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Pandya and Sumintra Prasad vs. The Nursing Registration Board

Introduction to Registered Nurse Scope of Practice in Australia

The purpose of the paper is to discuss about a legal case of "Haridavan Pandya and Sumintra Prasad Vs. the Nursing registration board” [RN Pandya & RN Prasad Health Care Complaints Commission v Pandya and Prasad [2017] NSWNMPSC]. Aim is to identify statement of decisions. In the legal case against Haridavan Pandya, has been reprimanded and his registration is subjected to the conditions relating to the practice, supervision and education (Hains, 2020). RN Sumitra Prasad is cautioned for future errors and practices. The case is about the importance of handover and to have effective communication, when communicating and handing over duties(McHugh et al, 2020). Case also concludes, that there was unsatisfactory professional conduct and lack of coordination between the nurses when departing (Fong, 2017).

Summary of the Case

In the case, Commission’s has advised protective orders based on findings, that there was an unsatisfactory professional conduct by RN Prasad and RN Pandya while performing their duties. In the case of Health Care Complaints Commission v Pandya and Prasad [2017] NSWNMPSC 2, RN Pandya and RN Prasad are employed in the Western Sydney Local Health District. RN Pandya was due to start his duties additionally in the Cumberland Hospital from 2.30 PM starting on 28th February 2014. At 3.00 PM. Patient referred to as A's wife has arrived to check the patient condition and contacted Acute Ward of the mental health facility of Western Sydney Local Health District. At that time RN Prasad has come from a roundabout and attended the request. When RN Prasad reached the 3rd floor to check the patient condition, he found the patient lying on the floor and taken his life (Birks, 2016). The course of the events during day, was found as RN Harivadan Pandya being assigned duty of the patient A care, till his shift, but as he has to travel and join another facility, RN Pandya did not inform team leader about his early departure and left half an hour before after handing over duties to RN Prasad (Birks, et al, 2017). RN Prasad, during her handover duties, had also tried to examine patient’s changing behavioural observation at 2.40 pm, but as she has to take other patient’s handover responsibilities so left at 2.45 pm. The case was reviewed under the Professional Standards Committee and the death cause is a matter of concern. During events, RN Prasad and RN Pandya were found to be negligent during handover duties, having inefficient communication and were found to have conducted a lack of standardized care (Currie, 2019). Care provided by RN Pandya were far from the below standard expected, as it was advised that RN Pandya should undergo an equivalent level of training or experience and it was found to be unsatisfactory professional conduct. Similarly, restrictions were placed on Pandya future employment, was directed for supervision and to undergo training (Chan, 2017).

The case provides detailed analysis of “patient A” cause of death as the negligence. As outlined from excerpts 35, Committee has advised over the legal principles and has found the civil standard of the practitioner to be sub-standard and questions the role of the practitioner to practice his duties. The case also highlights trust between the practitioners and patients and questions duties rendered by professionals when obligating a standardized care and protection to patients. Excerpts from 38, identifies RN Prasad professional duties were equally negligent and unsatisfactory. Committee also questions professional conduct of the RN Pandya Complaint. As per the Excerpts 50 RN Pandya’s has not taken approval from team leader to leave early from the vicinity and neither have made alternative arrangements. He should have obtained consent, as he has left the place without informing anyone.

Relevant Professional Errors NSW Health Policy

Handover Issues

  1. Law states that a patient incapable to take decisions, consent can be taken by the family or by the multi-disciplinary team, when treating the patient immediately. Even though RN Pandya has observed behavioural changes, still RN Pandya failed to provide detailed information to the RN Prasad and took decision to leave vicinity early, without providing care to patient (Fong, 2017).
  2. RN Prasad left his duties 30minutes prior without informing Team leader and he did not document patient observation before departing (Hains, 2020).

Negligence:

Duty of care

Duty of care is the standard of practice, obligated by healthcare professionals to provide care to patient. that mentions nurses have to provide to the patient promptly, which RN Pandya has failed to comply with (MacLellan, 2017).

Breach of duty

RN Pandya has failed to comply with his duties and maintaining professional conduct of practices.

Autonomy

As the patient has shown behavioural changes, it was the duty of RN Pandya to comply with duties and to make informed decisions after discussing with the family or with the multidisciplinary team.

Practice Might Change and Develop as A Result of This Incident

Action NMBA Code of Conduct

Principle 1.2 Honest and ethical practices

It was the duty of the RN Pandya, to take precise decisions, practice autonomy principle and should have taken informed decisions.

3.3 Communicate Effectively

Both the nurses should have communicated effectively about the patient A case in detail (NMBA, 2016).

6.1 Accounting, Rights and Responsibilities

Nurses should follow the framework of what is right and responsible, when complying with their duties.

ICN Code of Ethics

1.1 Primary professional responsibility is to provide adequate nursing care

Nurses have to provide diligent care and to follow the legal framework, when providing quality services.

1.3 Accurate, sufficient and timely information as a consent to be taken

As the patient A condition was deteriorating, RN Prasad failed to abide by his duties such as documentation and handover duties (MacLellan et al, 2020) Moreover, he did not inform his team leader of an early departure, during the lapse time of care accident took place.

