Code of Conduct for Nurses: Consent, Safety, and Drug Influence

Introduction

The legal requirements and professional behaviours are set by the code of conduct for the nurses. The code of conduct for the nurses further describe the principles that are to be maintained in professional practice in order to maintain effective professional practice. This code is abided by the National law made for the nurses in Australia. The code principles apply in all situations to all kinds of nursing practice. This involves any job that a nurse utilizes, whether paid or unpaid, clinical or non-clinical, nursing skills and expertise. This involves clinical care work, clinical leadership, responsibility for clinical governance, education, research, administration, management, consultative roles, regulatory or policy development. The code also applies to all settings where a nurse may participate in these activities, including face-to-face activities, publications, or online or electronically. The nurses should be aware of the obligations which are included under the National law in order to meet the legal requirements in their practice. Reflection is a very important process in nursing practice (Wain. 2017). Using reflection, the nurses make use of their experiences in their future implications in order to give culturally safe, ethical and legal care to the patients. Gibbs reflection cycle is used for the purpose of reflection. It involves six steps namely description, feelings, evaluation, analysis, conclusion and action plan. This assessment deals with the application of legal requirements and ethical standards the nurses should follow to the case studies provided. It further includes the reflection and learnings from the case studies using the Gibbs reflection cycle.

Case study 1:

According to the policies of medical treatment act, the nurses should take consent of the patients prior to the treatment and medical procedures (Dimovska et al. 2016). It is clearly mentioned in the policies that for the beginning of the treatment of the patient the consent of the patient is necessary. It is the right of the patients to provide consent for their treatment as mentioned in the National law. If the nurses conduct the treatment without the consent of the patient, there may be many legal consequences. In the following case study, it was necessary for a student nurse to have the consent of the patient to allow her into the operation theatre to provide treatment. According to the standards for the registered nurses, the student nurses should not be allowed in the operation theatre when the patient is not giving approval. Further for the ethical and legal practice in nursing profession the consent of the patient is very important (Dimovska et al. 2016). It is necessary for the nurses to maintain the ethical and legal standards. For the student nurses it is also important to have consent of the patient and the seniors in order to have access to the operation theatre.

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Reflection

During my placement in the operation theatre of the Sunshine Coast University Hospital (SCUH) I was buddied with a RN. I was provided with a list of gynaecology procedures. My first patient consented with another RN. The patient did not give consent to any student nurse to observe his situation or to help in his treatment. The RN was asking me to enter the operation theatre with her in order to assist her in the patient’s treatment. I told her that I was not allowed in the operation theatre because the patient did not give me consent to treat him even when he was given anaesthesia. I was feeling stressed in this situation because the RN was asking me to enter the operation ward, but the patient did not give me any consent to enter the operation theatre.

By the evaluation of the situation I gained knowledge how to take consent from the patient who is admitted in the operation ward profession (Lachman et al. 2015). The RN asked me to enter the operation theatre without the consent of the patient as he was under the effect of anaesthesia. According to the legal standards of nursing this was not ethical. The consent of the patient should be given for the treatment. I decided not to enter the operation theatre in order to follow the legal standards of the nursing profession (Mills. 2018).

From this case study, I analysed that for the practice in nursing as a student nurse the consent of the patient is most important for his treatment (Ausmed. 2017). The standards of registered nurses gave me a clear knowledge that it is necessary for the student nurses to follow the legal and ethical requirements. From the legal standards of nursing I have gained knowledge that it was not ethical to enter the operation theatre without the consent of the patient.

In my future implication before entering the operation theatre I should take care that the patient has provided the consent for my entry in the operation theatre (Ausmed. 2017). I will also try to make the RN aware about the complications according to the code of conduct and the national laws that the consent of the patients is important for the treatment of the patient. According to the medical treatment act, it is necessary for the nurses to follow the legal requirements of the nursing profession.

The action plan that I would plan in such cases would be to take consent form the patient for further treatment. I would try to convince the patient and be very calm so that the patient would allow me to enter the operation theatre in order to assist the RN in the process of treatment.

I would conclude from the above case study that the National law of Australia states that consent of the patient is important for the nurses for practice profession (Lachman et al. 2015). According to the medical treatment act the nurses should treat the patient only after the patient provides consent for the treatment.

Case study 2:

According to the Work Health and Safety Act 2011 (Ausmed. 2017), 'protecting employees and patients from harm to their hygiene, security, and healthcare.' This involves patient safety procedures for nurses and other health practitioners and implies that efficient hand washing is an important and legally needed practice at the healthcare setup. Around 1 in every 10 individual that are admitted to a healthcare provision creates an infection, which can dramatically affect their mortality and morbidity rates and increase hospital expenses. It justifies prevention of cross contamination using multi-step process involving presence of organisms on hands, transfer of microorganisms from health, survival of organisms on hands due to lack of hygiene, direct contacts with the patients leading to transmission (Ausmed. 2017).

Reflection

Being a registered nurse, I was assigned for the responsibility of administering medicines and assessing the vitals of all the patients in an emergency healthcare ward. I was working in collaboration with 3 other nurses for different patients as per the allocations by senior RN’s. I analyzed that the fellow nurses did not washed their hands while shifting from one patient to another. According to the policies set by WHO, a healthcare professional must wash their hand before and after touching a patient, before and after aseptic processes and after exposure to the patient's body fluids such as blood, puke, and saliva. I was alarmed at their actions as their negligence could have led to serious cross contamination infections to the patients. According to standard 6 of the registered nurse standards for practice NMBA (2016), the registered nurse's practices consistently according to the policies, guidelines, norms, laws and legislation. The nurses were not following the hand hygiene policy of the hospital that may have created serious issues in terms of their career and patient’s health and wellbeing. It has been reported that hand hygiene policies of a hospital govern the safety, and wellbeing of the patients in terms of hospital acquired infections, or nosocomial infections. I took them aside and told them the importance of following hand hygiene. I told them that every patient has different resistance toward the infections, and every patient encounters different type of infectious agents due to improper hygiene, contamination, and subsequent exposure to pathogens.

