NRSG374 Frank Clinical Placement Case Study Sample

• Subject Code : NRSG374
• University : Australian Cathloic University My Assignment Services is not sponsored or endorsed by this college or university.
• Subject Name : Nursing

Principles of Nursing: A Palliative Approach

Clinical placement is an important learning phase in the nursing profession and this duration, they understand the right use of the theoretical aspect in the clinical practise to improve the quality of care. The clinical placement guidelines are important to improve the practical skills of the nurse that are important to assist the patient (Stupans et al., 2013). The nurses caring for the dying patient are expected to work as per their professional role to address the physical as well as the emotional need of the patient as well as the family (Clark, 2017). The nurses are expected to follow professional standards and values in the care to justify their professional role in delivering quality care to the patient (Poorchangizi et al., 2017). The case study is about a 60-year-old Frank and he is recently diagnosed with stage IV glioblastoma multiforme that lead to him under the palliative care. The essay will present a critical perspective concerning the clinical placement guideline concerning the NSQHS, NMBA Standards and National Palliative Care Standard.

The nurse assists the patient after entering the palliative care setting by welcoming him and performed the necessary assessments that are important for identifying the patient health status. The Ndetei–Othieno–Kathuku (NOK) contact detail assessment and activities of daily living (RUG-ADL) assessment are considered to be important in palliative care (Denckla et al., 2017; Saotome et al., 2018). The National Palliative Care Standard (2020) proposed the standard and the first standard stated that the assessment of the patient is important. The Nursing and Midwifery Board (2017) stated the 4^th standard that includes that registered nurses are expected to conduct a holistic patient assessment which is also culturally appropriate. Australian Commission on Safety and Quality in Health Care (2017) stated the Comprehensive Care standard state that health care professionals are expected to conduct the integrated and timely screening of the patient to minimise the patient harm.

The case study indicates that the nurse has actively involved in the developing care plan considering the CT of Brain and MRI of the Frank revealed that presence of Glioblastoma Multiforme. The nurse helped the patient by suggesting concerning the palliative radiotherapy but it was refused by the patient and family. The advance care plan is required to improve the autonomy of the patient under palliative care (Jethwa & Onalaja, 2015). The National Palliative Care Standard (2020) stated the 2 standards that developing the care plan by partnering with the patient and the family to provide holistic care. Nursing and Midwifery Board (2017) frame the standard 5 which stated that develop the care plan by collaborating with the patient during the treatment. Australian Commission on Safety and Quality in Health Care (2017) stated that Comprehensive Care standard that stated that nurse is expected to develop the care plan corresponding to the screening and assessment of the patient to deliver the quality care.

The case study indicates that carers of the patient his wife was partnered in the care during the decision-making as she holds the right for the medical power of attorney. The communication with the family during the end-of-life care is important to help to be prepared for the loss they have to face and understand patient condition (Keeley, 2017). The National Palliative Care Standard (2020) stated the 3 standards which discuss that carers should be informed concerning the patient-related information and the resources that are important to improve involvement in the care. Nursing and Midwifery Board (2017) state the 1^st standard that is thinking critically and analyses in nursing practise and it states that nurses are expected to understand and respond to the role for the family or carers in the care to involve in decision making in the care. Australian Commission on Safety and Quality in Health Care (2017) state the 1 standard that is Clinical Governance Standard which state that nurse should support the carers or the family member by communicating the concern that is important to deliver the quality care.

The nurses have utilized their clinical skill in the setting to deliver the right care to the patient to reduce the suffering that will improve the easy and dignified death. The nurses are expected to deliver quality care to the patient concerning the health status that will help to reduce the pain and suffering (Schroeder & Lorenz, 2017). The patient was prescribed with the right medication and different referrals that are important to support and reduce the issue of the patient. National Palliative Care Standard (2020) standard 4 discuss that nurse are expected to provide the care to the patient that is framed concerning the clinical assessment. Nursing and Midwifery Board (2017) proposed the second standard that is Engages in therapeutic and professional relationships which state that nurse should deliver the person-centred care to improve health outcome. Australian Commission on Safety and Quality in Health Care (2017) proposed the 2 standard that includes Partnering with Consumer that state that health care professionals should partner with the patient during delivering the care. partnership with patient help to understand their preferences that are important to deliver person-centred care.

