Various ethical code of conducts that are being enumerated for the nurses under the code of ethics for nurses in Australia. These codes are applied to all kinds of nurses. It carter the need of multiple audiences as nurses, patients, nursing students, employers of nurses, and others related to the nursing community. The codes clearly describe that the nurses should be kind and considerate towards the other, the nurse should value informed decision making, nurses are responsible to have ethical management of the information and should promote sustainable health and wellbeing.
In the present case, a fellow student nurse had a heated argument with the patient which was wrong as the nurses are accepted to respect and value all the patients however in this case the patient was assaulted by the nurse. Under the code of ethics, it clearly mentioned that the nurses should report such incidents to the appropriate authority in the events regarding illegal, unethical, or incompetent practices. Since the protocol expects the person to be kind and considerate towards the patient assaulting him was wrong. Since it was unethical and inappropriate the complaint should be registered to the authorities. Another important conduct that is expected from the nurse is to create a culture of safety for others, under this case the nurse should have value the safety of the consumer. However, that was not done in the present scenario and an assault on the patient was made that has created fear among other patients which further makes it is important to report for the same.
The students working are expected to have lawful behavior which restricts them from performing any act that is not good for their profession. The reporting of any such unlawful act is very important as it comes under the mandatory reporting requirement. Whenever such wrong is done with any person it becomes the duty of the practitioner to provide apology and explanation for the actions performed on the person.
Like every profession, even nursing has certain boundaries that are needed to be maintained and the professionals are expected to respect those boundaries. According to the code of conduct for nurses, it is provided that no nurse should be indulged in any kind of physical assault like striking, applying unnecessary force, or restraining orders.
A similar case was addressed by the court in that such acts are considered malpractice. As these acts are because of negligence, misconduct, or breach of duty causing nursing malpractice. 4 practices that are included in nursing malpractice includes the duty of the nurse to the patient, breach of duty, the injury occurred to the patient and there must be a relation between the breach and injury to the patient (Reising, 2012). Under the given circumstance the student was present in the premise and the argument was going on with the patient at that time the student lost his temper and slapped the patient which a practitioner is not supposed to do hence that amount to a breach of duty this act has caused humiliation to the patient hence this establishes the causal relationship between the breach and the injury.
Another example in this regard can be undertaken from the case where an enrolled nurse was permanently disqualified from practicing nursing as he was held liable for misconduct by the assault on the patient. This case was heard by South Australian Health Practitioners Tribunal. In this case, the defendant slapped a 65 years old patient suffering from Alzheimer's act of the defendant constituted professional misconduct disqualifying him to register as a nurse in the future (Nursing and midwifery board, 2017).
Hence after considering all these circumstances the nurse needs to report the incident to an appropriate authority so that necessary action can be taken against the student that would give a deterrent effect on others regarding the same.
The issue of nurses dealing with alcohol and other drug problems is an issue at the workplace as it is important because it may hamper or impair the practice, they carry to deliver safety and care to the patient. Hence to perform the duties diligently it is important for the nurses to observe, think, and act effectively. While performing the duties the nurses should take sound decisions and make a correct judgment. However, if a nurse is intoxicated that may cause work-related problems that the nursing profession has failed to recognize.
Intoxication is explained as the consumption of a substance that exceeds the individual's tolerance and produces change to the body. it is not that the nurses are not permitted to drink alcohol, a low level of drinking is allowed and it is defined as the 4 standard drinks a day for men and 2 for women.
Nurses who are indulged in alcohol and other drug problem posses the risk to patient or client through intoxication as that may result in impaired judgment, mismanagement of medical facilities, negligence, and unsafe practices, all such actions lead to the risk to the public seeking help. Moreover, working with the hangover effect the decision-making capacity if the nurse keeping both the peer and patients at risk.
Alcohol consumption can lead to financial problems like low productivity, accidents, overwork claim, theft, or other criminal activities besides this the hospitals can be held liable for the litigation. Other than the financial cost intoxication often leads to poor healthcare to the clients and undermining the nursing profession. It is the nurse's responsibility to provide safe practice according to health and safety regulations. But intoxication projects the higher cognitive functions risking the nurse, clients, and the staff. Mixing of the drug has its own side effect.
Section 19 of the Occupational Health, Safety, and Welfare Act, 1986 provides that the employer should respect each employee or employer, ensuring reasonable practice at work safe from injury and risk to health. All these steps are needed to maintain a safe working environment, safe system of work, and planting substance in a safe condition. Under this section duty of care is enumerated where the employer needs to take the duty of care for the employees in managing alcohol and other drugs. Under section 21 of the OHSW Act, 1986 employees' responsibilities are provided under which the employee should take reasonable care for his health and safety and should act in a particular way or should avoid omission of an act. The section also ensures that the employee is not endangering the health and safety of any other person in the work environment.