1.6 Nurse should practice fair, equity and social justice

Both the nurses part of the case, should have been proactive, such as to treat patient A conditions like any other patients would have been treated. Patient was neglected for the care.

1.7 To provide professional practices and values, that would be respectful, be reciprocated and provide duties with compassion along with integrity

In the case, as Patient A was showing health behavioural changes, RN Pandya should have documented it and during handover, duties should have alerted RN Prasad. While Prasad noticed all the changing behaviour patterns, but due to the other handover duties in her shift, she had immediately move out, without documenting her observation. Later on she did not even cross-examine it.

2.1 Nurses have the responsibility and accountability to deliver practices competitively

The nurses have to ensure, responsibility and accountability, to follow their practices and duties. Firstly, RN Pandya was responsible for patient proper care. Secondly, RN Prasad at the time of handover duties has noted the changes in patient behaviour should have enacted with the proper care (Hains, 2020).

2.2 To deliver safety practices, provide quality care and to attain professional responsibility to engage and protect people, provide safety practices and care to employees

It is the duty of the “on the job” nurses to follow safe and competent standard practices and deliver quality results. Nurses should abide by the framework of professional codes and standards. (Hains, 2020)

2.3 To acquire individual competence when accepting and delegating responsibility

Nurses have the responsbility to seek approval from the team leader when departing early from duties. RN Pandya duties were also to conduct the professional observation during the handover duties and to document all the information.

3.4 To accept accountability, consider decisions, actions, and acquire responsibilities to follow such responsibilities

In the case, as during the handover duties, it was important to observe the patient, document it and even to report his early departure to the team leader or find alternative solutions, but RN Pandya failed to comply with, due to which there were minimum efforts to prevent accident.

4.2 Nurses should adequately follow an appropriate action to safeguard people, families along with the communities and practice duties

Nurses have a role to be accountable for their actions. Their professional practices and engagement should be for the overall betterment.

Future Practices

  • RN Pandya is reprimanded from the services, his registration is subjected to conditions that prevent him to practice, conduct supervision and undergo training.
  • To gain documentation skills and adequate handover techniques.
  • Sumitra Prasad has been cautioned.
  • To educate about the professional standards and to guide from the case about the ethical and legal dilemma faced (Hains, 2020).

Conclusion on Registered Nurse Scope of Practice in Australia

From the case study, I can conclude, that not only Haridavan Pandya has been negligent of his job duties, but also during the handover times, he has also not coordinated, communicated and has compromised his professional conduct. It is a case of unsatisfactory professional conduct. I agree, with the reprimand with respect to RN Pandya that exercises power, such as not to engage with any agency, to take any charge of a shifts and restrictions imposed on to become future Team Leader. Additionally, he is also restricted to work in a consecutive shifts and to provide written evidence to the Nursing and Midwifery Council of New South Wales. He is further advised for the training and under the Health Practitioner Regulation National Law 2009, Sections 125 to 127, RN Pandya is not allowed to practice anywhere in Australia apart from the New South Wales.

References for Registered Nurse Scope of Practice in Australia

Birks, M., Davis, J., Smithson, J., & Cant, R. (2016). Registered nurse scope of practice in Australia: an integrative review of the literature. Contemporary Nurse, 52(5), 522-543.

Birks, M., Cant, R. P., Budden, L. M., Russell-Westhead, M., Özçetin, Y. S. Ü., & Tee, S. (2017). Uncovering degrees of workplace bullying: A comparison of baccalaureate nursing students’ experiences during clinical placement in Australia and the UK. Nurse education in practice, 25, 14-21.

Chan, A., Molloy, L. J., Pertile, J., & Iglesias, M. (2017). A review for Australian nurses: Cannabis use for anti-emesis among terminally ill patients in Australia.

Currie, J., Chiarella, M., & Buckley, T. (2019). Realist evaluation of privately practising nurse practitioners in Australia: Development and refinement of theories. Collegian, 26(1), 8-15.

Fong, J., Buckley, T., Cashin, A., & Pont, L. (2017). Nurse practitioner prescribing in Australia: A comprehensive literature review. Australian critical care, 30(5), 252-259.

Hains, T., Rowell, D., & Strand, H. (2020). The legitimacy of the nurse practitioner as a non-medical surgical assistant: Historical evidence from Australia. Collegian.

MacLellan, L., Higgins, I., & Levett‐Jones, T. (2017). An exploration of the factors that influence nurse practitioner transition in Australia: A story of turmoil, tenacity, and triumph. Journal of the American Association of Nurse Practitioners, 29(3), 149-156.

McHugh, M. D., Aiken, L. H., Windsor, C., Douglas, C., & Yates, P. (2020). Case for hospital nurse-to-patient ratio legislation in Queensland, Australia, hospitals: an observational study. BMJ open, 10(9), e036264.

 NMBA (2016) . Nursing and Midwifery Board of Australia - Professional standards

https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards.aspx

Parry, Y., & Grant, J. (2016). Nursing in Australia. Understanding the Australian Health Care System, 245-255.

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