expected standards. In the mentioned case study, it was
highlighted that even though blood pressure of the patient was outside the normal range, the
buddy nurses said not to worry as it is normal for the patient. However, the previous blood
pressure record of the patient was within the normal range post admission. Upon reporting
the same to the buddy, they stated not to report to anyone. Not reporting to any one and
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continuing the same treatment might endanger the life of the patient and thus violation of the
ICN code of ethics. According to the International Council of Nurses (2012) or gICN code of
ethics, it is the duty of the nursing profession to overall health of the patient while preventing
illness. Rutledge, Retrosi and Ostrowski (2018) there are several barriers towards reporting
errors in practice and this include fear from getting bullied by the subordinate nurses, time
consuming nature of the reporting process and associated fear of repercussions.
According to the scenario, the patient is feeling secured and she also reports that she
has trust over nurse as she spends time with her in order to know her concerns. Here the RN
has executed the use of the effective communication in order to develop therapeutic nursing
and thus helping to generate the level of trust with then patient. The effective communication
skills include both verbal and non-verbal communication skills. Under verbal communication
skills, there occurs proper articulation of words (pronunciation) and use of proper vocabulary
in order to make it easier for the people to understand. Under non-verbal communication
skills, there are active listening, maintaining eye contact while talking or listening and
showing empathy to the patient. These help in the generation of emotional connection with
the patient and thereby help in the development of trust (Kim & Han, 2016). Development of
therapeutic relationships falls under the standard 2 of RN nursing professional standards of
practice. According to this standard, it is the duty of the RN to engage in therapeutic
relationships with the patient. Therapeutic relationships mainly involves use of effective
communication while giving proper respect to the dignity of the person’s culture, values,
rights and beliefs (2.2).
The buddy nurse has promised pain relief hours ago but has failed to provide the
same. This has lead to the violation of the nursing practice standard 6.1. According to this
standard, it is the duty of the nurse to provide safe and quality practice in order to achieve
goals and outcomes that are responsible to the nursing needs of the healthcare service users.
The standard of RN that coincided with this scope of practice is standard 5. According
to this standard, it is the duty of the nurses to develop proper nursing plan based on the
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clinical priority. It is the duty of the nursing professional to use proper assessment data and
best available evidences in order to develop the care plan. However, in this case study when
the buddy nurse was reported that patient is having headache, high blood pressure and slurred
words, he told to record the signs again. Upon recording the vital signs, it was found that
patient was having high blood pressure with deceased pulse rate. Thus indicates there is a gap
in the development of nursing care plan based on the clinical priority. 5.2 states that it is the
duty of the nurses to collaboratively develop nursing care plan in order to facilitate agreed
outcomes. However, there is a gap in collaboration between the nurse and senior or the buddy
nurse. The scope of the nurse practice (5.3), it is the duty of the nurses to document, evaluates
and subsequently modifies the plan in order to facilitate agreed outcomes (NMBA, 2016).
Here the modification of the patient’s care plan was observed upon witnessing deterioration
of the patients’ vital parameters. Patient was about to get discharged, but she was moved to
the ICU units as she encountered stroke. Tepper, Taneja and King (2019) reported that nurses
must act as per the health condition of the patient and change in the care plan must be done
based on the health status f the patients and this further increases the scope of generation of
patient centred care plan.
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Part B
As a student registered nurse, I am not entitled to conduct mandatory notification. According
to the Nursing and Midwifery Board Ahpra (2020), nursing students who are registered under
the National Law are not required to make mandatory notifications (complaint or concern). A
complaint or concern can only be raised about an impaired student. However, as a student, I
have certain duty of care. Under my duty of care, I would educate my buddy that is not safe
(both for him and for the patient) to participate in why while under intoxication state. It is due
to his intoxicated state and dismissive attitude that the patient’s condition went serious. Even
if the report (mandatory reporting), he might lose trust over me. The buddy said that he feels
that he trusts me and that is why, he has disclosed his concerns to me. Proper education about
the ill effects of substance abuse and intoxication will motivate him to overcome the same
and to indulge into healthy practice settings. However, being a RN himself, he is quite aware
about the ill-effects of substance abuse and thus my duty would be making him aware of the
same once again. Hagemeier et al. (2016) stated that the use of the effective communication
and skills is a useful tool for the conduction of the counselling. Counselling, motivation and
support done with the help of the effective communication skills will help to understand the
underlying mental health complications through which my buddy nurse is passing through
and thereby helping to understand the actual mental alignment promoting drug abuse and thus
helping to design patient centred care plan. However, even after counselling and self
awareness, buddy nurse fails to refrains him from substance abuse then the senior nursing
professionals or the other high member of the hospital administrated board must be reported
(mandatory reporting).
