NUR3020 Professional Transitions

Question:

Briefing on Assignment

Conduct an analysis of Case: Findings of Inquest into Albert Eric Bruce Biffin’s death, focusing on the three sections.

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In the Inquest into Albert Eric Bruce’s death, the Coroner reported that the medical cause of death was complications of an incarcerated Umbilical Hernia.

While Mr Biffin had a long history of medical problems, it was clear that he was able to remain independent in his residential care.

On February 27, 2013, Mr Biffin, at the age 86, died.

A number of registered nurse were involved in Mr Biffin’s care from February 24, 2013, to February 27, 2013.

The roles of the assistant in nursing and the endorsed registered nurse were crucial to the events that occurred and affected Mr Biffin’s death.

McDonald’s (2014) and Then (2014) have provided a chapter on DIRECT readings at the study desk NUR3020. This chapter explains that errors can occur but it is not always easy to attribute them to one individual.

Section 1: Conduct an analysis of nursing care (pages 7-11) The Inquest into the Death of Albert Eric Bruce Biffin1 outlines the role of the assistant nurse, endorsed registered nurse, and overall accountability of the registered nursing.

Assignment Section Two: The Tort Or Negligence

Section 2: Discuss how negligence can be applied to the registered nursing/clinical nurse in this instance.

The elements necessary to prove negligence in a claim are listed below.

Assignment Section Three: Ethics

Section 3: Ethical Analysis.

Aside from the legal aspects of this case, there are several ethical issues that could also be discussed. These include the care provided to a resident at a residential care facility and the testimony of residents.

You can use examples from the activities of the registered nurse, assistant in nursing, or enrolled nurse to criticize their behavior and consider resident rights while they are in residential care.

You can use literature and academic texts that are related to ethics to help you critique.

Answer:

Section 1

As nurses play an integral role in providing quality health services to all, they are highly respected and expected to be qualified, professional, and caring for their patients. (Daly Speedy, Jackson, 2017).

Any person authorized to use the title of registered nurse or enrolled nurse under section 141 (Nursing Act 1992) is allowed to practice nursing.

Registered nurse and enrolled nurse both work together. An enrolled nurse aids the registered nurse when making decisions regarding the patient’s medical status (Gaskin 2017).

The primary responsibilities for an enrolled nurse are to recognize normality and abnormality in assessments; perform delegated responsibilities; monitor the impact care has on any individual’s health (McDonald & Then (2014).

Regular communication between the registered nurse and the enrolled nurse regarding the health status of patients is required.

A registered nurse may need to be more attentive and involved with a particular patient at times when they are experiencing unpredictability or a change in their health (Masters thesis, Role development of professional nursing practice, 2015).

A registered nurse should also be more attentive when the patient is constantly being assessed and changes are needed in the patient’s care plan.

Inquest into death of Albert Eric Bruce Biffin raises concerns about nursing care. It questions whether nurses were accountable and if the care provided was adequate.

Bruce was found to have an umbilical hernia, which had been diagnosed recently by the coroner. He required immediate medical attention from Dr. Lambie and nursing care.

Bruce was vomiting and an enrolled nurse called to request a registered nursing nurse.

The registered nurse noticed that Bruce was experiencing pain in his lower abdomen.

The registered nurse suggested that Bruce be given Movicol for constipation.

The registered nurse began to communicate with Bruce and noticed the hernia’s size. It was inflamed, and it was pink.

As she was meeting Mr. Briffin, and he didn’t complain of pain in his stomach, the registered nurses did not examine the hernia. Instead, she believed that he was experiencing constipation and advised him to take movicol.

The nurse failed to notice Mr. Briffin’s changes in health. He complained of feeling sick and having stomach pains while she evaluated him.

The registered nurse did not pay much attention to the fact that Mr. Briffin was complaining of feeling unwell and having stomachaches. However, he later denied any pain and said he didn’t seem stressed.

The registered nurse was also informed about the hernia. He said it was not painful, but seemed more concerned about his constipation.

A registered nurse must be more attentive to patients experiencing rapid changes in their health. This is according to the nursing code of practices (Kangasniemi Pakkanen, Korhonen and Korhonen (2015)).

However, even though the nurse was alerted to the hernia, stomachache and other symptoms, she did not touch nor examine them.