The communication between the team during the care of the Frank was done appropriately as handover is transferred to the other health care professionals and referrals are done that includes physiotherapist, dietician. The collaboration of the health care professional team is important to deliver patient-specific care by considering every health aspect (Bloomer et al., 2019). National Palliative Care Standard (2020) proposed the standard 5 that state transition within and between services is important to provide seamless care and oral communication is important to coordinate. Nursing and Midwifery Board (2017) third standard which maintains the capability for practise that state that nurse are expected to actively engage with the profession to provide the continuous care to the patient to deliver integral care. Australian Commission on Safety and Quality in Health Care (2017) state the fifth standard that is Comprehensive Care standard and it discussed the collaboration within the team to improve the care.

The case study reflects grief or bereavement support to the family that is important to prepare them emotionally and mentally for the loss. Grief support is important for the family experienced the loss of the patient to support them and reduce the risk of any mental or emotional breakdown (Aoun et al., 2017). The nurses are expected to assist the family to understand the patient situation and support them to play an important role in supporting the patient. National Palliative Care Standard (2020) proposed the sixth standard that is Grief support which state that nurse are expected to assist the patient to prepare for the death and help them to understand the process of dying.

During the referrals generation, the nurse has considered the strong catholic belief of the patient and the family that indicate that the patient preferences are considered during the care. The referrals include a visit to the Catholic Priest for the anointed that will help to improve the mental and emotional wellbeing of the patient. Cultural competent care is important to support the emotional and physical aspect of the patient (Givler et al., 2020). National Palliative Care Standard (2020) put forward the seventh standard that is Service culture that state nurse should work by considering the values, culture and belief of the patient to deliver the person-centred care. Nursing and Midwifery Board (2017) standard 1 state that nurses are expected to respect all the culture and their belief. The nurses should respond to the family considering the different values and belief of the patient with the family. Australian Commission on Safety and Quality in Health Care (2017) proposed the Clinical governance standard that also added cultural safety in the care is important to improve the quality of care.

The nurses are continuously monitoring the patient to improve the care perspective that will lead to a better health outcome of the patient. The nurses are also collaborating with the wife of Frank to improve the care perspective that will facilitate the easy dying. National Palliative Care Standard (2020) eight standards that are Quality improvement which state that nurses are expected to monitor the services by engaging in the care to improve the quality which helps to improve the standard of the palliative care. The 8 standards added that nurse should improve the quality performance and patient outcome by increasing the quality of the care. Nursing and Midwifery Board (2017) standard first discusses that nurse are expected to be a part quality improvement process so that they can improve the clinical practice. The quality improvement in the care will help to deliver the patient-specific care that will lead to a better health outcome. Australian Commission on Safety and Quality in Health Care (2017) the Clinical governance standard state that nurses should identify the safety and quality measure by evaluating the performance or patient outcome. The nurse should identify the gap in care that need to be addressed to improve the quality of the care.

The way nurses staff has a deal with the deteriorating health status of the Frank and supported him during the terminal phase of the palliative care indicate that the staff is well aware of the different aspect of palliative care. The quality improvement in palliative care is important to address the different need of the patient concerning the health status (Kamal et al., 2015). National Palliative Care Standard (2020) 9 standard stated that health care workforce are expected to be appropriately qualified concerning the different aspect of the palliative care and they should continuously engage in the professional development to improve practise. Nursing and Midwifery Board (2017) standard 1 stated that nurse should develop their practice concerning their reflective experiences and knowledge to understand how these can be utilized in the clinical practice. Australian Commission on Safety and Quality in Health Care (2017) Clinical Governance standard state that organization should support the workforce to understand their role in the care followed by assigning the right role and responsibility concerning to their skills.

