Standard 1- Thinks Critically And Analyses Nursing Practice

Standard 1- Thinks Critically and analyses Nursing Practice

Situation- To assist the registered nurse in identifying child safeguarding issues who have come with his mother to the care unit.

Task- My task was to identify signs of physical, emotional, or sexual abuse and neglect by making use of the best available evidence, ethical decision, and timely documentation of assessments (Chehab et al., 2018).

Action- To understand the signs of abuse and neglect suffered by a child I made use of available evidence and research findings to identify whether the child was suffering from abuse or neglect by observing him both physically, emotionally, and mentally. I documented the findings or my assumptions for referral that would help during the process of decision-making and made use of relevant nursing guidelines, standards, and policies while communicating with the child and her mother.

Result- I was successfully able to identify that the 12 years old child, an immigrant, was suffering from both abuse and neglect which encouraged me to make use of safeguarding strategies until help arrived (Chehab et al., 2018).

Standard 2- Engages in Therapeutic and Professional Relationship

Situation- Since the child was suffering from abuse and neglect it was essential to collect relevant information from her.

Task- Building a therapeutic and professional relationship with the concerned child and my supervisors and colleagues (Mather & Cummings 2019).

Action- It was my responsibility to make the child feel safe and secure within the care unit and engage in communication so that relevant information could be gathered, therefore, I showed respect and compassion to the child, asked her about her likes and dislikes, and her cultural beliefs and values which helped her to gain trust in me, which helped her to share her ordeal of physical and sexual abuse at the place of her living. I was also further encouraged to ask her about the safeguarding expectations she has from the care unit which helped me to uphold her individuality and dignity.

I shared the relevant information with confidentiality with my supervisor and the registered nurse whom I was assisting and together we planned some referrals for the child that would optimize her health outcomes.

Result- The result was that I was successfully able to build a therapeutic relationship with both the patient and other professionals through communication, consultation, and coordination that helped in directing the child to resources that would help in meeting her security and care expectations (Mather & Cummings 2019).

Standard 3- Maintains Capability for Practice

Situation- During my placement, one of my colleagues came to work while she was suffering from a stomach infection.

Task- My task in this situation was to provide the colleague with relevant guidance regarding how to ensure her and others’ well-being and also promote patient safety and quality.

Action- I immediately informed my colleague regarding the consequences of her working while she was ill which would aggravate her health while at the same time, would also pose a risk to the patient and other professionals’ safety and health since her illness could transmit germs and infections to vulnerable patients thereby aggravating their health condition. Apart from this I also made her aware of how poor health would lead to poor or ineffective decision-making and delayed health service thereby leading to ethical and legal issues.  Nursing Practice Analysis Discussion Paper

Standard 2- Engages In Therapeutic And Professional Relationship

Result- My actions helped in preventing HCAIs thereby helping me to manage my own health along with that of my colleagues and patients. Additionally, my actions also led to a lifelong learning approach for continued professional development where my colleague and I realized the importance of being accountable for one’s actions and responsibilities (Liu & Aungsuroch 2018).

Standard 4- Comprehensively conducts Assessments

Situation- To clear my doubts regarding whether the immigrant child suffered from physical and sexual abuse or not I engaged in conducting assessments.

Task- My task was to conduct some tests and assessments to support my doubts and safeguarding issues.

Action- I made use of a range of assessment techniques where I conducted physical tests to identify signs of physical and sexual abuse on the basis of which actions could be taken. The results of the tests were documented and then I collaborated with the registered nurse to understand how this was affecting the mental health of the child and thereby helping us to design priority goals and care plans along with some referrals (Liu & Aungsuroch 2018).

Result- The physical assessment test made it evident that the child had suffered from physical and sexual abuse which thereby helped me and the registered nurse to decide an appropriate referral and safeguarding service for the child that would help in providing her with the required security, care, and would also advocate for her rights as a child and as an immigrant.

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Standard 5- Develops a Plan for Nursing

Situation- Planning nursing care and priority goals for the child

Task- After conducting comprehensive assessments and getting the results, it was now my responsibility to work collaboratively with the registered nurse and other concerned professionals to develop a safe nursing plan for the child.