Bruce was further evaluated by another registered nurse who gave him another dose Movicol for constipation.

The nurse observed Bruce’s vomiting, abdominal pain, and prominent umbilical hernia.

A registered nurse informed him that Dr. Lambie will be visiting Bruce on Sunday to assess the wound.

Dr. lambie visited Bruce and no registered nurse recorded his observations. Three registered nurses were to be there to care for Bruce.

Furthermore, Mr. Biffin was in residential aged care facilities (RACFs), which are run by nurses who are responsible for the daily maintenance, recording, and reporting of the operation and care of each resident. The registered nurses did not perform their duty of caring for Mr. Biffin (Gaskin, Georgiou, Barton & Westbrook, 2017).

After Dr. Lambie had left Monday, an enrolled nursing nurse reviewed Mr. Biffin. He complained of feeling sick and nausea.

She did not give any medications, but she simply described how he was feeling unwell just before Dr. Lambie visited.

A registered nurse administered two doses Movicol to him at 16:30.

After that, no doctor nor nurse visited Mr. Biffin, except for Tuesday 26th, when they were unable to provide any medical care.

The clinical nurse noticed that he was constipated and gave him movicol.

While the clinical nurse was responsible for supervising Jacaranda’s assistant and enrolled nurses, and overseeing all residents, it is clear that she should have been more attentive to Mr. Biffin.

While she claimed she had asked Bruce’s enrolled nursing to observe him, she did not keep a record of the document. She expected that the enrolled nurses would inform Bruce about any abnormalities she observed.

She didn’t know if she had instructed Dr. Lambie as an enrolled nurse to report any abnormal conditions.

This is a violation of professional ethics by the clinical nursing assistant (Davis, Morgans, & Burgess, 2017.

She simply noted that Mr. Biffin had not vomited without knowing anything about his health and that he felt unwell. This is contrary to her earlier statement that Bruce looked unwell while she was sitting in his chair.

A clinical nurse had a more senior role and more responsibilities than other staff providing care to Mr. Biffin.

She was not involved in Mr. Biffin’s treatment, but her primary responsibility was to care for a resident who had just had a hernia operation.

A verbal instruction to an enrolled nursing nurse, and that too on her first shift to observe the patient according, portrays a lack of guidance to a less skilled nurse. Clinical nurses need less information to gain about an elderly patient like Bruce (Scanlon Cashin Bryce Kelly & Buckely 2016, 2016).

Additionally, although the enrolled nurse was aware that Bruce’s condition was deteriorating, she didn’t inform the registered nurses. She instead handed the nurse to the assistant nursing and mentioned that Mr. Biffin needed help to go to the bathroom.

Bruce’s condition began to deteriorate and the assistant nurse called Bruce, who was the first time she had met her.

She was reading through the records and instead of calling an ambulance, she helped Bruce to change his dress. This is clearly a lack of decision-making ability, which is what one would expect from a registered or qualified nurse (Street Ottmann Johnstone Considine, Livingston, 2015).

These instances show that nurses have failed in their professional duties and have raised questions about their competence as well as accountability.

The role of registered nurses is to provide safe and effective health care services for patients.

They did not pay more attention to Mr. Biffin’s hernia pain or nausea, but continued to give him high doses when he was feeling unwell and could not eat.

They were held responsible for the provision of health services to Mr. Biffin in residential care facilities that they had failed to provide.

Section 2

Nursing involves close physical contact between the nurse and patient.

The nurse can be sued if the patient suffers injury due to negligence.

To prove negligence, the party complaining must show that they have suffered damages as a result of breaching their duty of care (Masters 2015).

It is essential that the aggrieved party demonstrates the following essential elements in order to establish negligence.

The plaintiff was entitled to a duty of care from the defendant

It was found that the defendant did not uphold the required standard.

Plaintiff has suffered damages from the breaching of the duty to care

It is possible that the defendant could reasonably have foreseen damages to the plaintiff.

The nurses, whether they are registered or clinical, have failed to fulfill a duty of caring that they owe to Mr. Biffin in this case.

Bruce was a resident in the Residential Aged Care Facilities (RACFs). The nurses owed Bruce a duty to care. As a registered nursing assistant, she was required by law to pay greater attention to patients whose health is changing frequently and their responses are unpredictable (Dwyer Craswell Rossi & Holzberger 2017, 2017).

