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This is the case study of Mrs. Barcroft who is a 79-year-old lady having multiple complications in the health system and deterioration of mental health status. She was admitted to the hospital because she was diagnosed with a chest infection, inconsistent urine, and infected ulcers on her right ankle. The lady was taken care of by a Registered nurse as well as midwifery both. In the morning, Mrs. Barcroft was approached to get out of her bed take a shower and dress her ulcerated ankle. The nurse here reacted very loudly to her that she wet the bed and needs a shower at that time. The nurse behaved in a very rude manner with Mrs. Barcroft and attempted her legs swing out of bed. This caused her pain on ulcerated wrinkles and then Mrs. Barcroft strikes the nurse in the face. This posed a violent situation between Mrs. Barcroft and the registered nurse attending her. Her, in this essay, the description will be there in this case involving professional and safe nursing practices along with the issues of informed consent and professional negligence.
A registered nurse must take care of the patient safely and acceptably to comply with the rules and needs of designation. Patient safety is required to protect the patient within healthcare organization by focusing on safety, following the practice of evidence-based management and leadership, and provision of ongoing learning and clinical decision making by providing support to the patient as well as other staff. Adequate mechanisms are followed in the nursing profession to promote interdisciplinary collaboration in work practices that defend against unsafe and fatigue work (Kennedy & Flaherty, 2016). In the case of Mrs. Barcroft, she was having multiple health problems including deterioration of mental health status. She was having multiple problems such as chest infection and ulcers on the right ankle due to which she was admitted to the hospital. The registered nurse and midwifery took care of her in the hospital. The nursing professional rudely behaved with her and even became violent at times (Younger, Douglas & Warren-Forward, 2018). She was a mental health patient, so a registered nurse was not allowed to practice in this manner with the patient according to professional code and ethics.
The point in taking care of Mrs. Barcroft is that a Registered nurse should ensure safe and professional practice in attending the patient. The hygiene practices are very important to her as she was having ulcers on her body due to which her bed was spoiled. The nursing professional here requires the attention to support the patient in maintaining their hygiene needs when the patient is admitted to the hospital. Personal hygiene of Mrs. Barcroft includes care of hair, skin, nails, mouth, eyes, ears, nose, perineal areas, and face shaving to have a potential impact on both skin health and patient’s comfort and wellbeing (Grauberger, Kerezoudis & Choudhry et al., 2017). The development of ulcers on Mrs. Barcroft's body is the signs of lack of hygiene that cause the build-up of pathogens and an increase in the risk of infection. However, the registered nurse the way she behaved with the patient was not acceptable as she swings her legs on the bed and caused lots of pain on her ulcerated ankle. Though, the patient must be helped to wash and dress by the staff in maintaining the patient's hygiene to carry out a holistic assessment (Lee & Lai, 2020). This allows time to address the concerns of the patient and provide them a valuable opportunity to assess the condition of the skin.
Every patient has their values and practices associated with hygiene that need consideration towards planned care. Here, as Mrs. Barcroft is the patient who requires bed bathing to maintain hygiene, so this method would be more effective for her and should be taken when there is no option. The nurse must encourage and offer the patient an opportunity to participate in their care. This will help in maintaining their independence, dignity, and self-esteem (Rix, 2017). Proper equipment should be used to prevent the patient as well as staff from the attack of micro-organisms responsible for healthcare-associated infections. Mrs. Barcroft was having an ulcer on her ankle, so the soap should be selected that can alter skin pH, which leads to skin breakdown and dryness. So, in these cases, skin-cleansing emollient creams should be used. Reusable cloths should be avoided to prevent the attack of bacterial infections caused by micro-organisms (Cardoso-Cita, Perea-Pérez & Albarrán-Juan et al., 2016). The professional responsibilities of taking care of patients should be maintained and this needs proper training, competency assessment, and supervised practice by policies and procedures. This will help Mrs. Barcroft in maintaining personal hygiene, mobility, personal care, and dressing. The requirement of the patient is also such that they require polite and soft behavior of staff involved in the team to take care of them. Thus, the nursing professional gets more idea of assessing the client’s actual performance with established standards related to ask and then educating the patient on proper methods of performing particular tasks. This involves compliance with safety measures and the use of assistive devices to facilitate their self-care hygiene. Mrs. Barcroft was having an ulcerated foot which means there were high chances of infection in that area, so hygiene maintenance will help him in speedy recovery. The evaluation of curb infection spread, identify patient correctly, use medicines safely, avoid errors, and assembling of a better team in the care of the patient are the ways for patient care evaluation (Ezeuko, 2019).