The essay can be concluded by stating that nurses in the case study have accurately followed all the different standards that are important to provide quality care while considering the palliative care to the patient. The NMBA, NHQHS and National Palliative Care Standards are important to deliver the quality care that leads to better patient outcome. Following the different nursing standard in the care is important to understand patient perspective and deliver the quality care that is important for improving the easy dying of the patient. The nurses have supported the patient and family holistically from suggesting right care followed by assisting in reducing pain to supporting the grief of the family. The holistic care is important to deliver the care that can address the physical, emotional and social need of the patient with the family.

References for Frank Clinical Placement Case Study

Aoun, S. M., Rumbold, B., Howting, D., Bolleter, A. & Breen, L. J. (2017). Bereavement support for family caregivers: The gap between guidelines and practice in palliative care. PLOS ONE, 12(10), 1-15. DOI:10.1371/journal.pone.0184750 

Australian Commission on Safety and Quality in Health Care. (2017). NSQHS Standards. Retrieved from: https://www.safetyandquality.gov.au/standards/nsqhs-standards

Bloomer, M. J., Botti, M., Runacres, F., Poon, P., Barnfield, J. & Hutchinson, A. M. (2018). Communicating end-of-life care goals and decision-making among a multidisciplinary geriatric inpatient rehabilitation team: A qualitative descriptive study. Palliative Medicine, 0, 1-9. DOI: 10.1177/0269216318790353 

Clark, K. (2017). Care at the very end-of-life: dying cancer patients and their chosen family’s needs. Cancers, 9(12), 1-10. DOI: 10.3390/cancers9020011 

Denckla, C. A., Ndetei, D. M., Mutiso, V. N., Musyimi, C. W., Musau, A. M., Nandoya, E. S. & McKenzie, K. (2017). Psychometric properties of the Ndetei–Othieno–Kathuku (NOK) Scale: A mental health assessment tool for an African setting. Journal of Child & Adolescent Mental Health, 29(1), 39–49. DOI:10.2989/17280583.2017.1310729 

Givler, A., Bhatt, H. & Maani-Fogelman, P. A. (2020). The importance of cultural competence in pain and palliative care. Treasure Island, United Kingdom: StatPearls Publishing.

Jethwa, K. D. & Onalaja, O. (2015). Advance care planning and palliative medicine in advanced dementia: A literature review. BJPsych Bulletin, 39(2), 74–78. DOI:10.1192/pb.bp.114.046896 

Kamal, A. H., Harrison, K. L., Bakitas, M., Dionne-Odom, J. N., Zubkoff, L., Akyar, I. & Bull, J. (2015). Improving the quality of palliative care through national and regional collaboration efforts. Cancer Control, 22(4), 396–402. DOI: 10.1177/107327481502200405 

Keeley, M. (2017). Family communication at the end of life. Behavioral Sciences, 7(4), 45. DOI: 10.3390/bs7030045 

Nursing and Midwifery Board. (2017). Registered nurse standards for practice. Retrieve from: https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx

Palliative Care Australia. (2020). National Palliative Care Standard. Retrieved from: https://palliativecare.org.au/standards

Poorchangizi, B., Farokhzadian, J., Abbaszadeh, A., Mirzaee, M. & Borhani, F. (2017). The importance of professional values from clinical nurses’ perspective in hospitals of a medical university in Iran. BMC Medical Ethics, 18(1). DOI: 10.1186/s12910-017-0178-9 

Saotome, T., Iwase, S., Nojima, M., Hewitt, B. & Chye, R. (2018). Assessment of activities of daily living and quality of life among palliative care inpatients: A preliminary prospective cohort study. Progress in Palliative Care, 26(1), 14–21. DOI:10.1080/09699260.2018.1427677 

Schroeder, K. & Lorenz, K. (2017). Nursing and the future of palliative care. Asia-Pacific Journal of Oncology Nursing, 5, 4-8. DOI:10.4103/apjon.apjon_43_17 

Stupans, L., March, G. & Owen, S. (2013). Enhancing learning in clinical placements: reflective practice, self-assessment, rubrics and scaffolding. Assessment & Evaluation in Higher Education, 38(5), 507-519, DOI: 10.1080/02602938.2012.658017

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