Enrolled Nurse Handed Over Medication: A Critical Thinking Case Scenario

The Issue

Question:

Discuss about the Development Interpretation and Application.

The issue that is being discussed by the authors in this article is that the enrolled nurse handed over medication to the patient without consulting the medical officer. In this case, the nurse did not use proper critical thinking skills to analyze the situation in an effective manner while working in an Emergency department. She gave the medications to the patient without taking permission from the medical officer. She must have followed safe and appropriate medication practice. This is against the nursing ethics and legal principles of nursing as the medication might have led to serious health issues and ultimately death of the patient (Cherry and Jacob 2016). She must have communicated in an effective manner with the medical officer while handing over the antibiotics to the patient. Nurses are considered as unregulated staffs who work under the guidance of the doctors and the clinicians. They play a significant role in providing quality care to the patients .The enrolled nurse should have taken permission from the doctor to meet the patient instead of discussing verbally with him. She must have taken the order of the medication from the supervising physician in written before giving it to the patient. The medication order should be documented in a proper manner and should have all the details of the client including the date of visit, name of the medicine, dosage, frequency of administration. It must have also contained the name and the signature of the prescriber. Nurse breached the ethical principles of nursing as she made a false entry in the record (Cherry and Jacob 2016).

The two main reasons cited in this issue are that this act of the enrolled nurse must have lead to serious health effects in the patient. She must have taken the advice of the medical officer before prescribing the pack of antibiotics to the patient. The nurse acted in her scope of practice because the patient was not ready to wait for a longer time to consult the doctor and it was an emergency situation (Raingruber 2016). She also made enquiries about the allergies that the patient was suffering from and the response of certain drugs. The enrolled nurse ten consulted the doctor verbally as the department was very busy during that time. This situation can be considered acceptable because if there was a delay in the treatment, it must have lead to adverse health conditions in the patient. Verbal communication in this case is considered as a means of miscommunication because a written piece of information is considered as more effective in nursing practice.

Reasons for the Incident

The nurse failed to apply contemporary nursing practice because she did not meet the ethical obligations of nursing and provided medications to the patient without the approval of the patient. She must have behaved in a professional manner and should have given the prescription of medications in written. She should have worked in accordance to standards of nursing practice that are being accepted and must not have made a wrong entry (Alligood 2013).

The three significant conduct statements from the Code of Professional Conduct for nurses that were breached in this situation are that the nurse did not practice in a safe and competent manner. The enrolled nurse did not work according to the standards of the nursing profession. The nurse did not promote the trust in the patient by not providing a written medication prescription. She did not behave in a professional manner and performed a unlawful and unethical practice (Kangasniemi, Pakkanen and Korhonen 2015). The nurse should have followed the principles of the code of professional conduct to build confidence and trust in the patient.

The three significant value statements from the Code of Ethics for nurses that were breached and/or not followed in this situation are that the enrolled nurse did not provide accurate and proper information related to the health issue of the patient. She did not advocate social justice and equity in allocating the medicaments. She did not demonstrate respect, trust, integrity and compassion towards her patient (Grace 2017). The enrolled nurse compromised the quality of care being provided to the patient in the emergency department. She did not implement appropriate standard of nursing practice and clinical knowledge.

The nurses must adhere to Health Practitioner Regulation National Law (South Australia) Act 2010 to provide quality care and an excellent patient experience to their patient (Gadbois et al. 2015). The aim of this law is establishing a national registration and authorization scheme for:

1. The regulatory act of health care practitioners
2. The students’ registration those who are undertaking the study programs which provide the qualification that can help the students to get registration in the profession of health.
3. To provide clinical trainings in a health profession.

The objectives of this scheme are –

• Providing protection to the public by making sure that only the health professionals those are trained and qualified enough for practicing in an ethical manner.
• Facilitating the workforce movement across Australia by reducing the burden of the health practitioner.
• By providing the facility of high quality education of health care workers.
• To provide the facility to access the services that is provided by the health care professionals to the public.
• To provide the facility for the rigorous and responsive assessments of the trained professionals.

A key professional or legal standard that was contravened is that the nurse did not follow her roles and responsibilities to provide safe nursing practice to the patient. The enrolled nurse did not consult the medical officer about giving medicines to the patient. She just consulted the patient about any side-effects and adverse response to drugs and provided antibiotic without any written prescription. She must adhere to the values of the nursing profession and provide personalized care to the patient. She should have explained the frequency of the antibiotic given to the patient to prevent any serious health issues. She must have acted pro actively to prevent the health issues and the symptoms faced by the patient. The nursing staff should communicate in an effective manner and provide proper information and knowledge about the disease and the medication given to the patient. The nursing staff and health care professionals should provide a healthy environment and follow proper strategies to improve the management of disease in the patients. They should work on different barriers such as a lack of time, pressure of work and lack of adequate clinical knowledge which would help in providing quality health care services to the patients. It is important to educate the patient to improve the condition of health care services and this case must have been handled tactfully. The nursing staff and other health care professionals must be well aware of the roles and responsibilities Furrow, B., Greaney, T., Johnson, S., Jost, T. and Schwartz, R., 2014. Health law. West Academic..