Regular and continuous assessments are required to change the care plan. Registered nurses are responsible.

In his advanced years, Mr. Biffin suffered from umbilical hernia. He was frequently nauseous, and was treated with movicol.

The clinical nurse is the senior nursing staff member responsible for supervising residents at the aged care facility. She is especially responsible for patients with frequent health changes and those who need regular monitoring (Blackman et. al., 2015).

Instead of reviewing Bruce’s records and making sure he was aware of the excessive dose of movicol, she simply instructed the enrolled nursing, a less skilled nurse, to check on Bruce’s health.

This violates Mr. Briffin’s duty of care.

Additionally, the registered nurses continued giving him movicol for constipation.

Even though Bruce was in a critical state of health, the nurses were still attending him.

Bruce’s condition was rapidly deteriorating and the registered nurses lacked the ability to make decisions. Instead of calling an ambulance, Dr. Lambie called for an ambulance. The registered nurse assisted Bruce in changing his clothes (Chang & Daly 2015).

The nurses breached their duty of care and caused Bruce’s health to deteriorate. Dr. Lambie was not notified of this fact, nor did they transfer Bruce to hospital.

They were able to reasonably anticipate the harm that Bruce would suffer (Foley & Christensen (2016)

The Coroner can refer to section AA under the Coroners Act (the Act) which describes deaths that are due to lack or treatment. It also includes the Framework for Nurses and Midwives Queensland approved by council in 2005.

The clinical nurses may be held responsible for their negligence.

Section 3

It is crucial for health care professionals to consider the concerns and managements of patients. The idea decision-making process must include ethical principles. Health care providers need to be willing and able to take action to safeguard the vulnerable and those who are least fortunate.

The nursing profession recognizes human rights and the need to protect the basic human right for all people to health.

Heaton, 2014. Nursing professionals must demonstrate a sufficient knowledge of ethics to be morally responsible.

The Senior position of the Clinical Nurse was to oversee the assistants and the nurses enrolled in the case.

The Clinical nurse was responsible for supervising all residents at the residential age care facility. She was also required to pay greater attention to patients who were under regular evaluations and were reported to be experiencing frequent changes in health.

She didn’t fulfill her duty. Bruce’s medical records were not reviewed by her. She instead gave instructions verbally to an enrolled nurse to examine Bruce’s condition. This shows a lack of decision making ability (Anderson Malone Shanahan & Manning (2015)).

Enrolled nurses are required to support the clinical nurse in making decisions using critical and reflective skills.

Nurses have an ethical responsibility to provide effective health care. In the case of elderly parents whose condition changes often, it is essential to pay more attention (Parahoo (2014)).

Residents of residential age care facilities have the right and ability to receive services and care whenever they need it.

In addition, nurses maintain an informal relationship of trust with their patients. This allows them to share their concerns and fears about their health.

References

Handover of clinical information to nurses at the bedside-an integrated review and analysis of tools and issues.

Journal of clinical Nursing,, 24(5), 662-671.

Factors that contribute to the failure of nursing care.

Journal of clinical Nursing, 24(1), 47-56.

Nursing practice and ethics.

Palgrave Macmillan.

Transitions in nursing-E-Book: Preparing to Practice.

A brief introduction to contexts of nursing.

Information management in Australian aged care: An integrative overview.

Health Information Management Journal 46(1), 3-14.

Evaluation of an aged care nurse practitioner: quality of care in a residential age care facility hospital avoidance.

BMC Health Services Research,, 17(1).33.

Negligence & the Duty to Care: A Case Study Discussion.

Gaskin S. G. (2017. August 20).

An investigation of residential aged-care facilities: Examining the role and importance of information exchange in residential aged home care work practices.

Legal aspects in nursing.

Kozier & Erb, Fundamentals of Nursing Australian Edition. 3, 57.

A comprehensive review of nursing ethics.

Journal of advanced Nursing, 71(8) 1744-1757.

The Guide for Nurses & Midwives: Ethics, Law and Healthcare.

Palgrave Macmillan.

Nursing research: Principles, process and issues.

Palgrave Macmillan.

The Australian context is complex in terms of the definition of nurse practitioner scope of practise.

Advanced care planning for older Australians presenting to the emergency room from their community or residential aged care facility.

Health & Social Care in the Community,, 23(5) 513-522.

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