Effective Team Working and Communication: A Case Study Analysis Report

This report presents a comprehensive analysis of the case of Dental Board of Australia v Karen Fazey, focusing on issues of effective team working and communication within a healthcare setting. The report examines the professional misconduct of Ms. Fazey, highlighting her failure to adhere to professional standards, including performing procedures beyond her scope of practice, and administering treatments without proper patient screening. It explores the factors contributing to these failures, such as potential work environment pressures, lack of continuous training, and conflicts within the workplace. The report further discusses the importance of evidence-based practice (EBP) and how its application could have mitigated the adverse outcomes in this case. It emphasizes the crucial role of nurses in maintaining patient safety by operating within established ethical codes and professional guidelines, as set by regulatory bodies like the NMBA and Dental Board of Australia. The analysis underscores the consequences of professional misconduct and the significance of effective communication and teamwork in delivering quality patient care.

Effective Team Working and Communication
EFFECTIVE TEAM WORKING AND COMMUNICATION
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Effective Team Working and Communication
Introduction
Patient safety is one of the compelling reasons why nurses are registered to practice in their
career. Registered nursing practitioners have to comply with rules and obligations pertaining to
their profession as well as applying proper reasoning to maximize patient safety and maximize
the delivery of care to patients. There are, however, cases where registered nurses fail to comply
with the regulations in place and this leads to adverse effects on patients as well as on their
career. Birks, Davis, Smithson, and Cant (2016) explain that nursing profession is one of the
highly regulated professions in Australia. The reason for regulation is to maximize professional
standards while at the same time maximizing quality service delivery and safety of patients
handled by nurses. The National Midwifery Board of Australia (NMBA) plays the role of
investigating and enforcing disciplinary measures against registered nurses who fail to comply
with their professional standards (Cashin et al., 2017). This paper reviews the case of Dental
Board of Australia v Karen Fazey.
Case Overview
Ms. Fazey treated patients beyond her scope of practice and administered patients without
screening her patients. She was supposed to provide dental services on children and adults, but
went ahead to carry out dental surgeries, which were beyond her scope of registration and
practice. She contributed to the early failure of the medicine prescribed due to lack of examining
or screening her patients before prescription. The Dental Board of Australia suspended Ms.
Fazey, cancelled her registration, suspended her service for three years, fined $3000, and asked
to pay the board a total of $5000.
Omissions that Contributed to the Case

Effective Team Working and Communication
According to the Dental Board of Australia (2016), Ms. Fazey was a registered nurse between
2007 and 2014 where she worked as a school nurse at Port Kennedy and Naroddin Primary
school. Ms. Fazey was a registered nurse and was supposed to treat children and adults during
her tenure as a nurse. However, she is reported to have treated thirteen patients without any
initial screen or examinations of the patients before treating them. Ms. Fazey is also reported to
have performed two oral surgical treatments on two patients while aware that she had not taken
any education in the field of dental surgery. The Dental Board of Australia (2014) has set the
scope of professional practice for all physicians working in the country. Additionally, Ms. Fazey
is also reported to have undertaken eighteen extensive treatments without consulting a dental
officer and also ignored the instructions given by the dental officer. The board found that Ms.
Fazey’s treatment plans were substantially below the set standards and translated to adverse
effects on treatment of patients she handled.
Several factors contributed to this case. First, the registered nurse did not conduct proper
screening of her patient before treating them. This is against the professional code of practice and
standards. According to Nursing Midwifery Board of Australia (NMBA) (2019), nurses are
required to practice in accordance to established code of practice when dealing with patients.
Proper screening of the patient and examination before prescribing medication is one of these
mandatory requirements. Nurses are also supposed to consult their seniors whenever they are in
doubt. Ms. Fazey did not take these requirements into consideration. She, instead, decided to act
on assumptions without prioritizing the health of her patients. This is a professional misconduct
as it placed the health of her clients at risk.
NMBA (2019) has also set standards for all nurses regarding their scope of practice. The
standards also reflect those of Dental Board of Australia. According to the case, Ms, Fazey

Effective Team Working and Communication
practiced beyond her scope when she performed surgeries on two patients even when she was
aware that it was beyond her scope of practice. This is against the Dental Board of Australia’s
regulations and attracts disciplinary measures that affect the nurse’s profession. Additionally, all
nurses are required to make person-centered approaches when managing patients. They are
supposed to support patients in accordance to the human values that support the welfare of the
patient. Ms. Fayez failed to provide person-centered approach when she treated her patients even
without screening them.
One of the important roles of a nurse is to make decisions on treatments and medications
to administer to patients. According to Dental Board of Australia (2019), the decisions that
nurses make have to be within their scope of training and qualifications. Ms. Fazey knew her
scope of practice, but failed to adhere to the scope of practice. It is important to take into
consideration some of the factors that may have contributed to Ms. Facey’s case can help
understand the impact of weaknesses in the healthcare sector and the transfer of adverse impacts
to the patient.
Other Factors that Contributed to this Case
While it is true that Ms. Fazey carried out responsibilities beyond her scope, it is
necessary to consider some of the factors that could have made her to provide medications
without screening. The healthcare sector in Australia has suffered the adverse impact of
registered nurses in the recent past, and the problem is still persistent. According to Woods and
Murfet (2015), the higher ratio of patients to nurses in healthcare setting has caused many
patients to strive in providing healthcare services. Ms. Fazey may have been working under
pressure while dealing with a higher number of patients, making it impossible for her to follow
all the relevant procedure required for her profession. While it is true that this should not be an

