Nursing Assignment: Case Analysis Of “Angel Of Death”

Question

Task: Rationale for nursing assignment task: As the complexities of caring for a patient in our healthcare system increases there is a need to improve our own critical thinking processes, our capacity to work in complex organisations and in making decisions as a Registered Nurse in an interdisciplinary team often when conflict arises in our personal and professional responsibilities. Our ability as Registered Nurses is affected by our awareness of the importance of our ethical responsibility and professional judgement in decision making in practice. Ultimately the decisions of a Registered Nurse can improve, change or benefit patients, families, colleagues and peers.

Task detail:
The case study highlights key areas in the ethical decision-making capacity of the Registered Nurse in a ward environment. The case study presents a situation where personal and professional conflict arises that requires the colleague, a Registered Nurse, who has been approached by an Enrolled Nurse with
information that causes tension, a need for solid professional judgement and for sound conflict resolution.
Your Nurse Unit Manager is keen to develop graduate nurse skills. He is aware that the situation raises concern in the clinical area and to ensure that all staff are equipped with the skills required to approach and manage these situations appropriately, your Nurse Unit Manager seeks a:

1. Critical evaluation of the ethical principles arising from this case that relates to the conduct of the Enrolled Nurse.
2. Evaluation of the key areas of professional judgement in personal and professional conflict resolution that the Registered Nurse utilises to make professional decisions.
3. Summary of the key ethical principles and professional decisions utilised by the Registered Nurse.

Case Study

The newspaper article and excerpt from the Tribunal report provides the scenario for the assignment.
The Australian Health Practitioner Regulation Authority (AHPRA) Tribunal Outcome in 2021 report Synopsis from the report On 17 July the nurse was at work and made comments to colleagues to the effect that she had helped the deceased to die, that she was proud of this, and that she believed in euthanasia, believed that it should be discussed, and more of it should occur. She referred to herself as the angel of death, and as Dr Kevorkian. When questioned about these statements by her employer, the respondent admitted that the morphine she had administered to the deceased was not a normal dose, because she was not going to let the deceased suffer, and said that she had acted in the best interests of the deceased. Following this, her employment was terminated on about 26 August 2014. Her registration as an enrolled nurse expired on 30 May 2015. At the hearing she said that she had not worked since, as a nurse or otherwise.
The complete Tribunal report is included in the ‘Assessment Tab, Assignment 1a’ on study desk.

Assessment Guidelines
Your assessment is required to be developed in the style of an essay for submission. A recording is provided in the Assessment tab that outlines each section of the assignment in detail.

The essay is to contain the following sections:
a. Introduction (100 words) –The introduction needs to provide the reader with an outline of the intended discussion based on the newspaper article, the AHPRA Tribunal outcomes and the ethical principles and areas of professional judgement arising.
b. Critical Evaluation (500 words) – This section is a critical evaluation of the ethical principles arising from the case study. It is not a discussion about euthanasia. The critical evaluation must relate to the conduct of the Enrolled Nurse and the discussion held with the Registered Nurse in the included newspaper article. The critical evaluation must be supported by peer reviewed journal articles and evaluate the ethical principles arising, the professional judgement needed in relation to conflict resolution and professional decision making.
c. Presentation of Key Findings (400 words) – A summary of the main points and key findings that specifically relate to the overarching professional responsibilities of the Registered Nurse. These professional responsibilities will include a summary of the ethical and professional judgement obligations of the Registered Nurse and how these were communicated with colleagues. A conclusive summary of the key points raised must be presented to conclude the assignment.

Answer

Introduction to nursing assignment:
The National Law has been guiding the National Board as well as the Australian Health Practitioner Regulation Agency regarding the process of referring registered health care professionals and nursing students to court which is called tribunal, in cases where professional is found to misconduct their role as a care provider. In cases of serious allegations of unprofessionalism and misconduct, the National Board has the right to cancel the registration as well as suspend the health care professional with consideration to the tribunal (APHRA Court and tribunal decisions, 2021). The assessment will thus focus on the case study of a nurse who refed herself as an angel of death and served a major part in the death of one of her patients on 26th august 2014.