According to Dzahar (2017), feces contains 1013bacteria’s per gram, and 100-10000 microorganisms resides per cm2on the surface of skin. Improper hygiene can lead to contamination that can invite various diseases to deteriorate health of the already sick patients. The nurses took my suggestions and advices in a positive way as I told them that patients at the hospital reported higher incidences of urinary tract infection, which may have been a cause of improper hand hygiene maintenance by the nurses. I explained them the steps of washing hands while assessing the patients. According to the (Thomas. 2015), proper hand hygiene requires rolling the sleeves of shirt while washing and cleaning the palms, thumbs, fingers followed by proper drying and rinsing using a clean and uncontaminated towel. The incident taught me the importance of maintaining hand hygiene while delivering quality care to the patients in order to reduce the incidences of urinary tract infections in the hospital. The human acquired infections are monitored and regulated by the center for disease control and prevention because these infections are not present in the patient at the time of administration but are developed during treatment in the hospital (Regunath & Monergo. 2018).

According to standard 3 of registered nurse standards for practice NMBA (2017), a registered nurse should engage in safe nursing procedures to ensure better health outcomes. Improper hand hygiene tends to develop into diseases and bacterial infections such as MRSA, which can lead to death or sepsis. It can also lead to severe conditions such as HIV, viral hepatitis, and bacterial sepsis that can be detrimental to the health and wellbeing of the patients. All the health problems that results from failure to follow hand hygiene are very critical and deteriorating. A registered nurse should always follow secure and responsible processes to deliver effective results that meet people's needs. According to standard 6 of the registered nurse standards for practice NMBA (2017), secure nursing practices of obtaining results that respond nursing requirements of patients should be followed. Hand hygiene is essential because it protects patients and employees from infection. During or after assessing or medicating a patient, hands should be washed because infection may result in patients being readmitted to the hospital that increasing their hospital bill and health problems (Ragunath & Monegro. 2018).In future I would always follow hand hygiene and teach the importance of hand hygiene to all my patients and colleagues.

Case study 3:

The NAADAC and NCC standards states that in nursing practice consumption of drugs is illegal. It has made certain legal and ethical code of conducts for the nurses (Mills. 2018). These standards states that if the nurses or the student nurses' practice under the influence of drugs then it is not legal and ethical. The standards of NAADAC ensures that they enable and recognize the legislations for the professional practice of nursing. They ensure that the student nurses follow the legal requirements in their practice which are stated by the National laws of Australia. According to the standard of the nursing profession it is necessary to provide quality care to the patients. It has been revealed in previous studies that under the influence of drugs the quality and safe practice of nursing is not maintained, the previous studies states that the nurses can make professional errors if they do practice under the influence of drugs (NMBA. 2019). In the given case study, it was observed that the student nurse was under drug influence and came to work. It is illegal for the student nurse and against ethical practice. The legal requirements of National law were violated in this case.

Reflection

During my placement as a facilitator in the hospital I came across an incident. In that incident I noticed that one of my students came to work but he was exhibiting a strange behaviour. His behaviour was departed from his normal behaviour. He was not able to concentrate on his work and was fidgeting constantly. The student was also not able to concentrate and follow my instructions. I decided to take the student side and ask him about the problem. I investigated him about the reason behind strange behaviour. I further asked him whether he was under the influence of any drug or he had consumed alcohol. The student provided with the information that he had consumed drugs on the night before and the behaviour was the result of the same. He further informed me that he consumed the drug because of the recent death of a family member.

I felt disturbed by seeing the situation of the student. I was angry as well because he was under the influence of drugs and he came to work. After seeing his strange behaviour, I was astonished because he was a brilliant student and was always active in his work. I analysed from the situation of the student that due to the consumption of drugs he was showing a strange behaviour. I also analysed that nursing practice under the influence of drugs is not safe. This is due to the reason the under the influence of drugs then concentration power of the nurses is affected, and they can make errors in their profession (Gu et al. 2015). I also analysed that the nurses cannot work efficiently if they consume drugs a night before.

According to standard 3 of registered nurse practice standards, the nurses should provide quality and safe care to the patients (NMBA. 2017). According to the legal standards mentioned in National law of Australia, the student nurses or practitioner nurses should not treat a patient or come to work under the influence of drugs. In this situation the student came to practice under the influence of drug which was not legal and ethical in nursing practice according to the legal requirements. In my future practice I would ensure that no such students come to work under the drug influence in order to follow the law and ethics of the nursing profession (Lachman et al. 2015). According to the National law for nurses the practice under drug consumption is illegal and should not be practiced.

In this case I make the student aware of the consequences that would have taken place if he would continue the practice under the influence of drugs (Byard & Payne-James. 2015). I also made him aware of the legal complications that he had obligated and why following of the rules was necessary for the student and practitioner nurses. I concluded him the above case that according to the legal requirements of the National law the practice of student under the influence of drugs was illegal and unethical (Byard & Payne-James. 2015). I would try that in my future practice I would not allow such students to enter the classroom or the hospital premises. This would enable me to ensure that the student follows the legal and ethical professional standards.

References

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