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- 1. ASSESSMENT 1: Peer Presentation PRESENTERS: GAGANDEEP KAUR XEREZ ACOSTA PRAMILA POUDEL DAMILOLA AWOMODU HSNS 207 Foundations of Nursing in the Australian Context
- 2. Introduction and Purpose of Code of Ethics The Nursing and Midwifery Board of Australia (NMBA), Australian College of Midwives (ACM), along with other national bodies, agreed to jointly adopt the International Council of Nurses Code of ethics for nurses (ICN Ethics) in March 2018 (Regulating Australia’s nurses and midwives, 2020). The code of Ethics set by NMBA and ICN is relevant to nurses at all levels and their areas of practice including research, clinical, management and education. Purpose •identify the fundamental ethical standards. •provide nurses with a reference point. •guide ethical decision-making and practice. •indicate to the community the human rights standards and ethical values it can expect nurses to uphold.
- 3. NMBA Code of Ethics for Nurses in Australia 1.Nurses Value Quality Nursing Care for all People 2.Nurses Value respect and kindness for self and others 3.Nurses Value Diversity of people 4.Nurses Value access to quality nursing and health care for all people 5.Nurses value informed decision making 6.Nurses value a culture of safety in Nursing and Healthcare 7.Nurses value ethical management of information 8.Nurses value a socially, economically and ecologically sustainable environment promoting health and wellbeing Code of Ethics for Nurses (2020). https://www.nursingmidwiferyboard.gov.au/news/2018-03-01-new-codes-of-ethics-in-effect.aspx
- 4. International Council of Nurses (ICN) Code of Ethics for Nurses ICN code of ethics for nurses was adopted by Australia in 2018. As per ICN, Code of Ethics for Nurses is based on four elements that outline the standards of ethical conduct (ICN, 2012). •Nurses and People •Nurses and Practice •Nurses and the Profession •Nurses and Co-workers International Council of Nurses (ICN). (2012). The ICN code of ethics for nurses. https://www.icn.ch/sites/default/files/inline-files/2012_ICN_Codeofethicsfornurses_%20eng.pdf
- 5. RN’s Ethical Practice while delivering care to Mr. Alvaro •Nurses value quality nursing care for all people •Nurses value access to quality nursing and health care for all people •Nurses value informed decision making •Nurses value ethical management of Information
- 6. Conclusion for Ethics Code of ethics in Nursing helps in resolving the ethical dilemma. Sometimes nurses can be pondered in question of wrong and right. Code of ethics is an essential tool to encounter ethical questions, problem solving, maintaining dignity, decision making and autonomy (Levett-Jones & Bourgeois, 2011).
- 7. ACCOUNTABILITY Nurses are accountable to three aspects Law Profession Ethical Principles
- 8. LEGAL ASPECTS To be well-informed about the relevant legislation and legal frameworks governing nursing practice (Heaton, 2018) To apply the legal aspects in their different areas of expertise (Heaton, 2018) To be aware of the potential liability if proven to practice below the standard of care and had caused harm intentionally or unintentionally (Heaton, 2018)
- 9. PROFESSIONAL ASPECTS Code of Conduct Registered Nurses Standards for Practice Guidelines e.g mandatory notification ETHICAL PRINCIPLES ICN Code of Ethics
- 10. Importance of the Law in Nursing Practice Provides legal framework for establishing actions (Heaton, 2018). It delineates nursing responsibilities and boundaries (Heaton, 2018). Assist in maintaining safe delivery of nursing care (Heaton, 2018).
- 11. Case scenario RN’s legal responsibilities in the care of Mr. Alvaro Scenario 1 : Collaboration between RN Gemma Grant, RN Rebecca Yanner and the GP in relation to arranging for Mr. Alvaro’s admission after his X-ray is reviewed by the GP Scenario 2 : Student nurse being asked by RN Yanner to explain the different x-ray services Scenario 3 : RN Grant undertaking general health history Scenario 4 : RN Grant asked the student nurse to take Mr. Alvaro’s vital signs, urinalysis, blood glucose level and weight.
- 12. Student Nurse Legal responsibilities • Provide past criminal history. • Ask for support and instructions. • Should follow policies of organization. • Always perform task under sufficient supervision • Maintain privacy of patient • Informed consent. • Documentation. (Stephens & Brighton, 2015) . Fig 1. Legal Responsibilities (2017). Retrieved from https://journals.rcni.com/nursing-standard/legal-responsibilities- ns.32.30.64.s37.
