• Subject Name : Nursing

Haridvan Ashokbhai Pandya Case Study

Introduction to Clinical Competence Assessment in Nursing

The primary aim of the assessment is in identifying the professional misconduct, which was discussed in detail in the selected case study on “Haridvan Ashokbhai Pandya”. Under this case study, the decision-making statement selected from the Decisions of the Professional Standards Committee from the Nursing and Midwifery Council of New South Wales. The thesis statement under the research will be to analyze professional misconduct as per the case study, to develop he sound professional nursing conduct in the future, which will automatically help in the development of future practices.

Before proceeding with this task, certain important nursing concepts that need to be cleared in this context are the effective integration of the 6Cs nursing practices as per the Australian Commission on Safety and Quality in Health Care. To follow the professional conduct, as per the case study, the registered nurse needs to follow certain nursing qualifications like to become competent, confident, etc (Australian Commission of Safety and Quality in, 2016). Along with this, the fact, which should also be taken under consideration, is following the ICN Code of Ethics for better care and treatment for the patients. These are certain concepts that will be clarified and explained in detail through which both the insightful and analytical outline can be obtained (NSQHS, 2017).

Summary of The Case

The case opens like this were during Friday, 2014, one of the visitors arrived at Bungarribee house to see his husband, who got admitted to the Acute Ward of the mental Health facility of the Western Sydney Local Health District. However, at the time of checking him, it has even found that the patient was not in his room. After checking the patient’s bathroom, it has been found that the patient was collapsed on the floor, taken his own life. The registered nurse who was looking after the patient was Mr Pandya who had departed earlier that day to look after the other patient.

Due to this, Mr Prasad who was also another Registered Nurse was provided with the responsibility to look after the patient. However, the concerned nurse has handed over this issue to another person, which had ultimately caused the incident to take place. The case had been put forwarded to the Court where it has been decided during 2017 that Mr Pandya who was responsible to look after the patient got reprimanded and the license of him to practice certain nursing care and the supervision also been strictly prohibited.

Identification of The Professional Errors that Resulted in This Incident

In the case study, the presence of unprofessionalism among the Registered nurses has been found who was not responsible enough in notifying the higher authorities of the hospital regarding their early departure, when they knew that they had been provided with the responsibility to check over the critical mental patient (K, 2015). Through the analysis of the case study, it has been found that the 6Cs of nursing is absent that is the care, compassion, competence, communication, courage, and commitment. It outlines that there existed a lack of communication among the registered nurse with the clinical experts and hence in this regard, it turns out to be necessary for adequate training on nursing subjects along with the conference attendance and the seminars, which in total will uplift the mentorship practices among the registered nurse (Yanhua & Watson, 2011). After thorough analysis, it has been found that there existed certain professional errors among the registered nurses like the absence of the clinical governances along with the safety and quality systems that are required in maintaining the quality lifestyle among the patients (White, 2015). Other than this, it can also be stated the registered nurses in the case study could have been responsible and professional before handing over the responsibilities of the patient to others and should notify the authority regarding their early departure since the patient case is critical. According to Mental Health Legislation and Human Rights, the registered nurse failed to follow highly prioritized nursing care standards, keeping in mind the patient’s cultural safety, which can be possible only through the nursing standard practices (Yanhua & Watson, 2011).

Additionally, the other professional misconduct that is reflected through the study was a lack of effective planning and programs which is necessary behind the effective as well as timing allocation, delegations, and supervision. Through the entire study, as per the NSW health policy documents, it is clear that the absence of accountabilities, collaborations, competencies, consultation, and delegations among the registered nurses have ultimately lead to this type of fatal incident (Australian Commission of Safety and Quality in, 2016). As per the latest health regulation, it has been found that the Policy Directives of the Mental Health Triage Policy lacks effective execution among the registered nurses in the hospital and hence effective communication between the registered nurses and the patients were not yet developed (Australian Commission of Safety and Quality in, 2016). Certain Nursing Standards especially the Clinical Governance Standard, Communicating for Safety Standard, Recognising, and Responding to Acute Deterioration Standard was missing among the performances of the Registered Nurses, which contributed towards such a fatal incident. As health professionals, registered nurses could develop their professional portfolios through regular learning and development processes. The reason behind the development of the professional portfolios is to help the patients to trust the registered nurses at the time of delegation of the duties (K, 2015).