According to the Nursing and the Midwifery Board of New South Wales (NSW),
(2020), the all registered health-practitioners have a professional yet ethical obligation for
protecting and promoting the health and safety in healthcare. The healthcare professionals
and their employers along with other healthcare -related education providers are entitled to
execute the responsibility of mandatory reporting under the Health Practitioner Regulation
National Law. Healthcare professionals, the education providers and their employers must
inform the Australian Health Practitioner Regulation Agency (AHPRA) if they have formed
any significant yet notifiable belief that said practitioner have behaved in a way that is
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constituted as a notifiable conduct. The notifiable conduct by the registered healthcare
professionals include: practising while under intoxication of drugs and alcohol; commitment
of sexual mis-conduct under the practice settings; placing the public at a risk of significant
yet fatal harm due to impaired health status. The mandatory notification also covers the
issues associated with placing the public at risk due to significant departure from the
acceptance of the prevailing practice standards. On 1st March 2020, revised guidelines for
mandatory notification came into effect and thus helping to establish new yet higher
threshold for proper treatment of the practitioners who were reported for committing
misconduct that significantly departs from the accepted practice standards 9 Nursing and the
Midwifery Board of New South Wales (NSW), 2020). There are separated guidelines for
mandatory notifications for the registered students and the registered nurses. Mandatory
reporting is a term that is used to described the legislative requirements that are been
imposed over selected classes of people in order to report the suspected cases of child abuse
or to other suspected cases of elder abuse and other “notifiable conduct” by the other
practitioner towards the government authorities (Nursing and Midwifery Board Ahpra,
2020)..
Mandatory notification thus means notifying the person who is committing the
misconduct such that improvement in the care plan must be undertaken. On the other hand,
mandatory reporting deals with reporting the deed or other mis-conduct to the higher
authority so that necessary actions can be taken and thus helping to improve the overall
quality of care. Reporting against child abuse both physical and sexual and mental falls under
the category of mandatory reporting and now under the mandatory notifications. Mandatory
notification mainly deals with the practice improvement of the nursing professionals by
reporting their mis-conduct while mandatory reporting mainly deals with the reporting of the
misconduct towards the patients or other injustice that is occurring towards the patients
especially children during the process of care or under the in-patient healthcare settings
(Nursing and Midwifery Board Ahpra, 2020).
Yes. mandatory notifications might help to protect the public and other healthcare
services. The promotion of the mandatory notification helps in increasing the overall quality
of care and increase the provision for the practice development. According to the NMBA
(2016) standard 1 for RN (2016), it is the duty of the nursing professional to promote practice
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improvement under the healthcare settings. Einboden, Rudge and Varcoe (2019) the nursing
professionals are in a well position for contributing improvement in the overall quality of care
and practice settings with the help of the mandatory reporting. Nurses’ relational approaches
are important in order to gain proper access to the private sphere of both the families of the
healthcare service users and the mental thought process of other nursing professionals. This
help to monitor and to investigate the situation and thereby helping in the implementations of
proper interventions in order to overcome the healthcare settings. Mandatory notification is
one of the possible mechanisms that are largely over-looked however, the nursing
professionals play a significant role in improving the overall public health approaches
through mandatory reporting. Regan, Effler, Thomson and Mak (2019) stated that mandatory
notification also help in improving the level of awareness among the RN nurses and thus
helping them to abide by the practice standards in nursing.
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References
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https://doi.org/10.1111/jocn.14097
Cardona-Morrell, M., Prgomet, M., Lake, R., Nicholson, M., Harrison, R., Long, J., ... &
Hillman, K. (2016). Vital signs monitoring and nurse–patient interaction: A
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Hagemeier, N. E., Tudiver, F., Brewster, S., Hagy, E. J., Hagaman, A., & Pack, R. P. (2016).
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pharmacist perceptions and behaviors. Research in social and administrative
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