- 13. Student Nurse Ethical and Professional responsibilities • Accurate information. • Proper communication (Browne, 2018). • Justice and equality. • Respect dignity, culture, ethnicity, values and beliefs of people. • Appropriate environment. • Perform evidence-based practice. (Nursing and Midwifery Board of Australia) Fig 2. Ethical responsibilities of Nurses (2018). Retrieved from https://work.chron.com/ethical-responsibilities-nurses-10778.html
- 14. Student Nurse Accountabilities • Answerable • Behaviors • Protect patients by providing safety care • Job motivation and performance Fig 3. Stethoscope (2020). Retrieved from https://www.istockphoto.com/photo/stethoscope-on-white-background- gm870061320-145220255
- 15. Case Scenario • Inform any errors and consequences. For example: Case study of Mr. Mateo Alvaro. • Proper documentation. • Inform RN about verbal information. (He has lost 10kg in two weeks)
- 16. Conclusion Same code of ethics. Supervision of RN. Basic knowledge. Accountable.
- 18. COMMUNICATION SCENARIO A - Good morning Mr Alvero. I - My name is Damilola, I am a student nurse at the University of New England, I am working with Nurse Grant (RN), I will be taking your vital signs today. Is that ok by you Mr Alvero D - This examination will last about 30 minutes
- 19. COMMUNICATIO N SCENARIO Cont’d E - This assessment would help in to closely observe your overall condition. T - Thank you for letting me be part of your care
- 20. ISBAR for Mr Alvaro I - INTRODUCTION S - SITUATION B - BACKGROUND A - ASSESSMENT R - RECOMMENDATION
- 21. AIDET Patient Communication. Studergroup.com. (2020). https://www.studergroup.com/aidet Browne, C. (2018). Ethical responsibilities of Nurses. Chron. https://work.chron.com/ethical-responsibilities-nurses-10778.html Bellchambers, H. (2015). Vital Signs. In A. Berman, S. Snyder, T, Levett-Jones, T. Dwyer, M. Hales, N. Harvery, … D. Stanley (Eds.), Kozier and Erb's Fundamentals of Nursing (3rd Australian ed., Vol. 1, pp. 580-630). Pearson Australia Govind, N. & Pich, J.(2018); Chapter 30: Vital Signs. Kozier and Erb's Fundamentals of Nursing: Concepts, process and practice. 4th Australian Ed. Melbourne, Australia: Pearson Australia Heaton, L. (2018). Legal aspects of nursing. In A. Berman, S. Snyder, T. Levett-Jones, T. Dwyer, M. Hales, N. Harvey, ... D. Stanley (Eds.), Kozier and Erb's Fundamentals of Nursing (4th Australian ed., Vol. 1, pp. 56-87). Pearson Australia. Iacono, M. V. (2019). Nursing integrity: A moral imperative. Journal of PeriAnesthesia Nursing, 34(1), 220-222. https://doi-org/10.1016/j.jopan.2018.12.002 International Council of Nurses (ICN). (2012). The ICN code of ethics for nurses. https://www.icn.ch/sites/default/files/inline-files/2012_ICN_Codeofethicsfornurses_%20eng.pdf Levett-Jones, T. (2018). Communicating. In A. Berman, S. Snyder, T. Levett-Jones, T. Dwyer, M. Hales, N. Harvey, ... D. Stanley (Eds.), Kozier and Erb's Fundamentals of Nursing (4th Australian Ed. Vol.1, pp. 486-515). Pearson Australia. Levett-Jones, T., & Bourgeois, S. (2011). The clinical placement: An essential guide for nursing students (2nd ed.). Libby Houston. https://www- elsevier-elibrary-com.ezproxy.une.edu.au/pdfreader/clinical-placement-essential-guide-for-nursing-students Nursing and Midwifery Board of Australia. (2018). Code of conduct for nurses. https://www.nursingmidwiferyboard.gov.au/codes-guidelines- statements/professional-standards.aspx Nursing Midwifery Board Australia. (2018). Code of ethics for nurses. https://www.nursingmidwiferyboard.gov.au/news/2018-03-01-new-codes-of-ethics-in-effect.aspx Nursing and Midwifery Board of Australia. (2016). Registered nurse standards for practice. https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards.aspx Nursing Midwifery Board Australia. (2008). Regulating Australia’s nurses and midwives. https://www.nursingmidwiferyboard.gov.au REFERENCE LIST
- 22. Parsons, B. (2018). Legal responsibilities. Nursing Standard, 32(30), 1-2. https://doi.org/10.7748/ns.32.30.64.s37 Rubio-Navarro, A., Garcia-Capilla, D. J., Torralba-Madrid, M.J., & Rutty, J. (2019). Decision-making in an emergency department: A nursing accountability model. Nursing Ethics, 27(2), 567-586. https://doi.org/10.1177/0969733019851542 Stephens, M., & Brighton, R. (2015). Values, ethics and advocacy. In A. Berman, S. Snyder, T. Levett-Jones, T. Dwyer, M. Hales, N. Harvey, ... D. Stanley (Eds.), Kozier and Erb's Fundamentals of Nursing (3rd Australian ed., pp.143-157). Pearson Australia. https://www.ebookcentral-proquest-com Tollefson, J. & Hillman, E. (2019). Clinical psychomotor skills: Assessment tools for nurses (7th ed.). South Melbourne, Victoria Cengage Learning Australia