Action- I collaborated with the registered nurse and shared the assessment document with her where we prioritized mental and emotional health services to be provided to the child and the types of services that would be most appropriate to offer her with relevant and effective help and support.

We then communicated with selected services and negotiated how the practice will be evaluated care will be offered along with the time frame and how resources can be coordinated to provide the best care to the child.

Result- My actions helped me to come up with the most appropriate and relevant nursing plans for the child which clearly aligned with her needs and preferences (Oshodi et al., 2019).

Standard 6- Provides safe, appropriate, and responsive quality nursing practice

Situation- Since I was working as an enrolled nurse, I ensured that I offer safe and appropriate nursing care to the child who had suffered sexual and physical abuse.

Task- My task was to come up with nursing plans and priority goals

Action- To ensure a correct and appropriate decision-making process, I practiced within my scope of practice where I consulted and coordinated with the registered nurse in matters that were beyond my understanding and control helped in offering safe, responsive, and quality nursing care.

Standard 3- Maintains Capability For Practice

At the same time, I also communicated regarding inappropriate care which at times though unintentionally are offered by care groups and services to children that might be below standards thereby helping me to ensure that legislations, safety guidelines, and protocols are followed effectively.

Result- I was successfully able to offer safe, appropriate and quality nursing practice to the child by ensuring that I worked according to my guidelines and standards, made clear communication, and designed effective and relevant priority care goals and treatment interventions that guaranteed safe, and quality care and planning (Oshodi et al., 2019).

Standard 7- Evaluates Outcomes to inform Nursing Practice

Situation- The child has been referred to child protection services, along with appropriate mental and emotional health services.

Task- My task is to evaluate the success of the treatment and priority goals, understand progress or signs of dissatisfaction and thereby make changes and modifications in existing plans.

Action- My actions were to regularly communicate and coordinate care with the concerned child services to get information regarding how the child was progressing. For this, I ensured that I maintain interaction with child service staff, and mental health counsellors and at the same time, also collect feedback from the child and understand how her negative feelings and experiences have changed since the time she has been referred to different yet appropriate services.

Feedback from all the above individuals and organizations was then documented by me and communicated to the registered nurse, where we planned for future goals and treatment interventions that the child should receive for her better recovery, growth as well as development.

Result- Most of the feedback that I received was positive thereby making the care and goal plan a success and at the same time, also helped in overcoming the safeguarding issues that were being faced by the child while she was under the care of her parents (Anderson et al., 2018).

During my placement, I was given the opportunity to work with an elderly aboriginal client who was suffering from mental health illness of dementia and suffering from a lack of self-esteem, morale, and confidence. To understand his care needs and expectations, I understood the importance of communicating with him.

Therefore, to build strong therapeutic communication I showed respect, empathy, and compassion towards the elderly patient and his mental health issue. I also made use of active listening skills which helped me to gather relevant information regarding the physical and mental health issues he was facing both as an elderly and aboriginal patient and the treatment he expected from the organization (Rønning & Bjørkly 2019). The process not only helped me to understand his treatment choices, but also his cultural values, beliefs, and preferences which were effectively communicated by me to other team members (Rønning & Bjørkly 2019).

The situation, therefore, helped me to develop the communication skills required of a professional nurse. Additionally, the situation also helped me to develop teamwork skills, where I recognized the importance of working in a multidisciplinary team that would be able to support and meet the different social, financial, physical, emotional, and mental health needs of the aboriginal patient. I realized the importance of adhering to transparent communication with team members which helped me to make different experts realize the expectations and care needs of the patients (Kleib et al., 2021).

Standard 4- Comprehensively Conducts Assessments

My communication skills also helped in promoting coordination and cooperation among the team members which led to appropriate decision-making and prevented care delays thereby helping in offering quality service to the patient. Therefore, working with the Aboriginal elderly client helped me develop my teamwork skills.

