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Regulations and laws that govern the nursing action and health care practice ensure that optimal patient care is ensured with no intentional or unintentional harm to the patient and adhere to the official medical guidelines (Poorchangizi et al., 2019). These regulations also ensure that the patient can get the best quality of care through ensuring systematic uniformity about the code of conduct, responsibility, and ethics (Monroe, 2019). This essay will focus on a critical evaluation of a particular case study and identify the professional errors associated with the same. Further, assertions on the code of conduct and health policy breach in the case study will also be analyzed. The practices that could change the outcomes of this incident will also be explored to refine and produce a conclusive critical analysis.
On 28/02/2014, a visitor had arrived at Bungarribee house at 3 PM to meet a man, her husband who had been admitted the acute ward of the mental health facility in the Western Sydney local health district the day before. However, when the patient was not found by the registered nurse, Sumintra Prasad after she had returned collecting the handover, the patient was searched for and was found dead in the bathroom. The alarm to ensure the well-being of the patient was raised however, the emergency rescue operation was initiated but it failed. Before collecting the handover, the nurse had taken a behavioural observation. The patient was in observation of another registered nurse, Harivandan Pandya who had left the facility early by thirty minutes to travel to another facility to commence another shift. This absconding of the patient by RN Pandya was deemed to be unsatisfactory professional conduct and resulted in his reprimand with restrictions on his employment and guided supervision for further education. Further, the care provided by RN Prasad was also found to be of below the standard and was thus cautioned.
The code of conduct has been established by the Nursing and Midwifery Board of Australia that focuses on providing prime quality care to patients through effective care (Nursing and Midwifery Board of Australia, 2018). Further, directives from the Health policy of western Australia. The Policy document of the Western Sydney Local Health District was also consulted that primarily asserted that the staff was required to obtain permission before leaving for breaks, duty obligations, or for any other reason. In this particular case, at the local level, there was an evident breach of this law from the General Information policy of the Western Sydney Local Health District. Further, the action of both the RN breached the suitable action developed by the Nursing and Midwifery Board of Australia as standards of practice for the Registered Nurses. The standard one of this regulation focuses on the importance of critical thinking and analysis in the process of decision making. Subsection 1.5 asserts, that the registered nurses must use ethical frameworks when making decisions to ensure beneficence and non-maleficence of the patient (Nursing and Midwifery Board of Australia, 2016). However, when the RN Pandya left the facility without seeking a proper channel and permission, the care of the patient was compromised. Since the patient was present in the mental healthcare unit, it was important for the RN to make sure that the assistance is always present in proximity to prevent incidences like self-harm and suicide.
The conduct was also a breach of standard 3, subsection 3.7 where the registered nurses are abided to promote the practice of nursing and ensure better outcomes of the patient. Moreover, a significant breach of standard six, that is, provision of safe, appropriate, and responsive nursing practice was also observed. The professional nurses must delegate the care of the patient through a goal-directed manner where the well-being of the patient is maintained (Nursing and Midwifery Board of Australia, 2016). The absconding of the patient by RN Pandya for another shift and movement of RN Prasad after having made observational records marks poor and substandard of quality of care and breaches the nursing standard for safety and quality care by leaving the patient without proper assistance and supervision. Further, since the standard six, substandard also obliges these nurses to follow the institutional, state, and national laws, it was also a breach of this standard marking the conduct of nurses as highly unprofessional and unethical. The Mental Health Policy of Western Australia asserts the need for person-centred care and consistent supervision to ensure the well-being of the patient. Poor channelling of care in the provided case study is, therefore, a breach under the Health Services Act 2016 with policy frameworks 26-27 section 34 (2) c and sections 44 and 45 (Government of Australia, 2019). This could be seen as ignorance in professional conduct and also be a breach aglint the guardianship and administration act of 1990 (DeLaune et al., 2019).