Contemporary Nursing Practice

The three types of professional development and review that should be undertaken by this nurse in order to prevent incidents in the future are that the nurse should have worked in a collaborative manner with the medical officer. This would have played a crucial role in managing the health disease and symptoms of the patient and the medicines prescribed to him. A proper mode of communication is required in such cases to improve the experience and the trust among the patients (Woods, Cashin and Stockhausen 2016). The nurse must have advised several preventive measures to be taken related to the health disease such as having a well balanced diet, exercise and intake of plenty of fluids such as water and juices.

The nurse must have complete knowledge about the impacts of the decisions that have been taken by them. They should be properly trained and take immediate actions when an emergency condition occurs as it would help in preventing serious health issues in the patient and would prevent death as well. The nurse should have provided proper counseling session to the patient in this case who visited the emergency department. It would have played a crucial role in improving the mental or psychosocial health of the patient (Woods, Cashin and Stockhausen 2016). The two professional issues that reflect the seriousness of the situation in this case are prescription of antibiotic to the patient without consulting the medical officer. The second issue is that the medicine should be given along with prescription containing the name of the patient and the drug prescribed.

The three benefits of the nursing practice as a nursing student are improvement in the knowledge of adhering to the principles of nursing practice in an ethical manner. The patients should be communicated effectively about the health issues and the treatment prescribed to them (Zahedi et al.2013). It is important to deal an emergency situation effectively to improve the health condition and experience of the patient. The nursing code of ethics and professional values should be incorporated in an efficient manner. The nurses should not prescribe any medicaments to the patients without taking any written approval from the patient. This would help in promoting the safety of the patient and improve his health and well being. The nursing staff should make sure that their decisions of health practices are executed in a proper manner.

They should also ensure that all the measures and the strategies taken are well planned before implementing to deliver proper health care services to all the patients (Zahedi et al.2013).

There are several benefits of this critical thinking case scenario such as it helped me to learn the roles and the responsibilities of the nurses in their profession. It helps me to understand that the main objective of the nursing practice is to provide personalized care to the patients who have visited the hospital for the treatment. Several measures and strategies should be taken in order to promote flexible health care services to the patients (Fowler 2015). The symptoms of the patient should be analyzed in a proper manner to avoid any adverse ill effects. The patients should be provided proper self management support from the nurses, clinicians and other health care professional. I also learned the importance of time management to handle emergency situations effectively.

References

Cherry, B. and Jacob, S.R., 2016. Contemporary nursing: Issues, trends, & management. Elsevier Health Sciences.

Raingruber, B., 2016. Contemporary health promotion in nursing practice. Jones & Bartlett Publishers.

Alligood, M.R., 2013. Nursing Theory-E-Book: Utilization & Application. Elsevier Health Sciences.

Kangasniemi, M., Pakkanen, P. and Korhonen, A., 2015. Professional ethics in nursing: an integrative review. Journal of advanced nursing, 71(8), pp.1744-1757.

Grace, P.J., 2017. Nursing ethics and professional responsibility in advanced practice. Jones & Bartlett Learning.

Zahedi, F., Sanjari, M., Aala, M., Peymani, M., Aramesh, K., Parsapour, A., Maddah, S.B., Cheraghi, M.A., Mirzabeigi, G.H., Larijani, B. and Dastgerdi, M.V., 2013. The code of ethics for nurses. Iranian journal of public health, 42(Supple1), p.1.

Fowler, M.D.M., 2015. Guide to the code of ethics for nurses with interpretive statements: Development, interpretation, and application. American Nurses Association.

Gadbois, E.A., Miller, E.A., Tyler, D. and Intrator, O., 2015. Trends in state regulation of nurse practitioners and physician assistants, 2001 to 2010. Medical Care Research and Review, 72(2), pp.200-219.

Furrow, B., Greaney, T., Johnson, S., Jost, T. and Schwartz, R., 2014. Health law. West Academic.

Woods, A., Cashin, A. and Stockhausen, L., 2016. Communities of practice and the construction of the professional identities of nurse educators: A review of the literature. Nurse education today, 37, pp.164-169.