Editor's Notes
- Ethics refer to moral principles that guide behaviour and decision making (Stephens & Brighton, 2015). The Code of Ethics for Nurses in Australia has been developed for the nursing profession in Australia. The code of Ethics outlines the nursing profession’s commitment to respect, promote, protect and uphold the fundamental rights of people who are both providers and recipients of nursing and health care. Code of ethics help the nursing profession to provide quality care by committing to the set standards, guidelines and values to run the health care system smoothly and safely. Code of ethics provide the nurses a reference point from which they can reflect on the conduct of themselves and others. Code of ethics guide the nurses about making ethical decisions regarding patient care and how they can deliver ethical practice in society. Code of ethics provide the public an idea about what standards and ethical values they could expect a nurse to uphold.
- This Code is complementary to the International Council of Nurses (ICN) Code of Ethics for Nurses and is intended to be interpreted in conjunction with that code. There are eight code of ethics for Nurses in Australia set by NMBA and each code of ethics is as explained below (Nursing and Midwifery Board of Australia [NMBA], 2018) 1.Nurses Value Quality Nursing Care for all People – This code involves nurses to take the responsibility for their actions and upholding and raising the standards of their profession while providing care to the patient. It also includes questioning any kind of unethical behaviour that occurs in nurse’s surroundings. 2.Nurses Value respect and kindness for self and others – Kindness and respect for others and our own ethical values and dignity can enhance the trustworthiness and build a relationship between the nurses, patient and the co-workers. 3.Nurses Value Diversity of people – Nurses are required to value and appreciate each and every individual’s uniqueness about their culture, language and country and this helps to create a positive working environment as well as comfortable quality care for patients. 4.Nurses Value access to quality nursing and health care for all people – Nurses are required to ensure that they value the rights and needs of patient to all services on a non-discriminatory and non-harmful manner. They seek to eliminate the judgement based on the individual’s race, religion, gender, social status, age or health status while providing equal access to health services for all people . 5.Nurses value informed decision making – Nurses require to respect their own and everyone else’s free and informed decision making. Nurses must ensure that their decision making is based on appropriate knowledge, evidence and research. Nurses value the legal and moral rights of the patients to participate in sharing and making decisions about their care and treatment. 6.Nurses value a culture of safety in Nursing and Healthcare – Nurses value their own safety and the safety of their patients, co-workers and community. They ensure the safety of their surroundings by detecting and preventing the risks of incidence in health care practice. Nurses practice safe delivery of care to the patients with shared knowledge and collaboratively prevent the health risks by early identification and management of any harmful events for their patients. 7.Nurses value ethical management of information – Ethical management of information require the nurses to maintain the privacy and confidentiality of all health care records and other documentation related to patient care. Nurses must ensure the safe and authorised sharing of information regarding patient’s medical history and treatment. 8.Nurses value a socially, economically and ecologically sustainable environment promoting health and wellbeing – Nurses value a health promoting environment and share the responsibility of efficient use of energy, water, fuel and other resources. Nurses require to take measures where possible, to avoid harmful practices and ensure the safe reuse and recycle of materials within the workplace.