While I was working in an acute care setting, an elderly woman had suffered from a cardiac arrest and was therefore admitted to the emergency ward. She had to be resuscitated after which she gained consciousness. After conducting tests and looking at her past medical history, it was found that she suffered from multiple comorbidities like rheumatoid arthritis, type 2 diabetes, kidney failure, and hypertension, where most of her diseases could not be treated. Therefore, owing to her health condition and having lost hope of recovery, she asked me and other professionals to not resuscitate her again if a similar situation arises.

I felt bad for the elderly patient since I was unsuccessful in providing her with any hope regarding her health progress. At the same time, the decision of the patient put me in an ethical dilemma where complying with her decision would raise patient harm while not complying with her decision would not help me to abide by the aspect of patient autonomy and patient-centred care. The situation surprised me since none of the patients in the acute care ever demanded something like her.

One thing that went well in the entire process was that my supervisor made me aware of my duties and responsibilities as a nurse and through communication with him I realized that one of my most essential duties is to prioritize patient health and safety. I was also supported by my colleagues who helped me to reach the correct decision.

However, one thing which did not go well was that I failed to inform the husband of the patient regarding her decision to not resuscitate her which led to some conflict with him since he was not taken into confidence while the decision was being made by his wife. It was this conflict, which led to some delay in the process of care that could have been prevented had I successfully informed and communicated her decision to the primary family member.

The situation I encountered, is clearly aligned with the nurses’ code of conduct where my responsibility as a nurse is to offer patient safety and quality care at all times irrespective of the situation or their demands. The nurse should work with the best available evidence that will help in offering the most appropriate and relevant care (Cowi et al., 2019).

Apart from this, the principles of care ethics state, the importance of adhering to the aspect of non-maleficence that is not promoting any kind of harm to the patient while they are in the care (Buchanan et al., 2022). In other words, it is the responsibility of every nurse to make the most appropriate decisions, take relevant actions and plan quality nursing interventions that will help in promoting patient health and safety and prevent patient harm due to neglect or incompetency (Buchanan et al., 2022). It is this principle that motivated me to not comply with the decision of the patient since it would promote harm and risk to her health and life.

Additionally, deontological ethics state, that some actions are morally obligatory irrespective of the results. Therefore, as a nurse, it was my moral obligation to promote patient safety and quality and prevent harm by disregarding her decisions (Silva et al., 2018).

Conclusion

Thus, I have learnt that as a nurse I should always promote patient safety and quality health irrespective of what the patient wants. I should have immense nursing competency and skills to understand whether the decisions being made by the patient for themselves are appropriate and will promote their health and well-being or not.

If I face a similar situation in the future, I intend to immediately communicate the patient’s demands to other healthcare professionals and family members. I will also effectively communicate the consequences of patients’ decisions to themselves and their families that will motivate and encourage them to change their decision which will help in promoting safe and quality nursing practice.

References

Anderson, C., Moxham, L., & Broadbent, M. (2018). Teaching and supporting nursing students on clinical placements: Doing the right thing. Collegian, 25(2), 231-235. https://doi.org/10.1016/j.colegn.2017.06.005

Buchanan, K., Newnham, E., Ireson, D., Davison, C., & Geraghty, S. (2022). Care ethics framework for midwifery practice: A scoping review. Nursing Ethics, 09697330221073996. https://doi.org/10.1177/09697330221073996

Chehab, M. A., Thakor, A., Tulin-Silver, S., Connolly, B. L., Cahill, A. M., Ward, T. J., & Venkatesan, A. M. (2018). STANDARDS OF PRACTICE. J Vasc Interv Radiol, 1, 19. 1 https://doi.org/10.1016/j.jvir.2018.06.007

Cowin, L. S., Riley, T. K., Heiler, J., & Gregory, L. R. (2019). The relevance of nurses and midwives code of conduct in Australia. International nursing review, 66(3), 320-328. https://doi.org/10.1111/inr.12534

Kleib, M., Jackman, D., & Duarte-Wisnesky, U. (2021). Interprofessional simulation to promote teamwork and communication between nursing and respiratory therapy students: A mixed-method research study. Nurse Education Today, 99, 104816.  Nursing Practice Analysis Discussion Paper