Answer to Question 1
This would fall under the Standards 4 and 1 of the Registered nurse standards for practice. As part of these standards, the nurses are required to conduct assessments comprehensively apart from thinking critically and analyzing nursing practice respectively. As a student on placement who has been asked to do a set of vital signs and once completed is required to document findings accurately, it falls under the duty to conduct comprehensive and systematic assessments. Both holistic as well as culturally appropriate assessments are to be carried out through utilization of a range of assessment techniques. Systematic collection of relevant and accurate information is indispensable for the sake of informing practice through these valuable pieces of data. Moreover, the nurses are required to maintain accurate, comprehensive and timely documentation with respect to the assessments, planning, decision-making, actions and evaluations thereby contributing to improvement of quality and relevant research undertaken. Doing a set of vital signs for the patient is integral to nursing practice and therefore accounts for conduct of comprehensive assessments. On completion of this task, accurate documentation of the assessments carried out also falls under the category of nursing standard whereby nursing practice is further analyzed through provision for critical thinking. Timely documentation of relevant assessments is considered a crucial aspect to facilitate the healthcare process ensuring decision-making and actions in due course of time. Hence, by performing all these tasks and following the standards, it is possible to attain improved quality of healthcare service for the concerned healthcare recipient.
Answer to Question 2
This would fall under the Standards 2 and 3 of the Registered nurses standards for practice. According to the provisions of these standards, nurses are required to engage in therapeutic and professional relationships and act by maintain the capability for practice respectively. On assessing the patient, when it is found that the blood pressure is well outside the normal range and the matter is informed to the buddy nurse, it falls under the purview of professional relationship where collegial generosity is expressed contextualizing mutual trust and respect in professional relationships. Reviewing the previous assessment record for the patient and escalating any necessary information to the colleague also is indicative of the responsibility and accountability of the actions taken to ensure safety in terms of healthcare practice. As part of their duties, nurses are required to contribute towards ongoing self-management in addition to making responses under situations that hold concerns regarding other health professionals’ capability of practice. Consideration of the situation at hand and responding to it in a timely manner also is a part of conforming to the standard of practice. Seeking and responding to practice review and feedback is ensured through such process. In appropriate course of actions taken through proper identification and promotion, the integral role of nursing practice and profession is established. Thus, influences are made with respect to making better healthcare outcomes for the concerned patient. Further, an environment for collaborative practice is this ensured on sharing necessary information with the colleague while performing nursing duty.
Answer to Question 3
This would fall under the Standards 2 and 6 of the Registered nurses standards for practice. As per these standards, the nurse engages in therapeutic and professional relationships in addition to providing safe, appropriate and responsive quality nursing practice. On going back to the patient for treatment, it is found that she trust the nurse because of quality time spent with her. Further, the patient expresses opinions that she can talk to the nurse more freely and also voices his feelings of headache. The patient also complains about not receiving the pain relievers as promised by the buddy nurse. However, she begins to slur her words. The behavior as expressed by the nurse is in accord with the standard 2 which calls for effective communication, and is respectful of an individual’s culture, values, beliefs, rights and dignity. This situation is a testimony to the establishment, sustenance and conclusion of relationships in manners that distinguishes the boundaries between professional and personal relationships. Moreover, as per standard 6, the nurse practiced within the scope of practice and operates in harmony with pertinent policies, guidelines, regulations, standards and legislations. Ideally, under such circumstances, the nurses hold the authority to identify as well as report potential and actual risk linked system issues and in situations where nursing may be below the expected standards. In response to the nursing needs of the concerned person, the nurse is required to render comprehensive, safe and quality practice thereby paving the way for comprehensive, safe ethical goal-directed actions.
Answer to Question 4
This would fall under the Standards 6 and 7 of the Registered nurses standards for practice. According to the provisions for these standards, nurses are entitled to provide safe, appropriate and responsive quality nursing practice apart from evaluating outcomes to inform nursing practice. As per the give situation, the patient has deteriorated as evident from her high blood pressure and dropped pulse. The attending nurse has informed about the slurred words, blood pressure and headache to the buddy nurse and only after nod from the colleague, the nurse came to know about her raised blood pressure and dropped pulse. Thus, the act is in accordance with the provision for a safe mode of nursing practice that is equally responsive to the nursing needs of the patient. Moreover, the attending nurse has abide by the standards by virtue of which it is required of them to utilize appropriate processes for the sake of identification of potential and actual system related risk issues. Further as per standard 7, nurses are responsible for evaluating and monitoring progress towards the expected outcomes and goals. According to the case study, the patient was thereafter treated for stroke after being called for a medical emergency. Moreover, her plan for discharge now has been shifted to move to ICU, thereby indicating revision of plan based on evaluation. Thus, the provisions of evaluation of practice on the basis of agreed priorities, goals, outcome and plans is kept intact while revising the plan as per the concerned patient’s requirements.
In the context of the given case study, it is mentioned that following the admission of the patient to the ICU, the buddy nurse apologizes and admits to the student nurse about his mistakes in not paying timely attention to his words and concerns about the deteriorating clinical signs for the patient. He also discloses that recently he has been struggling with drug use and was excessively using overnight while on duty. The buddy nurse also entrusts his trust on the student nurse and makes his confessions. Under such circumstances, as a student nurse and being a member of the healthcare services that provide guidance in performing duties in accordance with the available legislations and guidelines, I am bound to make a mandatory notification. The mandatory notification is prompted on assessment and consideration of various factors.