- The ICN first adopted an international code of ethics for nurses in 1953 and was reaffirmed recently in 2012. Nurses have to follow and oblige four fundamentals of responsibilities to promote health, to prevent illness, to restore health and to alleviate the suffering. On the basis of fundamentals, ICN developed the four principal elements that states the Standards of Ethical Conduct. 1.Nurses and People – The nurse’s main responsibility is towards people who needs the nursing care. While providing care to such people, Nurses have to be aware of the human rights, values, customs and spiritual beliefs of family, individual and community. Nurses must decide with whom they share the confidential information and must ensure the confidentiality and privacy of the information. 2. Nurses and practice – It is the responsibility of nurses to maintain the renewal of licensure to practice and maintain competency in their respective fields in which quality care is delivered. Nurses ensure to update their skills by learning the advancements in medical technologies time to time and enhance the professional delivery of patient care which can gain patient and public confidence. 3.Nurses and the profession – To maintain and implement research based professional knowledge and practice is also a part of nurse’s ethical practice. The professional care must be delivered in such a way that the safety and standards of clinical practice are not compromised for the patient as well as the staff and organisation. The nurses must be aware of and be able to question any kind of unethical behaviour and practice around their practice environment. 4.Nurses and co-workers – Nurse supports and maintains positive, cooperative environment by giving respect to the colleagues and other health professionals and help people working under the nurse’s supervision within an organisation. It is the major part of ethical practice in nursing to take an appropriate action when a patient’s, family’s or community’s health is endangered by a co-worker or any other person. Nurses must encourage and guide the practice of ethical decision making by working in groups with their co-workers.
- •Delivering quality nursing care for Mr. Alvaro is shown to be practised by RN Gemma, as she supervised the student nurse by making the Student nurse implement the professional knowledge and skills she has learnt, practical knowledge of using equipment under supervision of RN Gemma, to record accurate vital signs readings on the observation chart. Student nurse also adheres to this code by notifying RN Gemma about the assessment. RN Gemma showed delivery of quality care by taking the patient’s health history, using her clinical judgement and decision making to the assessment of Mr. Alvaro and informing an attending medical officer. •Registered Nurse Rebecca Yanner gave a call to RN Gemma Grant out of courtesy as the Dr asked to find out if there are any hospital beds available on the medical ward, as Mr. Alvaro may need hospital admission after the Dr reviews the x-ray for Mr. Alvaro. In this case, RN Yanner is ensuring Mr. Alvaro has access to quality nursing and health care, in case he needs a hospital bed. •Nurses value informed decision making and this ethical behaviour is shown by the student nurse when asked by RN Yanner to assist Mr. Alvaro and his wife about choosing the right Chest x-ray radiology and providing information about best place to get the medication. Student Nurse can use her best knowledge and should help in making the decision in regards to choosing the place which can be private or public radiology by explaining the costs, advantage and disadvantages of both the radiology to the patient and his wife and give them freedom to make a decision. In this scenario, student nurse is helping the Mr. Alvaro as an example of practising value for informed decision making. •The ethical management of information is maintained by RN Gemma and RN Yanner by keeping the documentation, records of observation charts and conversation about medical history of Mr. Alvaro in a safe, private and confidential manner. The RNs ensure they comply to this code by having an understanding of with whom they should share this information. The RN must also ensure all recordings are appropriately signed by her as well as the student nurse and are clear, accurate and easy to read by other staff involved in Mr. Alvaro’s care. This is how the ethical management of patient information is shown by the RNs in the case study.
- Ethical Dilemma – is defined as a problem where there is a choice to be made between options that seem equally unfavourable. Sometimes nurses can be pondered in question of wrong and right. Code of ethics is an essential tool to encounter ethical questions, problem solving, maintaining dignity, decision making and autonomy (Levett-Jones & Bourgeois, 2011).
