Details of the Case Study

All the registered nurses have to follow the code of professional conduct for nurses in Australia. The code of professional conduct provides the nurses and the midwives with some rules the professional nurses have to uphold by any means (Chang, & Daly, 2015). In the mentioned case study, Patient-A was admitted to the hospital on 6 January 2013 and died on 12 January 2013.  A registered nurse has been found guilty of conduction unsatisfactory service as she could not understand the seriousness of patient-A’s condition and failed to respond accordingly. The nurse has violated the professional code of conduct.

The duty of the respondent Nurse-in-charge Ms. Conyard started at 1430 hours on 11^th January. After reading the instructions, she was immediately informed about the patient’s condition (Marquis, 2012). As she read the conditions of the patient, she understood that the patient is in serious condition but she was made aware that the doctor of the patient is not available at that time (Andre, & Heartfield, 2011 ). She decided that she would arrange an appointment to see the patient by the locum who usually arrives 6 hours later. She needed to call the patient’s doctor immediately but she did not and waited for the locum who is not aware of the patient’s history.

The patient’s situation deteriorated at 1720hrs with nausea and abdominal pain. Her respiratory rates was very low and very lower blood pressure was of 89/53. The heart rate of the patient was  just 88. The enrolled nurse made the nurse-in-charge Ms. Conyard registered nurse aware of the situation. However, the registered nurse decided to review the patient by the locum whose timing was after 4 hours from that time (Adrian, & Chiarella, 2010). The patient was unattended by any doctor for near about 7 hours in total. The responded did not even recorded the patient’s vital at that time. Apart from having unstable vitals, the patient was reported to have continuous diarrhea. The respondent, Ms. Conyard still did not inform any doctor about the patient’s condition (Thompson, 2012). She should have called the doctor on emergency. She reported that the doctor was not present at the situation though the doctor said that he was present. The respondent nurse-in-charge Ms. Conyard did not even look properly that which doctor was on call that time and which doctor is free.

At 2100 hrs, two registered nurses assessed the patient-A according to ISBAR and red-listed the patient. The patient was described in the assessment as “deteriorating” and needs to be assessed by a doctor ASAP. Red listing a patient means the patient has be reviewed by a doctor within 10 minutes (Adrian, & Chiarella, 2010). However, the locum arrived at 2200 hrs (almost 2 hours after the nurses has red-listed the patient) but the emergency on call doctor reviewed the patient at 2300hrs (Almost 4 hrs after the red-listing). As the nurse-in-charge Ms. Conyard decided earlier that she would make an appointment with the locum as soon as he arrives, she failed to do that.  

Violation of Professional Code of Conduct

The respondent Ms. Conyard did not contacted any doctor about the patient’s condition. Ms. Conyard said that Dr. Heron, who was treating the patients was not present, which turned out to be incorrect (Schneider, & Whitehead, 2013). She did not contact the locum when he arrived and the on-call emergency physician was called at the last moment.

The respondent nurse has breached many NMBA professional codes of conducts, which she has to follow at any condition. The conduct statement 2 states the nurses have to practice according to the standard of profession. The nurses have to practice and widen the standard of quality and safe caregiving (Nursingmidwiferyboard.gov.au, 2008). Though the respondent nurse Ms. Conyard is experienced enough to be the in charge that day, she has violated this code of conduct (Thompson, 2012). She has failed to perform the basic of nursing, as she did not take charge during the situation though being informed of the situation and failed to provide the patient quality caregiving.

It is stated that the respondent Nurse-in-charge Ms. Conyard can be convicted under the national law 139B (Meaning of unsatisfactory professional conduct of registered health practitioner generally). Despite being adequately experienced, the respondent, Ms. Conyard has significantly provided below the standard practice for patient A. The third NMBA conduct statement clearly states that all the nurses have to be familiar with the national laws that are relevant with their clinical practice law (Nursingmidwiferyboard.gov.au, 2008). The NMBA standard-3 statement also makes it clear for the nurses that they must not perform such tasks, which is prohibited by the law.

The nurse-in-charge Ms. Conyard also breached the NMBA conduct statement-7, which states that, the nurses has to support the wellbeing of the patient (Nursingmidwiferyboard.gov.au, 2008). The nurse knew that the patient is in critical condition from the beginning of her duty but still was not sure about the decision she has to make for the wellbeing of the patient.