Critical Evaluation:
Focusing on the case reported on the new paper regarding an enrolled nurse who represented herself as an angel of death. According to Standard 8 enrolled nurses are guided to provide nursing care to patients which are informed and supported by research evidence. It focuses on enhancing and promoting the process of seeking reference from the registered nurse sot maintain professional decision making. In the case study, the enrolled nurse was found to misconduct the standard 8 of Nursing and Midwifery Board Australia standard under APHRA as she did not refer to the registered nurse and took euthanasia as an option to assist a patient through his death. She was found to address the act as a way to ease the suffering of the patient by helping him through the process of death (NMBA EN, 2021). It is necessary for nursing professionals to focus on evidence-based nursing practise to provide care and treatment to the patient. In the case study, there was a breach identified in standard 8 of the NMBA which promoted an act of misconduct. It was necessary and mandatory for the enrolled nurse to seek guidance and collaboration with the registered nurse before taking any step in the care and treatment plan. Another breach was identified in standard 9 of the Nursing and Midwifery Board Australia of APHRA which focuses on guiding the enrolled nurses about practising nursing care under safety and the guidelines and standard for quality improvement (NMBA EN, 2021). The enrolled nurse was found to misconduct her role as a care provider and assisted a patient to his death mu providing his overdose of drugs which is counted to be a criminal offence and leads to suspension of registration.

One of the ethical principles that were rising from the case study was mandatory reporting by the registered nurse on witnessing the misconduct and crime committed by the enrolled nurse. Mandatory reporting of the Australian Health Practitioner Regulation Agency guides the nursing professional and health care practitioner about the process of reporting any crime, unethical practice and misconduct within a care setting (Bradfield et al., 2020). It is the role of the registered nurse to mandatory report the crime conducted by the enrolled nurse has been the one to whom the nurse confronted.

According to National Law and National Board, the enrolled nurse misconducted her role as a care provider and assessed in taking the life of a patient by providing overdoes of morphine in order to ease his suffering. It is counted as a crime as she took the life of a patient along with violation of other standards and principles of nursing standards for enrolled nurses. Thus, focusing on the misconduct and crime, she has been sent to tribulate under consideration of the National Board and Australian Health Practitioner Regulation Agency to take strict action against the unlawful act (Teoh et al., 2019).

Presentation of Key Findings:
After assessing the ethical issues and principles that were violated in the case study by the enrolled nurses, it has been found that there is a certain role of the registered nurses which has a significant role in managing such situations. According to standard 2 of the Nursing and Midwifery Board Australia standard for registered nurses, it is necessary for a registered nurse to engage in a therapeutic and interprofessional relationship with patients as well as other nursing professionals (NMBA RN, 2021). In the case of the enrolled nurse, the registered nurse explains the need of developing an interprofessional relationship with the enrolled nurse to understand her process of acre delivery and the mindset she possessed during her progression of care delivery. It was found that ethical and legal guidelines of the nursing and midwifery board were violated along with criminal offences which led to the development of the condition (NMBA RN, 2021). The act of misconduct by the enrolled nurse explains the need of referring to tribunal and penalty as her unethical beliefs and mindset lead her to take a patient’s life. the case study and the violation of the ethics explain and justify the need for suspension and expiry of her registration as an enrolled nurse, as she might again develop major risk for other patients.

Thus, in order to conclude, it can be stated that the assessment helped in understanding the role of the National Law and National Board in assisting health care professionals to the tribunal on the act of misconduct and violation of act (AHPRA, 2021). The assessment highlights the essential role of nursing standards and ethical principles in nursing professionals as it serves by guiding the nurses on their role as care providers. Nursing and Midwifery Board Australia standard and ethical principles help nurses to understand and conduct their role in the care process as well as carry out care and treatment according to the safety and wellness of the patient. It is necessary for the National Board to take strict actions against such incidents where nurses violate their role as a professional in order to enhance the safety of the patient and address the breach that occurs within the health care setting.

References:
AHPRA. (2021). [Ebook]. Retrieved from https://www.ahpra.gov.au/documents/default.aspx?record=WD20/30461&dbid=AP&chksum=0sNkdBzefE4jEabpVY862A%3d%3d
APHRA Court and tribunal decisions. (2021). Australian Health Practitioner Regulation Agency - Court and tribunal decisions. Retrieved 17 November 2021, from https://www.ahpra.gov.au/Publications/Tribunal-decisions.aspx Bradfield, O. M., Bismark, M. M., Studdert, D. M., & Spittal, M. J. (2020). Characteristics and predictors of regulatory immediate action imposed on registered health practitioners in Australia: a retrospective cohort study. Nursing assignment Australian Health Review, 44(5), 784-790. https://doi.org/10.1071/AH19293
NMBA EN. (2021). Nursing and Midwifery Board of Australia - Enrolled nurse standards for practice. Retrieved 17 November 2021, from https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/enrolled-nurse-standards-for-practice.aspx NMBA RN. (2021). Nursing and Midwifery Board of Australia - Registration Standards. Retrieved 17 November 2021, from https://www.nursingmidwiferyboard.gov.au/Registration-Standards.aspx
Teoh, L., Marino, R. J., Stewart, K., & McCullough, M. J. (2019). A survey of prescribing practices by general dentists in Australia. BMC Oral Health, 19(1), 1-8. https://doi.org/10.1186/s12903-019-0882-6