Moreover, the registered nurses standards for practice also provide the necessary authority and directives to undertake a mandatory notification for the sake of safeguarding public and healthcare services in harmony with the Professional codes and guidelines (Nursing and Midwifery Board of Australia, 2016). According to the guidelines for mandatory notifications, directions are given to registered health practitioners, employers of practitioners and education providers regarding the requirements for mandatory notifications under the National Law. As per this, guidelines about students are relevant for registered health practitioners and education providers of registered students. Hence, students who are registered in the profession of healthcare under the National Law are expected to be familiar with such guidelines. However, a student need not make a mandatory notification, yet there remains provision for raising a complaint or concern about an impaired student (Australian Health Practitioner Regulation Agency, 2014). In the given situation, as a student nurse concern must be raised to education provider of registered student about the impaired student.
Unlike any other profession, healthcare professionals share the professional as well as moral obligation for protecting and promoting public health apart from fostering safe healthcare. However, under the ambit of the National Law, employers, health practitioners and education providers setting aside their other duties, also share the responsibilities of some mandatory reporting. Thus, in the context of public healthcare it is crucial to be acquainted with some terminologies that drive the course of actions for safeguarding the healthcare facilities provided to the targeted group. Amongst these, mandatory reporting and mandatory notification are two such clauses that need to be understood and applied in course of clinical practice. It is equally important to differentiate between these two overlapping terms for better applying them in the correct situations that might have arose in course of a clinical practice. As far as the term ‘mandatory reporting’ is concerned, it is used for describing the legislative requirement as imposed on certain selected group of people for reporting suspected cases of child neglect and abuse and even elderly abuse under special circumstances to the appropriate authorities.
These persons are legally bound due to their professional decorum to report any suspicion of such abuse to the relevant authority (Einboden et al., 2019). These laws have been put forth with the aim of preventing children from being abused apart from putting end to any possibility of abuse or neglect at the earliest stage possible. Therefore, mandatory reporting falls under the category of legal requirement for compelling members of a selected group of professionals including nurses to report suspicions that a child has been or is likely to be subjected to abuse or neglect (Leslie & Nelson, 2018). On the other hand, a separate term of ‘mandatory notification’ has been coined to distinguish the obligations as entrusted with the healthcare professionals. As per this, registered healthcare practitioners as well as employers and educators share a legal obligation to perform a mandatory notification under situations when they have formed reasonable beliefs that health practitioners have behaved in manner that comprise notifiable conduct in connection to the practice of their profession. Mandatory notification has been designed for the sake of improvement of patient and public safety through minimizing public exposure to risk of harm connected to the health practitioner’s conduct or impairment. A set of definite guidelines dictates mandatory notifications about registered health practitioners (Australian Health Practitioner Regulation Agency, 2014).
The significance of mandatory notifications can only be felt in the healthcare settings when properly utilized by the concerned persons. Practitioners and education providers can only make mandatory notifications about registered students under circumstances when they have a reasonable belief that a student has succumbed to impairment and while undertaking clinical training might pose substantial risk of harm for the public. These guidelines have been improvised and implemented with the motto of protecting the public from risk of harm. The details for making these notifications and the people who hold the authority to do this are also well laid by APHRA. Moreover, the notifiers are also protected under the National law as per specific provisions. Protections are rendered to anyone who notifies in good faith. However, there are certain exemptions regarding mandatory notifications for treating and non-treating practitioners.
Besides these, voluntary notifications can also be made in case the notifier feels that the student’s impairment might result in detrimental impact over the clinical training. Thus, there remains provision for a uniform nationally acceptable norms and provisions for conduct of the healthcare practitioners. Upholding and maintaining the highest standards of professional practice falls under the purview of these mandatory notifications. Undertaking such measures ensures quality and safety of health services. Relevant literature supports that indeed mandatory notifications hold the promise of making nursing a safe practice (Kochardy, 2010). As far as the notifiable conducts by registered healthcare practitioners are concerned, there are several aspects that fall under this category. It comprise of practicing while intoxicated by alcohol or drugs, sexual misconduct in the professional practice, putting the public at risk of substantial harm due to impairment or endangering the public because of significant departure from accepted standards of the profession. Hence, safety and protection from harm is ensured by these mandatory notifications by healthcare practitioners in course of their professional pursuits.
Australian Health Practitioner Regulation Agency. (2014). Guidelines for mandatory notifications.
Einboden, R., Rudge, T., & Varcoe, C. (2019). Beyond and around mandatory reporting in nursing practice: Interrupting a series of deferrals. Nursing inquiry, 26(2), e12285.
Kochardy, M. (2010). Impairing the practice of nursing: implications of mandatory notification on overseas-trained nurses in Australia. Journal of law and medicine, 17(5), 708-718.
Leslie, K., & Nelson, S. (2018). Mandatory Reporting of Health Professional Incompetence and Incapacity: Is it Time to Adopt the Australian Regime?. Nursing leadership (Toronto, Ont.), 31(3), 8-18.
Nursing and Midwifery Board of Australia. (2016). Registered nurse standards for practice. Australia, 4.
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