Question1: Application of the unsatisfactory professional conduct and theconduct pathway
Unsatisfactoryprofessional conducts refer the behavior of a health careprofessional that demonstrates the skills, knowledge, and judgmentsthat fail to meet the standards that would be expected from aprovider of an equivalent qualification (Nursing and MidwiferyCouncil, 2016). In the present case study, the nurse failed to keepthe record of the assessment that was done on Patent A. In addition,the nurse failed to notify a qualified doctor about the deterioratinghealth condition of the client. These conducts do not demonstrate thestandards of a qualified nurse. The conduct pathway was preferredbecause it focuses on issues pertaining to omissions and behavioralacts. A failure to notify the relevant parties about thedeteriorating health condition of a patient can be regarded as anomission. Therefore, the complaint could be handled effectively usingthe criterion provided by the conduct pathway.
Question2: Individual professional accountability
Inthe immediate situation, the nurse would be expected to conduct theassessment of the patient’s progress and document the outcome ofthat evaluation. Upon the discovery of the fact that the client’shealth was getting worse, the nurses would be expected to report thematter to the hospital management in order to ensure that animmediate action is taken, since the doctor attending to patient Awas out of reach.
Thecoordination of care would have involved three key parties. First,the nurses should have contacted the clinical nurse manager afterrealizing that Dr. Haron could not be reached. Secondly, it would beprudent to involve the emergency on-call doctor. The last party wasthe family of the patient A. Passing the information to the relevantauthorities and keeping proper documents of the patient’s progressare some of the key mitigating factors that would have reducedindividual accountability of the nurse.
Question3: Professional standards that were breached or apply to the casestudy
Thereare several professional standards under the NMBA codes that arerelevant to the situation, but three of them have a direct link tothe case study. The first relevant standard of practice requiresregistered nurses to conduct comprehensive assessment of theirclient’s condition (Nursing and Midwifery Board of Australia,2016). Under this standard, nurses are expected to apply differenttechniques to collect information that will then inform theirpractice. Most importantly, the information collected by the nurseshould be used to determine the well-being of the patient, establishpriorities, and inform referral decisions (NMBA, 2016). In thepresent scenario, the nurse collected accurate information indicatingthat the client’s health was increasingly getting worse, but failedto document and communicate the findings to individuals who could useit to make the referral decision in time. Consequently, the patientdied while being assessed for a flight to Armidale Hospital.
Secondly,a standard that requires nurses to develop plans that guide theirpractice would be applicable to the present situation. Under thisstandard, nurses are supposed to construct practice plans incollaboration with other health care professionals (NMBA, 2016). Thepractice plans should include option priorities, contingencies,goals, outcome, actions, and timeframes that are agreeable to therelevant parties (NMBA, 2016). In the present situation, the nursesbreached this standard by failing to develop a comprehensive practiceplan in collaboration with other health care professionals. This signof incompetence is demonstrated by the fact that the nurse heldcritical information about the poor progress of the Patient A,instead of informing the clinical nurse manager who would have takenthe necessary action. The information would have resulted in thedetermination of the necessary actions and priorities that would havehelped patient A.
Third,the nurse breached a standard that requires professionals of herqualification to provide safe, responsive, and appropriate qualitypractice. This standard holds that registered nurses should practicewithin their scope (NMBA, 2016). In the present case, the nurse madea decision to wait for the locum doctor after realizing that Dr.Haron could not be reached. This decision was beyond the scope of thenurse, given the poor condition of patient. The adherence to thisstandard would have helped the nurse communicate the matter to peoplein the higher authority for timely actions.
Question4: Professional behaviors that would have made a difference
Thenurse in the present case had the opportunity to engage in properprofessional behavior and avoid the complaint. For example, a properengagement with other stakeholders in the health care facilitieswould have resulted in a better decision. Professional health carerequires a lot of collaboration and consultation in order to achievethe desired quality of patient care (NMBA, 2016).
Theknowledge base is a critical aspect of the nursing practice thatdetermines the ability of professionals to deliver safe, responsive,and effective care. Knowledge base includes an understanding of theoperating procedures that guide nurses on the courses of action thatthey should take in every scenario. In the present case, the nurseinformed the tribunal that she knew that Dr. Haron could not becontacted. However, the nurse did not understand the appropriatecourse of action that would have resulted in an immediate action inthe favor of patient A.
Moreover,prior clinical experience helps professionals apply the knowledgegained in the past to address the current situations. The nurseshould have reflected on decisions taken by nurses to addressemergency cases in the past, even when the doctors on duty were notpresent or could not be reached. This knowledge would have helped thenurse make a decision that is consistent with the nursing practiceand standards.
Clinicalreasoning, on the other hand, helps the health care providers thinkabout unique scenarios and come up with rational decisions. Forexample, the nurse had the opportunity to think about asking foradvice from other members of staff (such as clinical nursing manager)instead of taking an irrational decision that did not take account ofthe pain that patient A was suffering from.
Clinicalactions are informed by data that has been collected regarding theprevailing condition of the patient. In the present case, the nursesconducted the assessment as expected, but it was necessary todocument the data in order to facilitate the development of aneffective clinical plan. The process of documenting the patient’sprogress would have helped the nurses realize that the patent’scase was an emergency.
Theaspect of reflection helps the health care professionals reconsidertheir decisions and determine whether they are the most effective fora given scenario. A reflection on the decision to wait for locumdoctor would have helped the nurse realize that the patient’scondition could get worse, thus provoke the health care provider toreconsider the case and take a more appropriate course of action.
Question5: Lessons learned about personal preparedness for professionalpractice
Oneof the key aspects that provided an opportunity to learn aboutaccountability is the level of engagement. The aspect of engagementimplies that a new graduate needs to work in collaboration with otherprofessionals in order to ensure that the care that they providemeets the standard and their decisions put the well-being of thepatients first. In my case, I believe that I have the academicknowledge that I need to address different medical condition, but Ineed to engage with experienced members of staff in order tounderstand the different procedures that are observed in the reallife situations. Therefore, being able to engage with other people ispart of the professional accountability that demonstrates mypreparedness for graduate practice.
Nursingand Midwifery Board of Australia (2016). Registerednurse standards for practice. NMBA.Melbourne: Nursing and Midwifery Board of Australia.
Nursingand Midwifery Council (2016). Definition of unsatisfactoryprofessional conduct and professional misconduct. NMCNew South Wales.Retrieved September 9, 2016, fromhttp://www.hpca.nsw.gov.au/Nursing-and-Midwifery-Council/Management-of-a-Notification–Complaint–by-the-Council/Conduct-Notifications–Complaints-/DUPCPM/default.aspx