The action of the RN Pandya also falls under the breach of ethical code of conduct established by the Nursing and the Midwifery Board of Australia. The first code that must be followed by the healthcare practitioners is to abide by the national law and the institutional as well as state laws for action in the care facilities (Parker & Hill, 2017). Further, the code of conduct also asserts that there is a need for effective communication in nursing practice to ensure the highest quality care for the patient. The lack of seeking permission to leave early by RN Pandya is a breach of the same. Further, not being able to record and communicate the need for supervision for the patient after observations also demonstrates a lack of effective communication on behalf of RN Prasad. The Code of conduct binds the registered nurses and the healthcare professionals under the regulations by AHPRA and National law that makes it necessary for the professionals to ensure beneficence of the patient through care (Nursing and Midwifery Board of Australia, 2018). Therefore, ignoring the needs of the patient, poor communication, and lack of adherence to the local, state, and national regulations have contributed towards unsatisfactory care and service towards the patient.
The conduct of the registered nurses towards the patient was highly unprofessional and poor costing the life of the patient. This conduct could have been better if approached with the assistance of guidelines and professional responsibilities (Parker & Hill, 2017). Especially, in consideration that the patient was admitted in the mental healthcare ward, assistance and care should have been provided to ensure the wellbeing of the patient by thorough supervision and ensuring the psychological stability of the patient (McAllister et al., 2019). When the RN Pandya had to leave the facility early, a due permission grant should have been taken. This would have allowed the head nurse to ensure availability of staff for supervision and catering to the patient needs and safety. Further, ignorant behaviour was also depicted by RN Prasad when even after recording the behavioural observations signs and inclinations towards the suicidal tendencies were not picked and this allowed the nurse to go for a collection of the clinical handover. The RN Prasad should have also collected the handover before checking the patient to ensure the previous developments that might have been missed, even if recorded in the initial observation (DeLaune et al., 2019). Therefore, these misconducts and errors could be managed with sheer acknowledgement of responsibility. Moreover, effective communication and person-centred care are critical aspects of quality care established by the code of conduct by the Nursing and Midwifery Board of Australia. Critical care and understanding of the patient needs and supervision would have allowed for picking up the suicidal tendencies and prevent this accident.
Critical care of the patient is dependent on the conduct of the care professionals in the facility. Therefore, the code of conduct, legislation, and the regulations have been drafted to ensure that a uniform framework is followed and quality care is provided to the patients. This essay provided a critical analysis of a particular case study where the ignorance and misconduct of the registered nurses resulted in a medical emergency and loss. This essay also identified the local as well as national regulations, legislative acts, and the code of conduct breached and associated with the case study. Moreover, discussion on how such an incident could have been avoided has also been provided. The patient in the case study was admitted in the acute mental care ward and through effective communication, responsibility, and care regimen, the life of the patient could have been saved. Further, through providing optimal care, the careers of the nurses involved would have also not been jeopardized due to legal breaches and non-adherence to the institutional and ethical considerations involved in patient care and security.
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Government of Western Australia (2019). Department of Health: Mental health policy framework statement. https://ww2.health.wa.gov.au/About-us/Policy-frameworks/Mental-Health
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Nursing and midwifery Board of Australia (2018). Code of conduct. https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwiZgp6GsoTrAhVZOSsKHc3zACsQFjABegQICxAD&url=http%3A%2F%2Fwww.nursingmidwiferyboard.gov.au%2Fdocuments%2Fdefault.aspx%3Frecord%3DWD17%252F23850%26dbid%3DAP%26chksum%3DL8j874hp3DTlC1Sj4klHag%253D%253D&usg=AOvVaw2_EwvXELm1PrjH5t5kPGZh
Parker, J. M., & Hill, M. N. (2017). A review of advanced practice nursing in the United States, Canada, Australia and Hong Kong special administrative region (SAR), China. International Journal of Nursing Sciences, 4(2), 196-204. https://www.sciencedirect.com/science/article/pii/S2352013216301910
Poorchangizi, B., Borhani, F., Abbaszadeh, A., Mirzaee, M., & Farokhzadian, J. (2019). The importance of professional values from nursing students’ perspective. BMC Nursing, 18(1), 26. https://link.springer.com/article/10.1186/s12912-019-0351-1
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