- Registered nurses are legally and conscientiously bound to practise safely within the legal boundaries of the National Law in each state and territory and the NMBA set of standards, guidelines, and codes of conduct (Nursing and Midwifery Board Ahpra [NMBA], 2018). Accountability refers to “being answerable to oneself and our actions on others” (Rubio-Navarro et al., 2019). Registered nurses should be accountable in three aspects: (1) law which is based on the governing laws and legislations relevant to nursing practice; (2) profession which is based on the professional codes of conduct, standards and guidelines, and; (3) ethical principles which is based on the moral principles and values upholding the nursing profession (Rubio-Navarro et al., 2019).
- Legal frameworks are the relevant legislations of the federal, state and territory that we are required to adhere to and follow as a guiding principle to be able to deliver safe quality nursing care (Heaton, 2018). Some example of which, but not limited to, are the following: Poisons and Therapeutic Good Act 1966 Privacy of health records and information Mental Health Act 2007 Guardianship Act 1987 Nurses should be aware and accountable of the legal implications in nursing practice in every decision and action (Heaton, 2018). The legal aspects governing nursing practice include informed consent, documentation, drugs and controlled substances, sexuall harrasment and workplace bullying and death and related issues (Heaton, 2018) Nurses are can be liable to crimes under the tort law, which is defined as civil wrong committed against a person or a property and is usually litigated in court by civil actions (Heaton, 2018). Intentional tort include: Assault - an attempt or threat to touch another person unjustifiably Battery - is the wilful touching of a person that may or may not cause harm False imprisonment - unlawful use of restraints Defamation - false accusation without any truthful basis. It can be through spoken words (slander) or any form of writing and image (libel). And if proven that there is a breach of confidentiality. Unintentional tort Negligence Malpractice Heaton, L. (2018). Legal aspects of nursing. In A. Berman, S. Snyder, T. Levett-Jones, T. Dwyer, M. Hales, N. Harvey, ... D. Stanley (Eds.), Kozier and Erb's Fundamentals of Nursing (4th Australian ed., Vol. 1, pp. 56-87). Pearson Australia.
- The NMBA developed the Code of conduct for nurses, Standard for practice and guidelines which regulates the practice of nursing and midwifery in Australia in accordance to the National Law (NMBA, 2018). The Code of conduct for nurses is composed of four domains and each domain has its own principles and values that clearly outlines the legal requirements to become registered nurse in Australia as well as the legislations relevant to nursing practice. Moreover, the code also stipulates the expected behaviour and conduct as a professional nurse (NMBA, 2018). The Code of conduct applies to setting where nursing skill and knowledge are used in a clinical or non-clinical context, may it be paid or unpaid services (NMBA, 2018). The Standards for practice consist of seven standards and their main purpose is to direct and maintain safe and clinically competent nursing practice (NMBA, 2018). Guidelines provide understanding about the expectation and requirements set by the NMBA (NMBA, 2020). Under the National Law, all registered health practitioners have a professional obligation to protect the welfare of the public which include notifiable conduct, abuse, neglect, and outbreaks of infectious diseases (Heaton, 2018). Additionally, registered nurses are also accountable to the ethical principles providing holistic care always taking into consideration the different human rights, such as “cultural rights, the right to life and choice, to dignity and to be treated with respect” (International Council of Nurses [ICN], 2012).
- Relating to the care of Mr. Alvaro the RN’s legal responsibilities are showcased in the following scenario: Scenario 1 showcases the adherence to the Code of Conduct for nurses related to practising safely, effectively and collaboratively through the collaboration between the two nurses when RN Yanner contacted RN Grant to inquire of bed availability for a possible admission of a patient in need of an X-ray review. This provides RN Grant the opportunity to ask for a brief description of Mr. Alvaro’s presenting problems in order to make arrangement in bed allocation and promote shared decision-making, if needed, although this has not been clearly stated in the case study. Moreover, this scenario highlights the need for nurses to engage in therapeutic and professional relationships as per the Registered Nurse Standards for Practice. Scenario 2 displays how RN Yanner has breached adhering to the Code of Conduct related to teaching and supervising, as well as the standards for practice related to therapeutic and professional relationships, when she delegated to the student nurse the responsibility of explaining to Mr. Alvaro and his wife Lucinda the different X-ray services while she was busy. This scenario depicts how RN Yanner have not properly supervised the student nurse in her learning needs by delegating such important task to the student nurse. Scenario 3 presents RN Grant’s commitment to her nursing practice standard related to completing comprehensive assessment when she undertook a general health history of Mr. Alvaro. Lastly, Scenario 4 portrays how RN Grant has provided the student nurse an opportunity to supervised learning when she asked her to attend to some nursing skills like vital signs taking, blood glucose and weight checking, and attending urinalysis in accordance to the fifth principle in the Code of Conduct for nurses.