Patient-A could have been saved if the respondent Nurse-in-charge Ms. Conyard nurse has behaved as professional. Ms. Conyard has failed as she could not recognized the condition of patient A. She did not arranged a doctor to do the medical review between the time 1710 hrs and 2100 hrs while the patient’s condition was pretty critical at that point as the patient blood pressure was 89/53 with the respiratory rate as low as 40-44 breath per minute (Nursingmidwiferyboard.gov.au, 2008). The patient was reported to have diarrhea and abdominal pain. Ms. Conyard should have arranged for a medical review after noticing the condition of the patient moment. 

Breach of NMBA Code of Ethics and Laws

The patient received the medical review performed by the emergency doctor almost 4 hours after the respondent nurse-in-charge Ms. Conyard herself listed the patient as red zoned. The Hunter New England NSW health policy clearly states that a red-zoned patient needs immediate help from the medical officer within 10 minutes after recognized as Red zoned. A medical officer was not immediately contacted and the medical practitioner who was treating the patient was not notified about the condition (Pairman et al. 2010).  If Ms. Conyard would have contacted any physician during that time, the patient could have been saved.

The respondent contacted the nurse manager for a drug for another patient but did not informed her about the condition of patient A. The nurse manager arrived with the drug sometimes after but Ms. Conyard still did not informed her about the condition of the patient even after she arrived there (Marquis, 2012). This kind of irresponsible behavior should not be expected from a registered nurse who has more than 10 years of experience and currently designated as in charge of the hospital nursing unit,

One can gain much knowledge from the case. A nurse should always be aware of all the relevant laws of nursing and Ms. Conyard violated the law 139B (Andre, & Heartfield, 2011). A registered nurse should be responsible enough to think about the welfare of the patient. Ms. Conyard behaved carelessly about the patient despite knowing that the patient is critical. She did not contacted anybody even after the nurse manager and the on call doctor was available. A nurse should devote her life to give care to a patient when in need (Masters, 2015). A nurse should document every move taken in the unit including the assessment of the patient, the action plan and what could be done for the welfare of the patient. The respondent nurse-in-charge Ms. Conyard failed to do it.

In the case study, the respondent, Ms. Conyard has been accused of according to the national law of 139B, which states of unsatisfactory professional conduct. The respondent Nurse-in-charge Ms. Conyard did not follow many NMBA code of ethics which must be followed by every nurse in every condition. Despite of having many knowledge and experience, Ms. Conyard failed to perform her work and was irresponsible. The nurses should learn many things from this provided case study.

Reference

Adrian, A., & Chiarella, M. (2010). Professional conduct: a casebook of disciplinary decisions relating to professional conduct matters. (2nd ed.) Sydney, NSW: Nurses and midwifery board of New South Wales

Andre, K & Heartfield, M. (2011).  Nursing and midwifery portfolios: Evidence of continuing competence (2nd ed). Chaswood, NSW: Elsevier Churchill Livingstone

Chang, E., & Daly, J. (2015). Transitions in Nursing-E-Book: Preparing for Professional Practice. Elsevier Health Sciences. (4th ed.) Chatswood, Australia: Elsevier Australia

Marquis, B (2012). Leadership roles and managemrnt functions in nursing: Theory and application (7th ed.). Philadelphia, PA: Wolters Kluwer Health/ Lippincott Williams & Wilkins.

Masters, K. (2015). Role development in professional nursing practice. Jones & Bartlett Publishers.

Nursing, A., & Council, M. (2008). Codes of Professional Conduct & Ethics for Nurses in Australia 2008. Nurses Board of South Australia. Retrieved from https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx

Nursing, A., & Council, M. (2008). Codes of Professional Conduct & Ethics for Midwives in Australia 2008. Nurses Board of South Australia. Retrieved from https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx

Pairman, S., Tracy, S. K., Thorogood, C., & Pincombe, J. (2010). Midwifery: preparation for practice (3rd ed.) Chatswood, NSW: Elsevier Australia.

Schneider, Z., & Whitehead, D. (2013). Nursing and midwifery research: methods and appraisal for evidence-based practice. Elsevier Australia.

Thompson, F. E. (2012). Moving from codes of ethics to ethical relationships for midwifery practice. Nursing Ethics, 9(5), 522-536.