Registered nurses play a central role in the care delivery service for patients who live in residential aged care. Patients of residential aged care have complex care needs and are at risk of unexpected admissions to the secondary care units (Craig, 2019). The application of standards of practice for registered nurses by the Nursing and Midwifery Board of Australia is important as it helps in achieving the quality nursing practice outcomes (Cashin et al., 2017). This assessment is based on a case study of a registered nurse Katie who works in residential aged care and has been noticed to not fulfil her responsibilities. In this essay, all the aspects of Katie’s practice will be analysed as per the standards of Nursing and Midwifery Board of Australia.
Katie, a registered nurse at residential aged care has seemed to appear uncared towards her patients. Her carelessness was observed through her actions such as she did not look after the wet bed sheets that were required to get changed and urine bottles of the patients were also not been emptied. These actions of her showed that Katie’s conduct was below the standards. The standard 6 of NMBA says that nurses must provide safe, appropriate, and responsive care to the patients (Nursing and Midwifery Board of Australia, 2016). Along with this, the code of conduct for nurses of Nursing and Midwifery Board of Australia (2018) principle 2 states that nurses must focus on providing person-centred care with the implications of evidence-based practice in order to achieve the desired health and well-being of the patients. Katie’s actions have clearly shown she does meet neither the NMBA standards for registered nurses nor the principles of code of conduct for nurses. In the case study it is given that she spends most of her time in the nurses’ station rather than attending her patients this reveals that Katie did not spend much time with her patients and might have lacked in developing a therapeutic and person-centred relationship with her patients. According to the standard 2 of NMBA standards for registered nurses, it is important for a nurse to get engaged in the therapeutic as well as a professional relationship. Katie can provide safe and quality care and form therapeutic and person-centred relationships with her patients by adhering to the standards of NMBA and principle of code of conduct. According to the principle, 2 of NMBA code of conduct nurses can apply the person-centred and evidence-based decision making and standard 6 of standards for registered nurse practice regarding providing safe, appropriate, and responsive care to the patients; she will be potential in delivering safe and quality care to her patients (Nursing and Midwifery Board of Australia, 2018; Nursing and Midwifery Board of Australia, 2016). She can also form therapeutic and person-centred relationships with her patients by abiding by the standard 2 of NMBA standards for registered nurses and getting engaged with patients by communicating and acknowledging them. Provision of safe and appropriate care to the patients is the ultimate goal of the nurses and the benefits of this for Katie in doing so lies in that. Katie will become potential in delivering safe and person-centred care and will also excel in her therapeutic communication skills. These qualities will help her in obtaining desired health outcomes of the patient. By evidence-based practice approach, Katie will enable herself in solving crucial problems of the patients as it will integrate her clinical expertise with the recent and the best research evidence (Li et al., 2019; Chein, 2019). Patient-centred care will help Katie in ensuring safe and quality health care services (Moody et al., 2018). Forming a therapeutic relationship with patients will help Katie in enriching the patients’ experiences and health outcomes. This is so because therapeutic relationships have been considered to be a primary component among all the types of health care interactions. This results in positive health care professional and patient experiences. It has the capacity of transforming the experiences and health status of the patients (Kornhaber et al., 2016). By engaging in such a relationship will not only benefit the patient but also Katie by expanding her knowledge, furnishing her skills, and increasing her self-satisfaction.
When Katie’s peers noticed her actions and her uncared behaviours towards her patients, they reported Katie’s conduct to their manager. This was reasonable as well as appropriate because Katie’s practice was below the standards and her uncared behaviour could have become threatening for the patients that were allocated to her. It could potentially deteriorate the patient’s health conditions and prejudice the patient’s safety. According to principle 4.1 of code of conduct (Nursing and Midwifery Board of Australia, 2018), nurses should vigorously address if any kind of indifference, lack of care, disengagement with the patients, or disrespect has been involved. The nurses can escalate such issues (if found) to the higher authority in order to ensure the safety of the patients. The standard 3 of NMBA registered nurse standards for practise says to maintain the capability for the practice. For a registered nurse it is important to consider and respond to the health and well-being of others in a timely manner. By raising this issue the peers responded well in order to ensure the health and well-being of Katie’s patients. Standard 3’s 3.4 states that it is important for the registered nurses to accept the accountability for decisions, behaviours, actions, and responsibilities that is intrinsic in their role. And not only this but they also have the accountability of others to whom they have been delegated the responsibilities. By raising the issue to the manager will help the manager to make Katie understand regarding her conduct and why it is important to not to do so. The peers of Katie are also registered nurses and as their own duty and responsibility, they just responded to Katie’s practice which was inappropriate and could have deteriorated patients’ health. So, the peers did the right thing by escalating this issue to their managers as it comes under their conduct also. However, as Katie’s colleagues, they could have discussed the same with Katie first because the inter-professional relationship is also an important aspect of nursing practice. By discussing with Katie and letting her know the consequences of her uncared behaviours towards her patients there were chances that Katie would have changed her perspective of practice. And, if there were no changes in her conduct then, escalating the issue to the manager would be appropriate. Nursing standards will help the peers and manager in this as standard 1 state to think the nurses critically and analyse the whole practice. Effective interprofessional communication with Katie will help them in understanding the reason behind her conduct. The manager can do appropriate training and counselling of Katie in order to enable her to conduct her practice well. By the provision of effective leadership, the manager can help Katie in strengthening her quality and integration of care. Manager’s effective leadership would be potential in transforming Katie’s uncared behaviour into safe, effective, person-centred, reliable, efficient, and equitable behaviour (Sfantou et al., 2017). This would help in developing Katie’s skills and her conduct this will help in ensuring patient safety and attaining the positive health outcomes of the patients.
From this assessment, it could be concluded that it is very important for the registered nurses to adhere to the code of conduct, guidelines, and standards of the Nursing and Midwifery Board of Australia. Being aware of all the professional values and adhering to that help the nurses in providing safe and high-quality care. Nursing standards, guidelines, and code of conduct are the professional values of the nurses and this result in enabling the nurses to deliver person-centred care and to make effective decisions regarding patient’s health. Not only this but if any of the other nurses breaches any guideline then, it is the right of the other peers to escalate the issue to the higher authority. This is so because such issues are associated with the patient’s safety and maintaining patient safety is the duty of every nurse even if the patients who have been facing the issue is not allocated to the other nurse.
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Chien L. Y. (2019). Evidence-Based Practice and Nursing Research. The Journal of Nursing Research: JNR, 27(4), e29. https://doi.org/10.1097/jnr.0000000000000346
Craig, L. (2019). The role of the registered nurse in supporting frailty in care homes. British Journal of Nursing, 28(13). https://doi.org/10.12968/bjon.2019.28.13.833
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Nursing and Midwifery Board of Australia. (2016). Registered nurse standards for practice. Retrieved from https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx
Nursing and Midwifery Board of Australia. (2018). Professional standards. Retrieved from https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx
Sfantou, D. F., Laliotis, A., Patelarou, A. E., Sifaki-Pistolla, D., Matalliotakis, M., & Patelarou, E. (2017). Importance of leadership style towards quality of care measures in healthcare settings: A systematic review. Healthcare (Basel, Switzerland), 5(4), 73. https://doi.org/10.3390/healthcare5040073
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