Along with professional and safe hygiene practices, the nurse has to perform all the care steps by obtaining informed consent from the patient before starting with treatment or intervention. In the case of Mrs. Barcroft, without asking her nurse pulled her from the arm and swings her legs from the bed. In doing so, she bumps her ulcerated ankle and cried out in pain. Moreover, after an angry reply from the patient to her, the nurse slapped Mrs. Barcroft on her arm and behaved rudely. She left the patient alone while she was a serious patient and swinging on the bed. This presents that she did not follow legal practices that have to comply in the nursing profession (Parmar & Rathod, 2016). Without taking consent, nursing professionals are not allowed to carry out some procedures or interventions with the patient. This is the requirement of the Nursing and Midwifery council’s code and is mandatory for all nursing professionals to follow. Nursing professionals must be aware of the requirement of informed consent to underpin any malpractice in case handling (Romero, 2018). Hence, informed consent is fundamental to the provision of person-centered care and prevention from negligent action during practice. Nursing professionals are involved in making clinical judgments and decisions throughout the day, similarly, here in this case of Mrs. Barcroft, the nurse took the decision and left her alone in the room. However, these are the points followed to assess the health status of patients and the provision of planned care based on the observations. The process of clinical decision-making is the analytical part of the profession to ensure safe and hygienic care to patients without any negligence (Hågensen, Nilsen & Mehus et al., 2018). As a registered nurse left Mrs. Barcroft alone in bed, this will be counted as negligent practice if the patient falls or got hurt from any type of injury. It is because nursing professionals must provide constant care and observation to admitted patients. Mrs. Barcroft was a mental health patient, so she needs constant care and the polite behavior of staff in handling. These decision-making processes have a great impact on the outcomes of patients and also describes the quality of care provided to the patient. Safe and appropriate care is considered as person-centered care because the patient’s needs, autonomy, and holistic care are of primary importance (Albolino, Bellandi & Cappelletti, et al., 2019). Hence, the patient-centered approach should be followed by a nursing professional to facilitate the contribution of care through shared decision making, mutual respect, and communication. All the registered nurses, midwives, and student nurses are accountable for their professional practice. They have to comply with the standards of NMC inpatient care, the compliance is “the professional standards that registered nurse and midwives must uphold is not negotiable or discretionary” (Aagaard & Kristensen, 2018).
Hence, from the above case of Mrs. Barcroft, the condition of the patient was explained that she was having an ulcer on her ankle that causes her lots of pain when getting hurt. She was also having mental illness sue to which she loses her consciousness and behaves rudely. Moreover, she was diagnosed with a chest infection and inconsistent urine means she was having multiple illnesses. The registered nurse care of Mrs. Barcroft also didn’t follow professional and safe practice measures while attending to her immediate hygiene needs. There were issues of professional negligence and Informed consent while taking care of the patient by her. She underestimated the meaning and importance of informed consent as this is the document that nursing professionals have to get approved otherwise they are not allowed to carry out some procedure or intervention with the patient. This is the requirement of the Nursing and Midwifery council's code and is mandatory for all nursing professionals to follow. Nursing professionals must be aware of the requirement of informed consent to underpin any malpractice in case handling. Hence, informed consent is fundamental to the provision of person-centered care and prevention from negligent action during practice.
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