Change in Practice as The Result of The Incident

As a result of this fatal incident that been outlined in the case study, if I was a registered nurse, I should develop certain habits so that I could act professionally in the future to promote health, alleviating the suffering among the patients, and also providing the patient with adequate respectful care and proper time. In this situation, it had been critically outlined by White (2015), that the registered nurse according to the case study was so busy with other cases and the handovers, they were not responsible enough in providing at least minimum time for the patent who was suffering from an acute mental health problem. This incident had been clearly explained by the author, Yanhua & Watson (2011) where he portrayed that actually, the registered nurses according to the NSW Health policy guidelines are highly time-bound and often fail in realizing that what will be the outcome of their any single wrong decision.

In this particular event, if I was there I should try to engage myself in a professional and therapeutic relationship with the patient as per the NSW Heath policy guidelines so that mutual trust and friendship can be easily developed among us. Here it has been pointed out with clear logic and reasoning by K (2015) that avoiding the patient and only the time-bound treatment will not help in his/her recovery. The solution will be providing more time needed to the acute mental trauma patient to help them in being recovered from loneliness and other problems. Hence, the professional practices, which needed to be learned by me in this context for the future betterment, are the use of the different partnership programs. Besides, to learn the different roles of the assessment techniques to study the behaviour of the patient and accordingly treating him with adequate care and mental support (Australian Commission of Safety and Quality in, 2016). At the same time, I should also be developing the behaviour observation chart of the patient to notice any changes among him. If I get busy with something else and had to leave the floor, I should be informing this at first to the higher authorities so that they can readily able to arrange some substitutes. Hence, overall timely action and the planning needed to be formulated as per the Western Sydney Local Health District General Information Policy. Hence as a whole, the below-mentioned image is important to be taken into consideration by the registered nurses at the time of treating the metal traumatized patients (NSQHS, 2017)

It had been clearly articulated by Benner (2004), that the use of the Dreyfus model turns out to be useful for the registered nurses where skill acquisition is one of the important criteria that needed to be checked by the registered nurses at the time of treating the acute mental traumatized patients. “The model is developmental in that changes in the performance in particular situations can be compared across time. However, the model does not focus or identify particular traits or talents of the person that generates the skilful performance” (Australian Commission of Safety and Quality in, 2016). The authors like White (2015) had beautifully examined the theory of nursing, where nursing as a practice needs both techniques as well as phronesis as being highlighted by Aristotle where the presence of adequate competencies among the registered nurses along with the emotional support is both needed for the patient for easy recovery (NSQHS, 2017).

Conclusion on Clinical Competence Assessment in Nursing

To conclude, it is very common for registered nurses to face problems at the time of facing new challenges in treating critical patients. At that time, they go through the transition phase. However, in this regard, the registered nurse needs to follow certain ethics and the medical standards without escaping from the situation or handing over the responsibilities to another person.

In this aspect, the ICN Code of ethics for the nurse can act as a guideline that is used by the nurses readily in every working aspect. It shows the strong collaboration of the registered nurses with eth National Nurses Association as per NSW policy guidelines from whom, they can be readily able to understand the effectiveness and the importance of the communications, education, managing the patient, and the control.

References for Clinical Competence Assessment in Nursing

Australian Commission of Safety and Quality in. (2016). National Safety and Quality Health Service Standards . Retrieved from https://www.safetyandquality.gov.au/wp-content/uploads/2011/09/NSQHS-Standards-Sept-2012.pdf

Benner, P. (2004). Using the Dreyfus Model of Skill Acquisition to Describe and Interpret Skill Acquisition and Clinical Judgment in Nursing Practice and Education. Bulletin of Science, Technology & Society, 24(3), 188-199. doi:10.1177/0270467604265061

K, D. (2015). Integrating the 6Cs of nursing into mentorship practice. Nursing Standard, 29(50), 49-58. doi:10.7748/ns.29.50.49.e9957

National Health and Medical research Council. (2006). Cultural competency in health: A guide for. Retrieved from http://www.mhahs.org.au/images/cald/CulturalCompetencyInHealth.pdf

NSQHS. (2017). National Safety and Quality Health Service Standards. Retrieved from https://www.safetyandquality.gov.au/publications-and-resources/resource-library/national-safety-and-quality-health-service-standards-second-edition

Nursing midwifery board. (2020). Retrieved from https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards/registered-nurse-standards-for-practice.aspx

White, J. (2015). Becoming a competent, confident, professional registered nurse. Netherlands: Elsevier.

Yanhua, C., & Watson, R. (2011). A review of clinical competence assessment in nursing. Nurse Education Today, 31(8), 832-836. doi:https://doi.org/10.1016/j.nedt.2011.05.003

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