Reference no: EM133250929

Paul Tan, a student nurse doing a clinical rotation in an emergency room, hears a scream from behind the curtains in a patient bay. Pulling back the curtain he sees a female Registered Nurse (RN) and a male Resident Medical Officer (RMO) examining a wound in a patient's heel. The patient is an 89-year-old contracted nursing home resident with advanced dementia who arrived in the ED an hour earlier without a family member or advocate. The patient presented with a fever; 38.8 degrees Celsius. The patient's gown is awry, the RN is holding the patient's leg straight up in the air with her perineal area clearly exposed, and the RMO has his gloved finger probing the wound. The RMO and RN are clearly focused on the wound and not the patient-in fact they seem oblivious to her screams. Paul wants to "rescue" the patient but hesitates, being unsure of his position and not wanting to be laughed at by his colleagues for being tender-hearted. Paul goes to the Nurses' Station to find someone to discuss this with. At the Nurses' Station he describes the situation to three RNs at the desk.

Amy is Paul's preceptor for the shift, she is an experienced RN who has worked in the ED for 10 years. She tells Paul not to let it bother him, that many nursing home residents are "screamers" and that the RN must follow the doctor's orders.

Gurvir, a recent graduate, voices his opinion that the patient should at least have some pain relief provided and surely had the right to be made comfortable before the procedure.

Eric, shakes his head, saying that the RN should have waited for the patient's enduring guardian before commencing the procedure.

Gretel, the co-ordinator, insists that it is important that the procedure is completed in a timely manner, as this would be minimal nursing care for a patient admitted to Emergency.

Questions

PROFESSIONAL PRACTICE

1. Define professional practice in nursing, including specific elements from the legislation and apply it to this case.

2. Identify, describe and apply 2 different elements from the professional practice framework that may contribute to a claim of professional misconduct in this case - Professional practice framework includes the Code of Conduct for Nurses, ICN Code of Ethics, RN Standards for Practice, NSQHS Standards