Effective Team Working and Communication
excuse for unprofessional conduct, sometimes nurses work in stressing environments and they
may be touched by pity when they see patients suffering. When this happens, they may think that
they are intervening to help the patient but they are working against their codes of practice.
Another issue that may have caused Ms. Fazey to administer treatment beyond her scope
may be due to greed for money. She may have seen that the patients were ready to pay for the
service but there was no qualified professional to administer the service. Regarding the dental
surgery she carried out, she may have failed to understand the scope of her practice and thought
that she was qualified to carry out all dentistry. This may be due to lack of proper training or
continues training on her qualifications. One could expect that if she had understood her scope of
practice, she may not have carried out dental surgeries when she knew that it was beyond her
scope of training.
Lack of continuous training may have also contributed to Ms. Fazey’’s mistake of
administering treatments without proper screening. Nurses are required to stay informed of their
roles and responsibilities. They need time to reflect on professional codes of conduct. They also
need time to study and research in best interventions in practice (Malik, McKennal, & Plummer,
2016). When working in busy and tight schedules, they hardly find time to reflect on what they
have learned. This creates high chances of operating on assumptions because the nurse has not
found time to go through the professional codes guiding her professional (Bach-Mortensen,
Lange, &Montgomery, 2018). It is important at this level to emphasize that this should not be an
excuse for professional misconduct because professional values should take precedence over
everything else. As a result, Ms. Fayez still takes responsibility for her misconduct.
Nevertheless, other people in Ms. Fazey’s department may also have contributed to this
case. Nurses experience conflicts in their profession just like any other profession that brings

Effective Team Working and Communication
people of diverse cultures together. The major adverse impact of conflicts is that they transfer the
costs to the patients, especially when workers fail to collaborate. Ms. Fazey may have had
personal differences with the dental officer. This could have made her to neglect the instructions.
Similarly, Ms. Fazey may have issues with her co-workers that may have forced her to fail to act
as a team player in her work environment.
Evidence Based Medicine and how the Nurse could have Used it
Evidence based practice (EBP), or evidence based medicine (EBM) has been considered
one of the best practices to help treat and manage diseases in the healthcare sector. Registered
nurses apply knowledge from research practices with the goal of providing the best and efficient
interventions in treating and managing diseases. Black, Balneaves, Garossino, Puyat, and Qian
(2014) define EBP or EBM as the best available information that can be used to answer the
question in clinical practice. The information mainly comes from peer reviewed research work
that has been reviewed and assessed by professionals. Reid, Briggs, Carlisle, Scott, and Lewi
(2017) further explain that evidence based knowledge relies on the latest available knowledge in
clinical setting to help make informed decision about a problem. For nurses to apply evidence,
they have to appraise the research resource to determine the efficiency of the information. Their
main role is to translate research findings into practice (Curtis, Fry, Shaban, & Considine, 2016).
The case of Ms. Fazey could have been solved if she had applied proper knowledge of
evidence based practice. Some of her mistakes may have been corrected if she had applied EBP
after realizing that she had not screened her patients before treating them. According to
Smeulers, Verweij, Maaskant, de Boer, Krediet, Nieveen, and Vermeulen (2015), nurses require
clinical guidance when applying evidence based practice in clinical settings. The guidance has to
come when the registered nurse is working under the instructions of a senior officer. For the case

Effective Team Working and Communication
of Fazey, she needed the assistance of the dental officer to guide her on making decisions when
working in the hospital setting. If she had relied on the assistance of the officer, she could not
have committed the professional misconduct that led to this case.
While it is true that EBP is the most preferred intervention, registered nurses often face
challenges that impact the full implementation of research in clinical settings. According to
Stokke, Olsen, Espehaug, and Nortvedt (2014), the implementation of EBP faces significant
challenges in terms of resources and time. The higher ratio of patients to nurses in hospitals
affects the effective implementation of EBP because nurses cannot find time to appraise research
and find the best intervention (Grove, Clarke, & Currie, 2015). Ms. Fazey may have worked in
an environment where she was in a tight schedule that could not allow her to appraise literature
on medication. If she could have spent time going through relevant EBP on the cases she was
handling, she could not have committed the professional misconducts by delivering substandard
treatments
It is evident from the case study that Ms. Fazey committed another professional
misconduct by administering medications without proper procedure, leading to its early
medication. EBP practice emphasizes on evidence and often requires that the physician compares
the available options to determine the best intervention (Stetler, Ritchie, Rycroft-Malone, and
Charns, 2014). The advantage of appraising research literature on a given literature is that the
clinician learns on the possible interventions in case of committing mistakes. If Ms. Fayze had
found enough time to assess the literature and compare the available options, she could have
known the best intervention for her mistakes and could not have caused adverse health impact on
her patients.
Conclusion

Effective Team Working and Communication
Nurses have crucial role to play in maintaining patients’ safety. They have to make sure
that they operate within the professional codes of practice. The NMBA Australia and the Dental
Board of Australia have set specific rules and ethical codes of conduct to guide nurses in their
profession. Any professional misconduct that undermines professionalism attracts disciplinary
measures. The case of Dental Board of Australia v Karen Fazey has indicated how registered
nurses can destroy their career when they engage in professional misconducts. Ms. Fazey
committed professional misconduct when she worked beyond her scope of experience. She
placed the heath of her patients at risk. While it is true that some factors may have contributed to
this case, it is evident that the registered nurse failed to take necessary measures to protect her
career. She could have applied evidence based practice to help address the problem.

Effective Team Working and Communication
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