Since the nurse must take care of the patients it is also important for the peers to take care of the nurses and safety of the people in the surrounding. However, peers often face various problems while reporting these issues as they often deny the problem and are reluctant to report about the peer's poor performance as they feel it is unjust for the fellow nurse to have disciplinary action against him. However, nurses should have clarity of what is wrong and what is an acceptable level of practice by the fellow employee. There are cases in which it is unacceptable to cover up for someone who is intoxicated and unable to work appropriately. Similar situation is given in the present scenario where the nurse finds her fellow employee in the lift where she was smelling strongly of alcohol.
In Australia, there is mandatory reporting of law that is for 14 health professionals which include the nurses as well hence the notification is needed to be provided to report for the matter (CNO,2019). Hence in the given case, the peer nurse must report the matter to the concerned authorities so that relevant steps can be undertaken for the safety of patients and fellow employee and employer.
The nurses are responsible for safeguarding and respecting the valuables and personal property of the patient at the time he is admitted to the health care facilities. The nurses are not allowed to borrow or steal the personal valuables of the client under any circumstances. Every facility has different rules for safeguarding the client's possession and valuables. These procedures typically discourage the nurse to retain the personal property of the client. Generally, nurses are responsible for taking care of their valuables. These policies and procedures are relating to safeguarding and maintaining the personal possessions of the valuables while they are hospitalized are to be followed by the concerned authority. The valuables are kept into an envelope with the name of the client, room number and the content in the envelop once the possessions are given to the nurses these are kept in the lockers. The valuables can include things like cash, credit card, jewelry, etc. the items that are placed in the envelopes are then listed into a description like a ring with red stone, $50 cash, black pearl necklace, etc. for the case of metal as the nurses are unable to distinguish between the original and the sterling metal they often list the item as yellow metal or white metal. All these valuables are needed to be secured by the nurses. When a patient is discharged the personal possessions are provided back to them. The patient checks and confirms the item in the envelope and even signs the statement that all the valuables that were submitted have been given back to them.
However, if any of the valuables that at the time of admission was given were not provided to the client that amount to theft. Honesty is an essential ingredient for ensuring the client's trust and the client's vulnerable position mustn't be abused by the nurse. In addition to this, the clients always trust the nurse and it is expected from the nurses not to abuse the trust entrusted upon them.
Nurses are in obligation to maintain the commitment they have towards their clients in the present case taking of the necklace without permission was the case of misappropriation of the property of the client as it destroys the nurse and client relationship regardless of knowledge. In the present case the property was misappropriated by the student but since he owned up for it and gave it back it would be reasonable for the registered nurse to explain to him how the process goes and what all are needed to be done with a warning as if that is not done it would be harmful for his professional life.
Registered nursing. 2020. Legal Rights and Responsibilities [online] Available at: < https://www.registerednursing.org/nclex/legal-rights-responsibilities/ >
CNO. 2019. Professional Conduct Professional Misconduct, College Of Nurses Of Ontario, [online] Available at < https://www.cno.org/globalassets/docs/ih/42007_misconduct.pdf>
SA Health. 2001. Alcohol and Other Drug Use Among Nurses [online] Available at < https://www.sahealth.sa.gov.au/wps/wcm/connect/379beb80417bae35ad91ef67a94f09f9/Alcohol+and+Other+Drug+Use+Among+Nurses+-+Guidelines+2001-DASSA-Oct2013.pdf?MOD=AJPERES&CACHEID=ROOTWORKSPACE-379beb80417bae35ad91ef67a94f09f9-n5jqt8x>
Nursing and midwifery board. 2018. Nursing and Midwifery Board Of Australia – Professional
Standards. [online] Available at: < https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Codes-Guidelines/Guidelines-for-mandatory-notifications.aspx
Occupational Health, Safety and Welfare Act (1986) [online] Available at: https://www.legislation.sa.gov.au/LZ/C/A/OCCUPATIONAL%20HEALTH%20SAFETY%20AND%20WELFARE%20ACT%201986/2002.05.03/1986.125.PDF
Nursing and midwifery board. 2017. Nurse permanently disqualified after assault on patient, Available at: https://www.nursingmidwiferyboard.gov.au/News/2017-11-20-permanently-disqualified.aspx
Reising, D. L. (2012). ‘Make your nursing care malpractice-proof’. American Nurse Today, 7(1), 24–28.
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