- Student nurses must perform every task within their scope of practice as they are legally bounded on same standard of skills as a Registered Nurse. 1. Provide past criminal history: Nursing students should inform Nursing and Midwifery Board of Australia (NMBA) about their past criminal history and must provide evidence of police check before commencing course, clinical placement and when they apply for RN. 2. Ask for support and instructions from RN: If student nurses are not confident in any specific task during practice, they need to ask for any help and assistance from RN. For example, if they are performing any task for which they are not qualified either by education or experience then, they have to wait for supervision from RN. 3. Should follow policies of organization: Student nurses need to go placement in different hospitals, aged cares, nursing homes, etc. Every organization have rules and policies so, they must follow those policies from where they get their clinical experiences. 4. Perform task under sufficient supervision: Tasks such as medication and injection must be performed under the supervision of RN. They must remember that they cannot perform any medication task legally. Before administering any medication, student nurse should ensure that it must be checked by two RNs. 5. Maintain privacy of patients: It is the responsibilities of nursing student and nurses to maintain the privacy of patient. They are not allowed to reveal any confidential information with other. For example, posting any unauthorized photographs and videos in social media. 6. Informed consent: Informed consent is a person’s agreement to healthcare which include knowledge of potential benefits and risks. It must be based on autonomy as every patient have right to make their own decision. Nurses should understand whether their client have legal capacity to sign the agreement for treatment or not. 7. Documentation: Documentation is a legal responsibility of nursing students which must be perform accurately and clearly. The main purpose of documentation is to obtain all the important information such as the condition, output, input, medication schedule as well as all the history of the patient (Stephens & Brighton 2015). It is a source of communication between health care staffs.
- Like Registered nurses, student nurses also have ethical and professional responsibilities. According to Nursing and Midwifery Board of Australia (NMBA), their responsibilities are: 1. Accurate information: Information that are provided by nursing student to their health co-worker and RN about the condition of patient must be accurate, timely and sufficient information for the provision of safe and competent nursing care. 2. Proper communication: Student nurse should monitor the impact of nursing care and maintains ongoing communication with the registered nurse regarding the health and functional status of the client. So that, they are able to provide support and comfort, assist with activities of daily living to achieve an optimal level of independence, and providing for emotional needs of the clients. 3. Justice and equality: They should make attitude for social justice and equality and treat all the people equally. 4. Respect dignity, culture, ethnicity, values and beliefs of people: Nursing student must have high level of respect on dignity, culture, ethnicity, values and beliefs of people. They must treat the client with respect as different people have their own opinion and beliefs regarding treatment. 5. Appropriate environment: An environment that is safe and comfortable for the client should be provided and standard precautions are used to insure professional hygienic practices. 6. Perform evidence-based practice: As student nurses, they should maintain the standard of practice and while performing any task during practice, they should reflect the evidence- based skill and knowledge.
- 1. Answerable: Student nurses must be answerable to any task and their own action or decision. They cannot neglect the legal standard of nursing care and should be able to give reasonable answer for any decision. 2. Behaviour: Nurses should have good behaviour and be honest with patients and other health co-workers. Any dishonesty like laziness and disrespectfulness is not acceptable. 3. Protect patient by providing safety care: One of the primary responsibilities of nurse is protecting patient. Therefore, nursing student must know that they should protect their patient from any harm. They should provide safe nursing practice related to the standard of quality and safety in patient care. If anything happens unfortunately, they should be accountable for that action. 4. Job motivation and performance: Accountability consist of nurse’s own care values, education and experiences which increases job motivation and also improves their performance.
- Student nurse should inform if they did any errors while performing their tasks. If they are failure to inform those errors then, consequences may result as a risk for patient’s health. For example, case study of Mr. Mateo Alvaro. In that case study, one of the student nurses is being asked to monitor vital signs and examine some laboratory tests like urinalysis, blood glucose level under supervision of RN, G Grant. Now, it is responsibility of that student nurse to document all the findings properly and clearly and if she did some errors in documentation, she is the one who will be accountable for her action. At the same time, Mr. Alvaro have told that he has lost 10 kg weight in two weeks since feeling unwell. This is also the responsibility of student nurse to inform all the verbal information given by the patient to her RN. If not, she will be accountable for her error.
- AIDET communication framework is increasingly being used by healthcare organizations to help staff communicate important information to patients in a logical sequence (AIDET Patient Communication, 2020). AIDET is used to improve patients care experience and satisfaction by decreasing the anxiety of patients and their families. A -Greet the patient by name and make eye contact. I - Introduce yourself with your name, skillset, professional certification, and experience. D - Give an accurate time expectation for tests, physician arrival, and identify next steps. E - Explain step by step what to expect next, answer questions, and let the patient know how to contact you. T - Thank the patient and/or family. Thank family members for being there to support the patient. REFERENCE: AIDET Patient Communication. Studergroup.com. (2020). Retrieved from https://www.studergroup.com/aidet.
- This is an example of how to frame communication using this powerful tool in Mr Alvaro instances, when the student nurse is taking his vital signs. A- Good morning Mr Alvaro. I- My name is dami, I am a student nurse at the University of New England, am working with Nurse Grant(RN), i will be taking your vital signs, some laboratory test (urinalysis and blood glucose test ) and checking your weight. Is that ok Mr Alvero? D- This examination will last about 30 minutes E- The apparatus i will be using in checking your vital signs are Sphygmomanometer(bp), thermometer, glucometer and urinalysis stripe, to check blood pressure, temperature, respiratory rate, heart rate, blood glucose level,and urinalysis. This assessment would help in to closely observe your overall condition. T- Thank you for letting me be part of your care REFERENCE Govind, N. & Pich, J. (2018). Vital Signs. In A. Berman, S. Snyder, T. Levett-Jones, T. Dwyer, M. Hales, N. Harvey, ... D. Stanley (Eds.), Kozier and Erb's Fundamentals of Nursing (4th Australian ed., Vol. 1, pp. 556-585). Pearson Australia. Tollefson, J. & Hillman, E. (2019). Clinical psychomotor skills: Assessment tools for nurses (7th ed.). South Melbourne, Victoria Cengage Learning Australia.
- Safe healthcare delivery depends on effective communication between healthcare workers, so therefore, it is of great importance that student nurses need to be confident and skilled in communicating with members of the healthcare teams so they can be able to signal for help when required. In regards to this, the ISBAR acronym have been in used to effectively streamline the way nurses communicate with doctors and colleagues during patient handover. This process has shown to increase patient safety. INTRODUCTION : Mr. Mateo Alvaro, 48 years old gentleman, married to Lucinda. An immigrant with Hispanic background. SITUATION : Admitted due to worsening condition. He presented with increasing breathlessness, fever and productive cough. BACKGROUND HISTORY : There is history of visiting the GP 3 days ago, with complains of bad colds, feeling feverish and productive cough for a period of 2 weeks CXR was ordered by the Doctor. Provisional diagnosis of Bacterial Pneumonia Presentation to Emergency Department : Accompanied by wife at 3AM with complains of increasing breathlessness, productive cough (green-colored sputum), fever, inability to manage his personal care and has not been to work for a week. Clinical assessment by the ED doctor : Mr Alvero is lethargic but oriented On chest examination: The Dr notes coarse crackles in RLL of the lungs on Auscultation Social history; he lives with his wife, no children. Volunteers in a catholic church with his wife. Family history : Father died of Mesothelioma after working as a builder in an Asbestos company. Mother is a known hypertensive with Reflux esophagitis and Rheumatoid Arthritis (Alive). Allergies: Nil allergies. ASSESSMENT : ED doctor decided to admit to the medical wards Vital signs ; BP, HR, TEMP, RR, SpO2, Urinalysis, blood glucose level, and BMI. RECOMMENDATION : Communicate findings with the Registered Nurse in charge. For review by the RN and Doctor in charge. REFERENCE: Levett-Jones, T., & Bourgeois, S. (2011). The clinical placement: An essential guide for nursing students (2nd ed.). Libby Houston. https://www-elsevier-elibrary-com.ezproxy.une.edu.au/pdfreader/clinical-placement-essential-guide-for-nursing-students